These diseases have multiple causes, cause multiple health problems and are often treated with a “mélange” of medicines and behavioral prescriptions, according to briefing moderator Virginia Cain, Ph.D., acting director of NIH’s Office of Behavior and Social Sciences Research.
“ The diseases we are facing today are not ones that can be easily fixed by a shot or surgery,” she said.

Although numerous studies suggest patients can play a major role in managing their chronic diseases, they aren’t getting much help, said Jacqueline Dunbar-Jacob, Ph.D., R.N., of the University of Pittsburgh School of Nursing. She noted that most patients have “one hour of contact with the health care system per year,” which is not enough to build partnerships with physicians or even understand a complicated pill-taking regime.

Non-medical factors like education, income and community environments have significant effects on how patients manage or fail to manage their diseases, the briefing speakers agreed. For instance, education can affect how well diabetic and HIV patients stick to their prescribed therapies, said Dana Goldman, Ph.D., of RAND. James Hill, Ph.D., of the University of Colorado Health Sciences Center presented data suggesting that changes in neighborhood layout and other environmental fixes may help people keep the pounds off and slow obesity rates.

The briefing was sponsored by the Coalition for the Advancement of Health Through Behavioral and Social Sciences Research.