Debates about globalization and health focus almost exclusively on communicable diseases. However, chronic diseases— especially cardiovascular diseases, cancer, chronic respiratory diseases and diabetes—now constitute the bulk of the global burden of disease. This chapter provides updated information on trends in the major macro-determinants of chronic diseases such as urbanization, globalization, and aging. Further, it summarizes evidence of the impact of known risk factors for chronic diseases such as tobacco, diet/nutrition, physical activity, and alcohol. Reasons for failure to invest in prevention are outlined and the importance of implementing available knowledge about preventive and therapeutic strategies is stressed.