In 1988, the U.S. Centers for Disease Control and Prevention (CDC) established the Chronic Disease Division to target cancer, birth defect, and health issues related to the environment.

As chronic diseases became the leading causes of illness and death in the United States by the middle of the 20th century, 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.

The discovery that smoking caused lung cancer can be viewed as the first and most important advance in chronic disease etiology. The results from the first studies of lung cancer were summarized in the first Surgeon General’s Report on Smoking and Health, published in 1964.