During the past century in the United States, advances in public health and health care have increased life expectancy by approximately 30 years and led to dramatic changes in the leading causes of death (1). As chronic Diseases became the leading causes of illness and death in the United States by the middle of the 20th century (2), public health researchers began to shift their focus to identifying their complex and interrelated causes. In addition, researchers began to study ways to prevent and control chronic Diseases through clinical and community-based interventions. This increasing importance and interest in chronic Diseases led to the establishment of the National Center for Chronic Disease Prevention and Health Promotion at CDC in 1988 and is reflected in the publication of articles about chronic Diseases in MMWR, with few if any articles before 1980, increasing to about 20% of articles since 1990

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