病気

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結核を引き起こす病原菌の一種である結核菌の走査型電子顕微鏡写真である。

病気とは、生体の全部または一部の構造または機能に悪影響を及ぼす特定の異常な状態であり、外的な傷害に直ちに起因するものではない。病気はしばしば特定の徴候や症状を伴う病状として知られている。病気は病原体などの外的要因によって引き起こされることもあれば、体内の機能不全によって引き起こされることもある。例えば、免疫系の内部機能不全は、様々な形態の免疫不全、過敏症、アレルギー、自己免疫疾患など、様々な異なる疾患を生じさせる。

人間においては、病気はより広義に、罹患者に苦痛、機能不全、苦痛、社会的問題、または死を引き起こすあらゆる状態、あるいはその人に接する人々に同様の問題を引き起こすあらゆる状態を指すことが多い。この広い意味では、傷害、障害、障害、症候群、感染症、孤立した症状、逸脱した行動、構造や機能の非典型的な変動を含むこともあるが、他の文脈や他の目的では、これらは区別可能なカテゴリーと見なされることもある。病気に罹患し、病気とともに生きることで、罹患者の人生観が変化することがあるため、病気は身体的だけでなく、精神的にも人々に影響を与えることがある。

病気による死は自然死と呼ばれる。病気には大きく分けて、感染症、欠乏症、遺伝性疾患（遺伝性疾患と非遺伝性遺伝性疾患の両方を含む）、生理的疾患の4種類がある。病気はまた、伝染性病気と非伝染性病気のように、他の方法で分類することもできる。ヒトにおいて最も死亡率の高い病気は冠動脈疾患（血流障害）であり、次いで脳血管疾患、下気道感染症である。先進国では、全体として最も病気を引き起こす病気は、うつ病や不安症などの精神神経症状である。

病気の研究は病理学'と呼ばれ、病因、つまり原因の研究も含まれる。

用語

概念

多くの場合、disease、disorder、morbidity、sickness、illnessなどの用語は互換的に使用されるが、特定の用語が望ましいと考えられる状況もある。

Disease(病気)
病気という用語は、広義には身体の正常な機能を損なうあらゆる状態を指す。このため、病気は身体の正常なホメオスタシス過程の機能障害と関連している。一般的に、この用語は特に感染症を指すために使用される。感染症とは、ウイルス、細菌、カビ、原虫、多細胞生物、およびプリオンとして知られる異常タンパク質を含む病原性微生物因子の存在に起因する臨床的に明らかな疾患である。正常な腸内細菌や酵母の存在やパッセンジャーウイルスの存在など、臨床的に明らかな正常機能の障害を生じない、また生じない感染やコロニー形成は、疾患とはみなされない。対照的に、潜伏期間中は無症状であるが、後に症状が出ると予想される感染症は、通常、疾患とみなされる。非感染性疾患は、ほとんどの形態のがん、心臓病、遺伝病を含む他のすべての疾患である。
Acquired disease(後天性疾患)
後天性疾患とは、先天性疾患である出生時にすでに存在していた疾患とは対照的に、生涯のある時点から始まった疾患のことである。Acquiredは「伝染病によって感染した」という意味にも聞こえるが、単に出生後のある時期に後天的に発症したという意味である。また、二次疾患を意味するようにも聞こえるが、後天性疾患は一次疾患であることもある。
Acute disease(急性疾患)
急性疾患は短期的な性質のもの（急性）であり、この用語は時に劇症性をも含意する。
Chronic condition or chronic disease(慢性状態または慢性疾患)
慢性疾患とは、時間とともに持続するものであり、多くの場合、少なくとも6ヶ月と特徴づけられるが、天寿を全うすると予想される病気も含まれる。
Congenital disorder or congenital disease(先天性障害または先天性疾患)
先天性疾患は出生時に存在する疾患である。多くの場合遺伝性疾患または障害であり、|遺伝することがある。また、HIV/AIDSなどの母親からの垂直感染の結果であることもある。
Genetic disease(遺伝病)
遺伝性疾患または疾病は、1つまたは複数の遺伝的突然変異によって引き起こされる。遺伝することが多いが、ランダムな新たな突然変異もある。
Hereditary or inherited disease(遺伝性疾患)
遺伝性疾患とは、遺伝である遺伝子の突然変異によって引き起こされる遺伝病の一種である（家族内で発生することもある）。
Iatrogenic disease(医原性疾患)
医原性疾患または病態は、治療の副作用であれ、不慮の結果であれ、医療介入によって引き起こされるものである。
Idiopathic disease(特発性疾患)
特発性疾患は原因や原因が不明である。医学が進歩するにつれて、原因がまったく不明であった多くの医薬品は、その原因の一端が解明され、特発性の地位を脱した。例えば、細菌が発見されたとき、細菌が感染症の原因であることが知られるようになったが、特定の細菌と病気は関連づけられなかった。別の例では、1型糖尿病のある種の原因は自己免疫であることが知られているが、それが働く特定の分子経路はまだ解明されていない。また、ある因子がある病気と関連していることはよく知られている。しかし、関連と因果関係はまったく異なる現象であり、関連する現象だけでなく、第三の原因が病気を生み出しているかもしれない。
Incurable disease(不治の病)
治すことができない病気。不治の病は必ずしも終末期疾患ではなく、病気の症状を十分に治療することで生活の質にほとんど影響を与えないこともある。
Primary disease(一次性疾患)
一次性疾患とは、後遺症や一次性疾患によって引き起こされる合併症である二次性疾患とは対照的に、病気の根本原因に起因する疾患のことである。例えば、風邪は一次性疾患であり、鼻炎は二次疾患、すなわち後遺症の可能性がある。医師は、抗生物質を処方するかどうかを決定する際に、患者の二次的な鼻炎を引き起こしている一次性疾患、すなわち風邪や細菌感染が何であるかを判断しなければならない。
Secondary disease(二次性疾患)
二次性疾患は、先行する原因となる疾患、すなわち一次性疾患または単に「根本的な原因」と呼ばれるものの、後遺症や合併症として発生する疾患を指す。これは根本原因とも呼ばれる。例えば、細菌感染は、健康な人が細菌にさらされて感染する一次的なものと、感染しやすい体質を作る一次的な原因による二次的なものがある。例えば、免疫系を弱める一次的なウイルス感染は、二次的な細菌感染を引き起こす可能性がある。同様に、一次的な熱傷で傷口が開いていると、細菌の侵入口となり、二次的な細菌感染を引き起こす可能性がある。
Terminal disease(終末期疾患)
終末期疾患とは、死が避けられないと予想される病気のことである。以前はエイズが末期疾患であったが、現在では不治の病であるが、医薬品を使って無期限に管理することができる。
Illness(疾患)
疾患(illness)と疾病(sickness)という用語は、一般的には病気(disease)という言葉の同義語として使用される。ただし、病気という用語は、時折患者が自身の病気に対する個人的な経験を指すために使用されることがある。このモデルでは、人は病気であっても病気でない場合があります（具体的に定義されるが無症状である、例えば不顕性感染などの医学的な状態がある場合、または臨床的に明らかな身体的な障害があるが、それに対して病気や苦痛を感じない場合がありる）。また、病気であっても「疾患」でない場合もある（例えば、通常の経験を医学的な状態として認識したり、生活の中で非疾患的な状況を医学的に認識すること、例えば恥ずかしさから不快感を感じ、それを通常の感情ではなく病気と解釈する場合がある）。病気の症状はしばしば感染の直接の結果ではなく、進化した反応、すなわち体による病気の行動の集合であり、感染をクリアし、回復を促進する役割がある。病気の側面には倦怠感、うつ病、食欲不振、眠気、痛覚過敏、および注意を集中できないといったものが含まれることがある。
Disorder(障害)
障害とは機能的な異常や障害のことである。医薬品障害は、精神障害、身体障害、遺伝的障害、情動・行動障害、機能障害に分類される。障害という用語は、疾患や病気という用語よりも価値中立的で汚名を着せにくいとされることが多く、状況によっては好ましい用語である。精神保健において、精神障害という用語は、精神疾患の状態における生物学的、社会的、心理学的要因の複雑な相互作用を認める方法として使用されるが、障害という用語は医学の他の多くの分野でも使用され、主に代謝異常などの感染性生物に起因しない身体的障害を特定するために使用される。
Medical condition or health condition(医学的状態または健康状態)
医学的状態または健康状態は、通常医学的治療を受ける病気、病変、障害、または非病原的な状態を含む広範な概念である。これには、妊娠や出産なども含まれる。一般的には医学的状態という用語は精神疾患も含むが、一部の文脈ではこの用語は特に精神疾患を除くすべての病気、傷害、または疾患を指すために使用される。精神障害の診断と統計マニュアル（DSM）、広く使用されている精神医学のマニュアルであるが、すべての精神障害を定義しているものでは、一般的な医学的状態という用語を精神障害を除くすべての病気、疾患、および傷害を指すために使用しています。この用法は、精神医学の文献でも一般的に見られます。一部の健康保険ポリシーでは、精神疾患を除くすべての病気、傷害、または疾患を医学的状態として定義することもある。
病気のような用語よりも価値中立的であるため、病状という用語は、有害とは思わない健康問題を抱える人々によって好まれることがある。その一方で、自閉症の権利運動の支持者のように、病状の医学的性質を強調することによって、この用語が否定されることもある。
病状という用語は医学的状態の同義語でもあり、その場合は医学的見地から個々の患者の現在の状態を表す。この用法は、例えば患者を危篤状態であると表現する場合に現れる。
Morbidity(病的状態)
病的状態（{ety|la|morbidus|sick,unhealthy}}）とは、何らかの原因による病気の状態、障害、または不健康のことである。この用語は、あらゆる形態の疾患の存在を指す場合と、健康状態が患者に及ぼす影響の程度を指す場合がある。重症患者の場合、罹病度はしばしばICUスコアリングシステムによって測定される。併存症（共存症）とは、統合失調症と薬物乱用など、2つ以上の病状が同時に存在することである。
疫学や保険数理学では、罹患率（罹患割合または罹患頻度とも）という用語は、発生率、病気や病状の有病率、またはある期間内にある病態を経験する人の割合（例えば、1年間に20％の人がインフルエンザにかかる）のいずれかを指すことがある。この病気の指標は、ある症状の死亡率とは対照的であり、ある時間間隔の間に死亡する人の割合である。罹患率は、健康保険、生命保険、介護保険などの保険数理において、顧客に請求する適正な保険料を決定するために使用される。罹患率は、保険会社が被保険者が特定の病気にかかったり発症したりする可能性を予測するのに役立つ。
Pathosis or pathology(病理または病理学)
病理(pathology)（複数形pathoses）は’’病気(disease)と同義である。また、pathologyという言葉もこの意味を持っており、医師たちが医学文献でよく使用するが、一部の編集者は「pathology」を他の意味に予約することを好むことがありる。時折、わずかな示唆的なニュアンスが、「pathology」または「pathosis」を選好させることがある。これは「まだ十分に解析されていない病態生理学的プロセス」を意味するものとして「pathology」や「pathosis」を選好するか、「すでに診断基準によって定義された具体的な病気の実体」を意味する「disease」を選好するかという違いがある。これは指示的に量ることが難しいが、認知的な同義性が一定でない理由を説明している。
Syndrome(症候群)
症候群とは、原因がわかっているかどうかに関係なく、いくつかの徴候や症状、またはしばしば一緒に起こる他の特徴の関連性のことである。ダウン症のようないくつかの症候群は、原因が1つ（出生時に余分な染色体）しかないことが知られている。パーキンソン症候群のように複数の原因が考えられるものもある。例えば、急性冠症候群は単一の疾患そのものではなく、むしろ冠動脈疾患に続発する心筋梗塞を含むいくつかの疾患のいずれかの現れである。しかし、他の症候群では原因不明である。よく知られた症候群名は、根本的な原因が判明した後でも、あるいは考えられる主原因がいくつもある場合でも、しばしば使用され続ける。前者の例として、ターナー症候群やディジョージ症候群は、徴候や症状の集合としてだけでなく、疾患の実体としても捉えることができるにもかかわらず、いまだに「症候群」の名前で呼ばれることが多い。
Predisease(疾患前段階)
prediseaseとは、疾患の不顕性または前駆症状の前兆である。糖尿病前症や高血圧前症が一般的な例である。「Predisease」の疾患分類学（nosology）や認識論（epistemology）に関する議論は激しいもので、なぜなら、しばしば明確な境界が存在せず、サブクリニカル／前駆／前兆段階に対する正当な懸念（一方で）利益相反に基づく病気の煽り立てや医学化とを区別することが難しいからである。正当な疾病予備軍を特定することは、その人に健康的な運動をさせるといった有益な予防策につながるが、健康な人に根拠のない疾病予備軍のレッテルを貼ることは、重症の人にしか効かない薬物を服用したり、便益対費用比が微々たる薬物処方例（CMSの無駄のカテゴリーに入る）にお金を払うといった過剰治療をもたらす可能性がある。「無駄、詐欺、乱用」の分類に入る）。病態を先天性疾患と呼ぶことの正当性には、3つの要件がある：
  • 例えば、前癌状態は時間の経過とともにほぼ確実に癌に変化する。
  • リスク低減のための行動力-例えば、前がん組織を切除することで、致命的ながんになるのを防ぐことができる。
  • どんな介入を行っても利益が損害を上回る利点がある場合、がん予備状態の組織を取り除くことはがんを予防し、それによりがんによる潜在的な死亡を防ぐことができる。

Types by body system

Mental
Mental illness is a broad, generic label for a category of illnesses that may include affective or emotional instability, behavioral dysregulation, cognitive dysfunction or impairment. Specific illnesses known as mental illnesses include major depression, generalized anxiety disorders, schizophrenia, and attention deficit hyperactivity disorder, to name a few. Mental illness can be of biological (e.g., anatomical, chemical, or genetic) or psychological (e.g., trauma or conflict) origin. It can impair the affected person's ability to work or study and can harm interpersonal relationships. The term insanity is used technically as a legal term.
Organic
An organic disease is one caused by a physical or physiological change to some tissue or organ of the body. The term sometimes excludes infections. It is commonly used in contrast with mental disorders. It includes emotional and behavioral disorders if they are due to changes to the physical structures or functioning of the body, such as after a stroke or a traumatic brain injury, but not if they are due to psychosocial issues.

Stages

"Flareup" redirects here. For the Transformers character, see Flareup (Transformers).

In an infectious disease, the incubation period is the time between infection and the appearance of symptoms. The latency period is the time between infection and the ability of the disease to spread to another person, which may precede, follow, or be simultaneous with the appearance of symptoms. Some viruses also exhibit a dormant phase, called viral latency, in which the virus hides in the body in an inactive state. For example, varicella zoster virus causes chickenpox in the acute phase; after recovery from chickenpox, the virus may remain dormant in nerve cells for many years, and later cause herpes zoster (shingles).

Acute disease
An acute disease is a short-lived disease, like the common cold.
Chronic disease
A chronic disease is one that lasts for a long time, usually at least six months. During that time, it may be constantly present, or it may go into remission and periodically relapse. A chronic disease may be stable (does not get any worse) or it may be progressive (gets worse over time). Some chronic diseases can be permanently cured. Most chronic diseases can be beneficially treated, even if they cannot be permanently cured.
Clinical disease
One that has clinical consequences; in other words, the stage of the disease that produces the characteristic signs and symptoms of that disease. AIDS is the clinical disease stage of HIV infection.
Cure
A cure is the end of a medical condition or a treatment that is very likely to end it, while remission refers to the disappearance, possibly temporarily, of symptoms. Complete remission is the best possible outcome for incurable diseases.
Flare-up
See also: Exacerbation
A flare-up can refer to either the recurrence of symptoms or an onset of more severe symptoms.
Progressive disease
Progressive disease is a disease whose typical natural course is the worsening of the disease until death, serious debility, or organ failure occurs. Slowly progressive diseases are also chronic diseases; many are also degenerative diseases. The opposite of progressive disease is stable disease or static disease: a medical condition that exists, but does not get better or worse.
Refractory disease
A refractory disease is a disease that resists treatment, especially an individual case that resists treatment more than is normal for the specific disease in question.
Subclinical disease
Also called silent disease, silent stage, or asymptomatic disease. This is a stage in some diseases before the symptoms are first noted.
Terminal phase
If a person will die soon from a disease, regardless of whether that disease typically causes death, then the stage between the earlier disease process and active dying is the terminal phase.
Recovery
See also: Convalescence and Recuperation
Recovery can refer to the repairing of physical processes (tissues, organs etc.) and the resumption of healthy functioning after damage causing processes have been cured.

Extent

skin rash on the leg
This rash only affects one part of the body, so it is a localized disease
Localized disease
A localized disease is one that affects only one part of the body, such as athlete's foot or an eye infection.
Disseminated disease
A disseminated disease has spread to other parts; with cancer, this is usually called metastatic disease.
Systemic disease
A systemic disease is a disease that affects the entire body, such as influenza or high blood pressure.

Classification

Main articles: Nosology and Medical classification

Diseases may be classified by cause, pathogenesis (mechanism by which the disease is caused), or by symptom(s). Alternatively, diseases may be classified according to the organ system involved, though this is often complicated since many diseases affect more than one organ.

A chief difficulty in nosology is that diseases often cannot be defined and classified clearly, especially when cause or pathogenesis are unknown. Thus diagnostic terms often only reflect a symptom or set of symptoms (syndrome).

Classical classification of human disease derives from the observational correlation between pathological analysis and clinical syndromes. Today it is preferred to classify them by their cause if it is known.

The most known and used classification of diseases is the World Health Organization's ICD. This is periodically updated. Currently, the last publication is the ICD-11.

Causes

See also: Cause (medicine) and Transmission (medicine)

Only some diseases such as influenza are contagious and commonly believed infectious. The microorganisms that cause these diseases are known as pathogens and include varieties of bacteria, viruses, protozoa, and fungi. Infectious diseases can be transmitted, e.g. by hand-to-mouth contact with infectious material on surfaces, by bites of insects or other carriers of the disease, and from contaminated water or food (often via fecal contamination), etc. Also, there are sexually transmitted diseases. In some cases, microorganisms that are not readily spread from person to person play a role, while other diseases can be prevented or ameliorated with appropriate nutrition or other lifestyle changes.

Some diseases, such as most (but not all) forms of cancer, heart disease, and mental disorders, are non-infectious diseases. Many non-infectious diseases have a partly or completely genetic basis (see genetic disorder) and may thus be transmitted from one generation to another.

Social determinants of health are the social conditions in which people live that determine their health. Illnesses are generally related to social, economic, political, and environmental circumstances. Social determinants of health have been recognized by several health organizations such as the Public Health Agency of Canada and the World Health Organization to greatly influence collective and personal well-being. The World Health Organization's Social Determinants Council also recognizes Social determinants of health in poverty.

When the cause of a disease is poorly understood, societies tend to mythologize the disease or use it as a metaphor or symbol of whatever that culture considers evil. For example, until the bacterial cause of tuberculosis was discovered in 1882, experts variously ascribed the disease to heredity, a sedentary lifestyle, depressed mood, and overindulgence in sex, rich food, or alcohol, all of which were social ills at the time.

When a disease is caused by a pathogenic organism (e.g., when malaria is caused by Plasmodium), one should not confuse the pathogen (the cause of the disease) with disease itself. For example, West Nile virus (the pathogen) causes West Nile fever (the disease). The misuse of basic definitions in epidemiology is frequent in scientific publications.

Types of causes

A child rides a bicycle. An adult and a child walk a dog along a path in a green park..
Regular physical activity, such as riding a bicycle or walking, reduces the risk of lifestyle diseases.
Airborne
An airborne disease is any disease that is caused by pathogens and transmitted through the air.
Foodborne
Foodborne illness or food poisoning is any illness resulting from the consumption of food contaminated with pathogenic bacteria, toxins, viruses, prions or parasites.
Infectious
Infectious diseases, also known as transmissible diseases or communicable diseases, comprise clinically evident illness (i.e., characteristic medical signs or symptoms of disease) resulting from the infection, presence and growth of pathogenic biological agents in an individual host organism. Included in this category are contagious diseases – an infection, such as influenza or the common cold, that commonly spreads from one person to another – and communicable diseases – a disease that can spread from one person to another, but does not necessarily spread through everyday contact.
Lifestyle
A lifestyle disease is any disease that appears to increase in frequency as countries become more industrialized and people live longer, especially if the risk factors include behavioral choices like a sedentary lifestyle or a diet high in unhealthful foods such as refined carbohydrates, trans fats, or alcoholic beverages.
Non-communicable
A non-communicable disease is a medical condition or disease that is non-transmissible. Non-communicable diseases cannot be spread directly from one person to another. Heart disease and cancer are examples of non-communicable diseases in humans.

Prevention

Main article: Preventive medicine

Many diseases and disorders can be prevented through a variety of means. These include sanitation, proper nutrition, adequate exercise, vaccinations and other self-care and public health measures.

Treatments

Main article: Therapy

Medical therapies or treatments are efforts to cure or improve a disease or other health problems. In the medical field, therapy is synonymous with the word treatment. Among psychologists, the term may refer specifically to psychotherapy or "talk therapy". Common treatments include medications, surgery, medical devices, and self-care. Treatments may be provided by an organized health care system, or informally, by the patient or family members.

Preventive healthcare is a way to avoid an injury, sickness, or disease in the first place. A treatment or cure is applied after a medical problem has already started. A treatment attempts to improve or remove a problem, but treatments may not produce permanent cures, especially in chronic diseases. Cures are a subset of treatments that reverse diseases completely or end medical problems permanently. Many diseases that cannot be completely cured are still treatable. Pain management (also called pain medicine) is that branch of medicine employing an interdisciplinary approach to the relief of pain and improvement in the quality of life of those living with pain.

Treatment for medical emergencies must be provided promptly, often through an emergency department or, in less critical situations, through an urgent care facility.

Epidemiology

Main article: Epidemiology

Epidemiology is the study of the factors that cause or encourage diseases. Some diseases are more common in certain geographic areas, among people with certain genetic or socioeconomic characteristics, or at different times of the year.

Epidemiology is considered a cornerstone methodology of public health research and is highly regarded in evidence-based medicine for identifying risk factors for diseases. In the study of communicable and non-communicable diseases, the work of epidemiologists ranges from outbreak investigation to study design, data collection, and analysis including the development of statistical models to test hypotheses and the documentation of results for submission to peer-reviewed journals. Epidemiologists also study the interaction of diseases in a population, a condition known as a syndemic. Epidemiologists rely on a number of other scientific disciplines such as biology (to better understand disease processes), biostatistics (the current raw information available), Geographic Information Science (to store data and map disease patterns) and social science disciplines (to better understand proximate and distal risk factors). Epidemiology can help identify causes as well as guide prevention efforts.

In studying diseases, epidemiology faces the challenge of defining them. Especially for poorly understood diseases, different groups might use significantly different definitions. Without an agreed-on definition, different researchers may report different numbers of cases and characteristics of the disease.

Some morbidity databases are compiled with data supplied by states and territories health authorities, at national levels or larger scale (such as European Hospital Morbidity Database (HMDB)) which may contain hospital discharge data by detailed diagnosis, age and sex. The European HMDB data was submitted by European countries to the World Health Organization Regional Office for Europe.

Burdens of disease

Disease burden is the impact of a health problem in an area measured by financial cost, mortality, morbidity, or other indicators.

There are several measures used to quantify the burden imposed by diseases on people. The years of potential life lost (YPLL) is a simple estimate of the number of years that a person's life was shortened due to a disease. For example, if a person dies at the age of 65 from a disease, and would probably have lived until age 80 without that disease, then that disease has caused a loss of 15 years of potential life. YPLL measurements do not account for how disabled a person is before dying, so the measurement treats a person who dies suddenly and a person who died at the same age after decades of illness as equivalent. In 2004, the World Health Organization calculated that 932 million years of potential life were lost to premature death.

The quality-adjusted life year (QALY) and disability-adjusted life year (DALY) metrics are similar but take into account whether the person was healthy after diagnosis. In addition to the number of years lost due to premature death, these measurements add part of the years lost to being sick. Unlike YPLL, these measurements show the burden imposed on people who are very sick, but who live a normal lifespan. A disease that has high morbidity, but low mortality, has a high DALY and a low YPLL. In 2004, the World Health Organization calculated that 1.5 billion disability-adjusted life years were lost to disease and injury. In the developed world, heart disease and stroke cause the most loss of life, but neuropsychiatric conditions like major depressive disorder cause the most years lost to being sick.

Disease category Percent of all YPLLs lost, worldwide Percent of all DALYs lost, worldwide Percent of all YPLLs lost, Europe Percent of all DALYs lost, Europe Percent of all YPLLs lost, US and Canada Percent of all DALYs lost, US and Canada
Infectious and parasitic diseases, especially lower respiratory tract infections, diarrhea, AIDS, tuberculosis, and malaria 37% 26% 9% 6% 5% 3%
Neuropsychiatric conditions, e.g. depression 2% 13% 3% 19% 5% 28%
Injuries, especially motor vehicle accidents 14% 12% 18% 13% 18% 10%
Cardiovascular diseases, principally heart attacks and stroke 14% 10% 35% 23% 26% 14%
Premature birth and other perinatal deaths 11% 8% 4% 2% 3% 2%
Cancer 8% 5% 19% 11% 25% 13%

Society and culture

Obesity was a status symbol in Renaissance culture: "The Tuscan General Alessandro del Borro", attributed to Andrea Sacchi, 1645. It is now generally regarded as a disease.

How a society responds to diseases is the subject of medical sociology.

A condition may be considered a disease in some cultures or eras but not in others. For example, obesity can represent wealth and abundance, and is a status symbol in famine-prone areas and some places hard-hit by HIV/AIDS. Epilepsy is considered a sign of spiritual gifts among the Hmong people.

Sickness confers the social legitimization of certain benefits, such as illness benefits, work avoidance, and being looked after by others. The person who is sick takes on a social role called the sick role. A person who responds to a dreaded disease, such as cancer, in a culturally acceptable fashion may be publicly and privately honored with higher social status. In return for these benefits, the sick person is obligated to seek treatment and work to become well once more. As a comparison, consider pregnancy, which is not interpreted as a disease or sickness, even if the mother and baby may both benefit from medical care.

Most religions grant exceptions from religious duties to people who are sick. For example, one whose life would be endangered by fasting on Yom Kippur or during Ramadan is exempted from the requirement, or even forbidden from participating. People who are sick are also exempted from social duties. For example, ill health is the only socially acceptable reason for an American to refuse an invitation to the White House.

The identification of a condition as a disease, rather than as simply a variation of human structure or function, can have significant social or economic implications. The controversial recognition of diseases such as repetitive stress injury (RSI) and post-traumatic stress disorder (PTSD) has had a number of positive and negative effects on the financial and other responsibilities of governments, corporations, and institutions towards individuals, as well as on the individuals themselves. The social implication of viewing aging as a disease could be profound, though this classification is not yet widespread.

Lepers were people who were historically shunned because they had an infectious disease, and the term "leper" still evokes social stigma. Fear of disease can still be a widespread social phenomenon, though not all diseases evoke extreme social stigma.

Social standing and economic status affect health. Diseases of poverty are diseases that are associated with poverty and low social status; diseases of affluence are diseases that are associated with high social and economic status. Which diseases are associated with which states vary according to time, place, and technology. Some diseases, such as diabetes mellitus, may be associated with both poverty (poor food choices) and affluence (long lifespans and sedentary lifestyles), through different mechanisms. The term lifestyle diseases describes diseases associated with longevity and that are more common among older people. For example, cancer is far more common in societies in which most members live until they reach the age of 80 than in societies in which most members die before they reach the age of 50.

Language of disease

An illness narrative is a way of organizing a medical experience into a coherent story that illustrates the sick individual's personal experience.

People use metaphors to make sense of their experiences with disease. The metaphors move disease from an objective thing that exists to an affective experience. The most popular metaphors draw on military concepts: Disease is an enemy that must be feared, fought, battled, and routed. The patient or the healthcare provider is a warrior, rather than a passive victim or bystander. The agents of communicable diseases are invaders; non-communicable diseases constitute internal insurrection or civil war. Because the threat is urgent, perhaps a matter of life and death, unthinkably radical, even oppressive, measures are society's and the patient's moral duty as they courageously mobilize to struggle against destruction. The War on Cancer is an example of this metaphorical use of language. This language is empowering to some patients, but leaves others feeling like they are failures.

Another class of metaphors describes the experience of illness as a journey: The person travels to or from a place of disease, and changes himself, discovers new information, or increases his experience along the way. He may travel "on the road to recovery" or make changes to "get on the right track" or choose "pathways". Some are explicitly immigration-themed: the patient has been exiled from the home territory of health to the land of the ill, changing identity and relationships in the process. This language is more common among British healthcare professionals than the language of physical aggression.

Some metaphors are disease-specific. Slavery is a common metaphor for addictions: The alcoholic is enslaved by drink, and the smoker is captive to nicotine. Some cancer patients treat the loss of their hair from chemotherapy as a metonymy or metaphor for all the losses caused by the disease.

Some diseases are used as metaphors for social ills: "Cancer" is a common description for anything that is endemic and destructive in society, such as poverty, injustice, or racism. AIDS was seen as a divine judgment for moral decadence, and only by purging itself from the "pollution" of the "invader" could society become healthy again. More recently, when AIDS seemed less threatening, this type of emotive language was applied to avian flu and type 2 diabetes mellitus. Authors in the 19th century commonly used tuberculosis as a symbol and a metaphor for transcendence. People with the disease were portrayed in literature as having risen above daily life to become ephemeral objects of spiritual or artistic achievement. In the 20th century, after its cause was better understood, the same disease became the emblem of poverty, squalor, and other social problems.

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