Table of Contents

International Handbook on Ageing and Public Policy

International Handbook on Ageing and Public Policy

Handbooks of Research on Public Policy series

Sarah Harper, Kate Hamblin, Jaco Hoffman, Kenneth Howse and George Leeson

The International Handbook on Ageing and Public Policy explores the challenges arising from the ageing of populations across the globe for government, policy makers, the private sector and civil society. It examines various national state approaches to welfare provisions for older people, and highlights alternatives based around the voluntary and third-party sector, families and private initiatives. The Handbook is highly relevant for academics interested in this critical issue, and offers important messages for policy makers and practitioners.

Chapter 15: Developing appropriate and effective care for people with chronic disease

Bert Vrijhoef and Arianne Elissen

Subjects: economics and finance, health policy and economics, politics and public policy, public policy, social policy and sociology, ageing, comparative social policy, economics of social policy, health policy and economics


Chronic diseases are disorders of long duration and generally slow progression (Council of the European Union, 2010). Most notably, they include four major non-communicable diseases listed by the World Health Organization: cardiovascular diseases, cancer, chronic respiratory diseases and diabetes mellitus (WHO, 2008). In 2006, 20 to 40 per cent of persons in the age category of 15 years and older residing in the EU reported having one or more long-term illness (TNS Opinion & Social, 2007). In the USA, estimates are that one out of every two adults suffers from chronic disease (Wu and Green, 2000). Also, in developing countries, death and disability from chronic diseases now exceeds that from communicable diseases due to the rising average age and changing epidemiologic profile of the population (Nugent, 2008). Chronic disease have a common set of clinical risk factors – hypercholesterolemia, hypertension and obesity – and their associated behavioural risk factors – tobacco, physical inactivity and unhealthy diets (Stuckler, 2008). In coming years, there will be a growing number of persons with multiple health problems, a phenomenon most common among the elderly (Nolte et al., 2008). Chronic conditions cause great disability during life: diabetes mellitus, for instance, is a leading cause of blindness, end-stage renal failure, non-traumatic limb amputations and cardiovascular morbidity (Dagogo-Jack, 2002).

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