The U.S. health care system faces spiraling costs from chronic, or noncommunicable, illnesses such as diabetes, heart disease and preventable cancers. But public health experts are discovering that just pushing people to change bad habits isn't working. Instead, they are placing more focus on "making the healthy choice the easy choice" through such efforts as reformulating processed foods and making streets safe for walkers and bikers. Some in Congress and the Obama administration made a big push for community-based disease prevention approaches, but concerns over the budget deficit could result in major cuts to the Prevention and Public Health Fund enacted as part of the 2010 health reform act. However, some say the government is overreaching in its war on obesity, and studies show that some prevention efforts add to health care costs. The fight against preventable disease is not a U.S. problem alone. In poor countries, the biggest threats are the same ones afflicting Americans: lack of exercise, smoking and unhealthy diets.

Nellie Bristol is a veteran Capitol Hill reporter who has covered health policy in Washington for more than 20 years. She now writes for The Lancet, The British Medical Journal and the Journal of Disaster Medicine and Public Health Preparedness. She recently earned a master's degree in public health/global health from The George Washington University, where she earned an undergraduate degree in American studies.