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Chronic diseases have taken center stage in the ever-changing field of global health, accounting for approximately 60% of all deaths that occur around the world. The conventional approach to these diseases has largely employed individual culpability, motivating prevention strategies that include dietary modification as well as physical activity. On the other hand, this traditional approach has resulted in criticisms from Ernesto Moralez, who has served as a public health educator and researcher and has championed an innovative approach to public health that was inspired by successful strategies being used in controlling infectious diseases.

Infectious illnesses, like tuberculosis and pneumonia, have killed millions of people throughout the entirety of human history. However, the course of public health took a drastic turn in the early 20th century, when the industrialized countries started to undergo a demographic transition and hence experienced an increased prevalence of chronic diseases such as heart disease, cancer, and diabetes, among others. Although they lack infectious or communicable traits, these conditions can never be underscored in their contributions to global mortality.

The current focus on prevention, which incorporates changes in lifestyle and practices, as well as pharmaceutical interventions, does not therefore tackle the root causes responsible for chronic diseases. Ernesto Moralez insists that public health officials cannot rely upon this approach, because attempts at persuading individuals to adopt healthier habits are usually made too late during the progression of the disease.

Ernesto Moralez seems to urge us to borrow from effective strategies in infectious disease control. By focusing on vectors such as mosquitoes and ticks in infectious disease control, Moralez sees parallels that can be applied to chronic diseases. Analysis from disease clustering indicates that there is a need to address the root causes, more so in the low-income areas where health care is scarce, unemployment is high, and where neighborhood factors are not conducive to the health of affected individuals.

Ernesto Moralez recommends zoning policies that would limit the selling of tobacco and vaping products since the promotion and ease of acquisition of these products correlate with disease clusters. Rather than placing blame solely on personal choices, Moralez points toward changing the environmental factors that contribute to such choices. Because of the greater number of tobacco and liquor stores in low-income neighborhoods, the disease pattern is reminiscent of a contagion.

From Moralez’s point of view, an emphasis on prevention confers inappropriate moral responsibility to citizens without sufficient attention to the limits within which choices can be exercised. By tackling underlying reasons and adopting policies that limit the presence of harmful products within certain neighborhoods, Moralez believes systemic reform will result in longer-lasting change.

Ernesto Moralez has made efforts to infuse this paradigm shift into public health education. He has woven it in by incorporating this change into his curriculum and the introductory public health textbook he co-authored, which is due out in 2024. By transmitting this other way of seeing things, Moralez seeks to transform the very modality through which future public health professionals think about reducing chronic diseases.