A primary care physician sits in her office withher patient, an overweight 57-year-old man withdiabetes and hypertension. She knows that inaddition to treating his chronic medical conditions, she also should encourage him to quit smoking, modify his diet, and increase his level of activity to reduce the risk of developing disabling or fatal heart disease or stroke. At the same time, a public health officer in another part of town focuses on overcoming the challenges presented by lack of access to healthy foods and open space for exercise and by the easy availability of cigarettes in the community in which this patient lives—all of which likely have contributed to the development of the patient's chronic medical conditions.
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