Building healthier communities begins with addressing the issues that most affect quality of life. Through research, outreach, education, and community partnerships, the Center for Health & Social Issues focuses on six critical areas of prevention: obesity, cardiovascular disease, diabetes, mental health, cancer, and healthcare access.
Obesity
Obesity is a chronic, complex disease characterized by excessive body fat that can negatively affect health. It develops through a combination of factors, including genetics, eating patterns, physical activity, access to healthy foods, socioeconomic conditions, medications, and the environments in which people live and work. Because these factors can vary from person to person, obesity is not simply the result of individual diet or exercise choices.
Obesity can increase the risk of several serious health conditions, including heart disease, stroke, type 2 diabetes, high blood pressure, osteoarthritis, and certain cancers. It can also affect quality of life and contribute to stigma and discrimination.
Global Impact
Obesity is a growing global public health concern. In 2022, 2.5 billion adults aged 18 years and older were overweight, including 890 million adults living with obesity. Overall, 43% of adults worldwide were overweight and 16% were living with obesity. In addition, more than 390 million children and adolescents aged 5-19 were overweight in 2022, including approximately 160 million living with obesity. Worldwide, adult obesity has more than doubled since 1990, while obesity among adolescents has increased fourfold.
For adults, overweight is generally defined as a body mass index (BMI) of 25 or higher, while obesity is defined as a BMI of 30 or higher. BMI is a screening measure based on a person's weight and height and does not directly measure body fat. For children and adolescents, BMI is interpreted differently and must be considered in relation to age and sex.
Prevention and Management
Healthy eating, regular physical activity, adequate sleep, and other healthy behaviors can help reduce the risk of obesity and support overall health. For people living with obesity, treatment may include nutrition and physical activity support, behavioral interventions, prescription medications, and, when appropriate, weight-management procedures or surgery. Effective management is often individualized and may involve ongoing support from healthcare professionals.
Because obesity is influenced by factors beyond individual choices, communities can also play an important role in prevention. Improving access to nutritious foods, safe places for physical activity, healthcare services, and supportive environments can help make healthy choices more accessible and sustainable.
If you are concerned about your weight or your risk for weight-related health conditions, talk with a healthcare professional about an approach that is appropriate for you.
Cardiovascular diseases (CVDs) are a group of disorders that affect the heart and blood vessels. While often referred to as “heart disease,” cardiovascular disease includes a much broader range of conditions, including coronary heart disease, cerebrovascular disease (stroke), peripheral arterial disease, rheumatic heart disease, congenital heart disease, and other conditions affecting the heart and circulatory system.
Some cardiovascular diseases develop gradually and may not cause noticeable symptoms until a serious event occurs. When symptoms are present, they can vary depending on the condition. Common warning signs may include chest pain or discomfort, shortness of breath, unusual fatigue, dizziness, palpitations, or swelling. Heart attacks and strokes can occur suddenly and require immediate medical attention. Symptoms can also differ between individuals, so it is important not to assume that cardiovascular disease will present in the same way for everyone.
Global Impact
Cardiovascular diseases are the leading cause of death worldwide. In 2022, an estimated 19.8 million people died from CVDs, representing approximately 32% of all deaths globally. Of these deaths, 85% were caused by heart attacks and strokes. More than three-quarters of cardiovascular disease deaths occur in low- and middle-income countries.
Many cardiovascular diseases can be prevented or their risk reduced by addressing modifiable risk factors. Important risk factors include tobacco use, unhealthy diet, physical inactivity, harmful use of alcohol, obesity, high blood pressure, high blood glucose, and unhealthy cholesterol levels. Environmental factors, including air pollution, can also contribute to cardiovascular risk.
Prevention and Early Detection
Taking steps to maintain cardiovascular health can help reduce the risk of heart disease and stroke. This includes eating a balanced diet, engaging in regular physical activity, avoiding tobacco products, limiting harmful alcohol use, maintaining a healthy weight, and managing blood pressure, cholesterol, and blood sugar levels.
Regular healthcare visits can help identify cardiovascular risk factors before they lead to serious complications. Early detection and appropriate treatment can reduce the risk of cardiovascular events and improve long-term health outcomes. If you experience symptoms that may indicate a heart attack or stroke, seek emergency medical care immediately.
Diabetes is a chronic metabolic disease that occurs when the body does not produce enough insulin or cannot effectively use the insulin it produces. Insulin is a hormone that helps move glucose (blood sugar) from the bloodstream into the body's cells, where it is used for energy. When diabetes is not well controlled, elevated blood glucose levels can gradually damage the body's organs and blood vessels.
There are several types of diabetes, with type 1 and type 2 being the most common. Gestational diabetes can also develop during pregnancy, and other less common forms of diabetes can result from specific medical conditions or medications.
Types of Diabetes
Type 1 diabetes occurs when the body's immune system attacks the cells in the pancreas that produce insulin. As a result, the body produces little or no insulin. Type 1 diabetes can develop at any age and currently cannot be prevented. People with type 1 diabetes require insulin every day to manage their blood glucose and maintain their health. With appropriate treatment and support, people living with type 1 diabetes can lead healthy, active lives.
Type 2 diabetes occurs when the body does not use insulin effectively and, over time, may not produce enough insulin to maintain healthy blood glucose levels. Type 2 diabetes is the most common form of diabetes, accounting for approximately 90–95% of diagnosed diabetes cases among U.S. adults. Risk factors include having prediabetes, being physically inactive, having overweight or obesity, having a family history of type 2 diabetes, and increasing age. Type 2 diabetes can often be prevented or delayed through healthy lifestyle changes, and it can be managed through lifestyle changes, medications, insulin, or a combination of treatments.
Global Impact
Diabetes is a growing global health concern. The number of people living with diabetes increased from approximately 200 million in 1990 to 830 million in 2022. In 2022, approximately 14% of adults aged 18 years and older were living with diabetes, more than twice the proportion in 1990. More than half of adults aged 30 years and older living with diabetes were not taking medication for the condition in 2022.
Diabetes also has a significant impact in the United States. According to the CDC's latest estimates, approximately 40.1 million Americans had diagnosed or undiagnosed diabetes in 2023, representing about 12% of the U.S. population. An estimated 11 million U.S. adults had undiagnosed diabetes, meaning they met laboratory criteria for diabetes but were not aware that they had the condition. In addition, approximately 115.2 million U.S. adults had prediabetes.
Health Complications
When blood glucose levels remain elevated over time, diabetes can damage blood vessels and nerves throughout the body. Diabetes can increase the risk of heart disease, stroke, kidney disease, vision loss, nerve damage, and lower-limb complications that may lead to amputation. Maintaining blood glucose, blood pressure, and cholesterol levels within recommended ranges can help prevent or delay many of these complications.
Prevention and Management
Type 1 diabetes cannot currently be prevented. However, healthy lifestyle habits can help reduce the risk of developing type 2 diabetes and can support overall health for people living with any type of diabetes.
Eat a balanced diet. Choose a variety of nutrient-rich foods, including vegetables, fruits, whole grains, lean proteins, and healthy sources of fat. Limiting foods and beverages high in added sugars and highly processed foods can also support healthy blood glucose levels.
Stay physically active. Regular physical activity can improve how the body uses insulin and can help maintain healthy blood glucose levels. Aim for regular moderate-intensity activity throughout the week, as recommended by your healthcare provider.
Maintain a healthy weight. For people who have overweight or obesity, even modest weight loss can reduce the risk of developing type 2 diabetes.
Know your risk. People with risk factors for type 2 diabetes may benefit from regular screening for diabetes and prediabetes. Early detection allows people to take steps to prevent or delay complications.
Follow your treatment plan. People living with diabetes should work with their healthcare team to monitor blood glucose and manage medications, nutrition, physical activity, blood pressure, cholesterol, and other aspects of their health.
Diabetes can be managed effectively, but management is an ongoing process. If you are concerned about your risk for diabetes or have symptoms such as increased thirst, frequent urination, unexplained weight loss, fatigue, or blurred vision, talk with a healthcare professional about screening and appropriate care.
Mental health is an essential part of overall health and well-being. It refers to a person's emotional, psychological, and social well-being and influences how we think, feel, relate to others, cope with stress, learn, work, and make decisions. Mental health exists on a continuum and can change throughout a person's life in response to biological, psychological, social, and environmental factors. Having challenges with mental health is a common part of life and does not necessarily mean that someone has a mental illness or mental disorder.
Mental health conditions include a wide range of mental disorders and other conditions that can cause significant distress or interfere with daily functioning. Common mental disorders include anxiety disorders, depression, bipolar disorder, post-traumatic stress disorder (PTSD), and eating disorders, among others. Effective treatments and supports are available for many mental health conditions. However, stigma, discrimination, cost, limited access to services, and other barriers can prevent people from receiving the care they need.
Global Impact
Mental health is a significant global public health concern. In 2021, approximately 1.1 billion people worldwide (1 in 7 people) were living with a mental disorder. Anxiety and depressive disorders are among the most common mental disorders worldwide. Mental disorders can affect relationships, education, employment, physical health, and overall quality of life. Despite the availability of effective treatments, many people living with mental health conditions do not have access to appropriate care.
Mental and Physical Health
Mental and physical health are closely connected. Mental health conditions can affect physical health and may be associated with an increased risk of chronic conditions such as cardiovascular disease and diabetes. Likewise, living with a chronic physical health condition can increase the risk of experiencing mental health challenges. Supporting both mental and physical health is therefore an important part of overall well-being.
Positive Mental Health
Positive mental health can help people:
Cope with the stresses of life
Recognize and develop their abilities
Build and maintain healthy relationships
Learn and work effectively
Adapt to challenges and changes
Make meaningful contributions to their families and communities
Mental health can be supported through healthy behaviors, strong social connections, and access to appropriate care. Helpful strategies may include:
Connect with others. Spend time with supportive friends, family members, coworkers, or community groups.
Stay physically active. Regular physical activity can support both mental and physical well-being.
Get enough sleep. Establishing consistent sleep habits can support mood, concentration, and overall health.
Develop healthy coping skills. Find positive ways to manage stress, such as exercise, relaxation techniques, hobbies, mindfulness, or spending time with supportive people.
Take care of your physical health. Eating a balanced diet, staying active, and attending regular healthcare visits can support overall well-being.
Seek professional help when needed. A healthcare provider or mental health professional can help identify concerns and connect you with appropriate treatment and support.
Help others. Volunteering, supporting others, and participating in your community can contribute to a sense of connection and purpose.
Seeking help is a sign of taking care of your health, not a sign of weakness. If you are experiencing persistent changes in your mood, thoughts, behavior, relationships, sleep, or ability to function in daily life, consider talking with a healthcare or mental health professional.
If you or someone you know is experiencing a mental health crisis or having thoughts of suicide, call or text 988 to reach the Suicide & Crisis Lifeline. In an immediate life-threatening emergency, call 911.
Cancer is a broad group of diseases in which abnormal cells grow uncontrollably and may invade surrounding tissues or spread to other parts of the body. Cancer can develop in almost any part of the body, and different types of cancer have different risk factors, symptoms, screening recommendations, and treatments. Cancer is one of the leading causes of death worldwide, accounting for nearly 10 million deaths in 2024, or nearly one in six deaths globally. Many cancers can be prevented by reducing exposure to known risk factors, while others can be detected early and treated effectively.
In 2022, nearly 20 million new cases of cancer were diagnosed worldwide and approximately 10 million people died from cancer. The most diagnosed cancers globally were lung, breast, colorectal, and prostate cancers.
Prostate Cancer
The prostate is a small gland located below the bladder and in front of the rectum in people with a prostate. It produces fluid that helps make up semen. Prostate cancer develops when abnormal cells in the prostate grow uncontrollably.
Prostate cancer is the most common cancer among men in the United States, excluding skin cancer, and the second-leading cause of cancer death among U.S. men after lung cancer. The American Cancer Society estimates that approximately 333,830 men will be diagnosed with prostate cancer and 36,320 will die from the disease in 2026. About 1 in 8 men will be diagnosed with prostate cancer during their lifetime. Prostate cancer is uncommon in men younger than 40, and approximately 6 in 10 cases are diagnosed in men age 65 or older.
Risk increases with age, and prostate cancer occurs more frequently among Black men and men of African ancestry. Having a close relative, particularly a father or brother, with prostate cancer can also increase risk. Other factors, including inherited genetic changes, may contribute to an individual's risk.
Prostate Cancer Screening
Screening can help identify prostate cancer before symptoms develop, but screening is not appropriate for everyone and has potential benefits and risks. The American Cancer Society recommends that men discuss prostate cancer screening with a health care provider so they can make an informed decision based on their individual risk.
Age 50: Men at average risk who are expected to live at least 10 more years.
Age 45: Men at higher risk, including Black men and men with a father or brother diagnosed with prostate cancer before age 65.
Age 40: Men at particularly high risk, including those with more than one first-degree relative diagnosed with prostate cancer at an early age.
The prostate-specific antigen (PSA) blood test is the primary test used for prostate cancer screening. A digital rectal examination (DRE) may also be performed, although it is not used as the primary screening test.
Maintaining a healthy lifestyle can reduce the risk of several chronic diseases and may contribute to overall health. Avoiding tobacco, staying physically active, maintaining a healthy weight, and eating a balanced diet are important components of cancer prevention and overall well-being.
Colorectal Cancer
Colorectal cancer is a cancer that begins in the colon or rectum, which make up the lower portion of the digestive system. Most colorectal cancers begin as polyps, which are growths on the inner lining of the colon or rectum. Some polyps can become cancerous over time, which is one reason regular screening is important.
Colorectal cancer is the third most commonly diagnosed cancer worldwide and the second leading cause of cancer-related death globally. In 2022, approximately 1.9 million new cases and more than 900,000 deaths from colorectal cancer occurred worldwide.
Risk increases with age, although colorectal cancer is increasingly being diagnosed in younger adults. Risk factors include a family history of colorectal cancer, certain inherited conditions, inflammatory bowel disease, physical inactivity, overweight and obesity, tobacco use, alcohol consumption, and diets high in processed and red meat and low in fruits and vegetables.
Colorectal Cancer Screening
For people at average risk, the American Cancer Society recommends beginning regular colorectal cancer screening at age 45. Screening options include stool-based tests, colonoscopy and other visual examinations, and certain blood-based tests. People with a family history or other factors that increase their risk may need to begin screening earlier or be screened more frequently.
Reducing Your Risk
You can take steps to help lower your risk of colorectal cancer:
Eat a diet rich in fruits, vegetables, and whole grains.
Limit processed and red meat.
Maintain a healthy weight.
Stay physically active.
Avoid tobacco products.
Limit alcohol consumption.
Follow recommended colorectal cancer screening guidelines.
Lung Cancer
Lung cancer begins when abnormal cells in the lungs grow uncontrollably. It is the most commonly diagnosed cancer and the leading cause of cancer death worldwide. In 2022, approximately 2.5 million people were diagnosed with lung cancer and more than 1.8 million died from the disease.
In the United States, lung cancer is the third most common cancer and causes more deaths than any other type of cancer in both men and women. In 2023, more than 228,000 new lung cancer cases were reported in the United States, and more than 128,000 people died from lung cancer in 2024.
Risk Factors
Cigarette smoking is the leading risk factor for lung cancer. In the United States, cigarette smoking is linked to approximately 80% of lung cancer deaths. Other risk factors include exposure to secondhand smoke, radon, air pollution, asbestos, and other workplace carcinogens. Lung cancer can also occur in people who have never smoked.
Reducing Your Risk
You can reduce your risk of lung cancer by:
Not smoking.
Quitting smoking if you currently smoke.
Avoiding secondhand smoke.
Testing your home for radon.
Following workplace safety guidelines when exposed to carcinogens.
Discussing lung cancer screening with a health care provider if you are at high risk.
Lung cancer screening is recommended only for certain adults at high risk, particularly those with a significant history of cigarette smoking.
Breast Cancer
Breast cancer develops when abnormal cells in breast tissue grow uncontrollably. Although breast cancer can occur in both women and men, it is much more common in women.
Breast cancer is the most commonly diagnosed cancer among women worldwide. In 2022, approximately 2.3 million women were diagnosed with breast cancer globally, and approximately 670,000 people died from the disease.
In the United States, the American Cancer Society estimates that approximately 321,910 women will be diagnosed with invasive breast cancer and 42,140 women will die from breast cancer in 2026. About 1 in 8 women in the United States will develop invasive breast cancer during their lifetime.
Signs and Symptoms
Possible signs and symptoms of breast cancer include:
A new lump or thickening in the breast or underarm.
A change in the size or shape of the breast.
Changes in the skin of the breast, such as dimpling or redness.
Changes to the nipple, including a newly inverted nipple.
Nipple discharge that is not breast milk.
Changes in the appearance or texture of the breast or nipple.
Persistent swelling or changes that are unusual for you.
Not all breast changes are caused by cancer, but new or unusual changes should be discussed with a health care provider.
Breast Cancer Screening and Risk Reduction
Regular screening can help detect breast cancer earlier, when treatment is more likely to be successful. Screening recommendations depend on age and individual risk. The American Cancer Society recommends that women ages 40 to 44 have the option to begin annual mammograms, while women 45 and older should receive mammograms annually, with individualized considerations for women at older ages. Women with a higher-than-average risk may need additional screening, such as MRI, and should discuss their screening plan with a health care provider.
Steps that may help reduce breast cancer risk include:
Maintain a healthy weight.
Stay physically active.
Limit alcohol consumption.
Avoid tobacco products.
Discuss your individual breast cancer risk with a health care provider.
Follow recommended breast cancer screening guidelines.
Report new or unusual breast changes promptly.
For people at particularly high risk, health care providers may discuss additional risk-reduction strategies, including medications or, in select circumstances, preventive surgery.
Cancer Prevention
Although not all cancers can be prevented, many cancer cases can be reduced by addressing known risk factors. The World Health Organization estimates that approximately 38% of cancers can currently be prevented through avoiding risk factors and implementing evidence-based prevention strategies.
Important ways to reduce cancer risk include:
Avoid tobacco products and secondhand smoke.
Maintain a healthy weight.
Stay physically active.
Eat a balanced diet rich in fruits, vegetables, and whole grains.
Limit alcohol consumption.
Protect yourself from excessive ultraviolet radiation.
Reduce exposure to known environmental and occupational carcinogens.
Follow recommended cancer screening guidelines.
Stay up to date on cancer-preventing vaccines, such as HPV and hepatitis B vaccines, when recommended.
Regular health care visits and appropriate screening can help identify certain cancers at earlier stages, when treatment may be more effective.
Access to health care means being able to obtain timely, affordable, appropriate, and high-quality health services when they are needed. Access is an important social determinant of health because the ability to obtain health care can influence disease prevention, early diagnosis, treatment, quality of life, and overall health outcomes.
Access to health care involves more than simply having health insurance. Important components include:
Coverage: Having health insurance or another way to pay for needed health services can make it easier to obtain routine, preventive, and medical care.
Availability of services: People need access to health care facilities, medications, specialists, and other services in their communities or through appropriate remote options.
Timeliness: Health care should be available when a person recognizes a need for care. Delays can contribute to worsening illness, complications, and higher health care costs.
Usual source of care: Having a regular health care provider or facility can support preventive care, chronic disease management, and early detection of health problems.
Workforce and quality: Communities need enough qualified health professionals who can provide safe, high-quality, culturally responsive, and patient-centered care.
Barriers to Health Care
People may experience barriers that make it difficult to obtain needed health services. These barriers can vary depending on where a person lives, their financial circumstances, and their individual needs.
Common barriers include:
High costs of medical care, medications, or insurance
Lack of health insurance or inadequate coverage
Shortages of health care providers
Long distances to health care facilities
Lack of reliable transportation
Long wait times for appointments
Limited availability of specialty or behavioral health services
Language and communication barriers
Lack of culturally responsive or appropriate care
Physical or technological barriers for people with disabilities
Limited access to reliable health information
These barriers can cause people to delay or avoid needed care. In the United States, 8.2% of people reported being unable to obtain or having delayed necessary medical care in 2024, with cost being an important contributor to delayed care. People who do not have a usual source of care may also experience delayed diagnosis and treatment and are less likely to receive recommended preventive services.
Consequences of Limited Access
When people cannot obtain health care when they need it, they may experience:
Unmet health needs
Delayed diagnosis and treatment
Missed preventive screenings and vaccinations
Difficulty managing chronic conditions
Preventable complications and hospitalizations
Increased financial stress and medical debt
Greater disparities in health outcomes
Reduced quality of life
Improving access to primary and preventive care can help prevent illness, identify health problems earlier, and reduce avoidable complications.
Health Care Access and Social Determinants of Health
Access to health care is closely connected to other social determinants of health, including income, education, housing, transportation, employment, and the physical environment. These factors can influence whether people have the resources and opportunities needed to obtain health services.
Health and economic conditions can also reinforce one another. Poor health can make it more difficult to work, attend school, or maintain financial stability, while limited financial resources can make it more difficult to afford health care, medications, transportation, and healthy living conditions. As a result, policies affecting these factors can have important effects on population health.
Improving health outcomes therefore requires more than providing medical services. Health care systems, communities, and policymakers must work together to reduce barriers and create conditions in which everyone has a fair opportunity to achieve good health.
Ph.D., Epidemiology, University of the West Indies
Biography
Dr. Damian K. Francis is a Nutritionist and Epidemiologist trained at the Caribbean Institute for Health Research, University of the West Indies, Jamaica. Dr. Francis is the Director of the Center for Health & Social Issues at Georgia College & State University. He is an Emerging Leader of the Americas Programme (ELAP) scholar, completing a research fellowship in knowledge synthesis and knowledge translation at the University of Ottawa. Dr. Francis is the founder of the Cochrane Caribbean and currently serves as adjunct faculty for the World Health Organization (WHO)/Cochrane/Cornell Summer Institute for systematic reviews in nutrition for global policymaking. He serves both the Pan American Health Organization and as a member of the Essential Medicine List expert panel. Dr. Francis is an Assistant Editor for the Campbell Collaboration Nutrition Sub-group of the International Development Coordinating Group. He enjoys teaching epidemiology, translational research methods and mentoring students in research. Dr. Francis has a track record of excellence in research publication which has focused on the epidemiology of chronic non-communicable diseases among people of Afro-Caribbean heritage with an emphasis on health equity, systematic reviews of interventions, and the food environment as a risk factor for diseases.
