Combattre les maladies chroniques

MONTRÉAL – Beaucoup de personnes craignent terriblement de subir un accident vasculaire cérébral aux effets débilitants ou une crise cardiaque fatale. Quelques-uns réagissent néanmoins aussi émotionnellement devant les risques de maladies chroniques, un terme que l’on définit vaguement et dont la signification va un peu dans tous les sens, mais qui est quand même très utile pour structurer les services de soins de santé. Or les maladies chroniques sont devenues un grand problème qui nécessite une réplique collective.

Historiquement, les maladies chroniques désignaient des pathologies de longue durée. Or, la médecine se structurant de plus en plus autour de ces maladies bien définies, le terme a fini par désigner un ensemble indéfini de pathologies qui englobe les maladies cardiovasculaires, le cancer et les différents types de diabète, mais qui exclut les maladies infectieuses, comme la tuberculose et le paludisme ou les maladies mentales.

Au XIXe siècle, les maladies chroniques étaient considérées comme problématiques en partie parce que les malades accaparaient les rares lits des hôpitaux qui concentraient leurs efforts sur les traitements de maladies graves, mais guérissables. Mais les maladies chroniques sont vite devenues un problème de santé publique beaucoup plus répandu à mesure que semblaient s’accroître les décès causés par le cancer, les maladies cardiovasculaires et les diabètes. En fait, l’augmentation initiale du nombre de décès signalés en raison de ces maladies est probablement le résultat de meilleures méthodes d’identification et de diagnostic. Remplir un certificat de décès n’est pas une science exacte et les médecins ont tendance à porter leur attention surtout sur les causes qu’ils connaissent.

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