CHANGING PATTERNS OF DISEASE
During the past 50 years, the health problems of the American people have changed significantly. Many infectious diseases have been controlled or eradicated; others, such as tuberculosis, ac-quired immunodeficiency syndrome (AIDS), and sexually trans-mitted diseases, are on the rise. An increasing number of infectious agents are becoming resistant to antibiotic therapy as a result of widespread inappropriate use of antibiotics. Therefore, condi-tions that were once easily treated have become complex and more life-threatening than ever before.
The chronicity of illnesses and disability is increasing because of the lengthening life span of Americans and the expansion of successful treatment options for conditions such as cancer, human immunodeficiency virus (HIV) infection, and spina bifida; many people with these conditions live decades longer than in earlier years. Chronically ill people are the largest group of health care consumers in the United States (Davis & Magilvy, 2000). Because the majority of health problems seen today are chronic in nature, many people are learning to protect and maximize their health within the constraints of chronic illness and disability.
As chronic conditions increase, health care broadens from a focus on cure and eradication of disease to include the prevention or rapid treatment of exacerbations of chronic conditions. Nurs-ing, which has always encouraged patients to take control of their conditions, plays a prominent role in the current focus on man-agement of chronic illness and disability.