三个地方有疑问

In conclusion, spine pain plays an enormous role in both the physical and financial well-being of our population. Despite an incredible financial investment, our current approaches to treatment have failed to decrease its prevalence and are not sustainable. As providers, it is our responsibility to recognize the barriers of education, to work to increase communication, and to promote cultural transformation to improve outcomes for our patients and our country. If we are able to produce a decrease in the prevalence of spine pain by even 1%, we will have accomplished more than we have in the past 18 years, and this should serve as motivation for dynamic change.

总之，脊柱疼痛对人类的身体健康和经济状况都有巨大的影响。尽管有令人难以置信的财政投资，但目前的治疗方法未能降低其患病率，且不可持续。作为医疗服务提供者，我们有责任认识到教育的不足，应努力增加沟通，并促进文化转型，以提高患者和国家的健康水平。如果我们能够使脊柱疼痛的患病率减少即使只有1%，我们也将取得比过去18年更大的成就，这应该成为发展的动力。

role这里翻译成影响是不是更好？

什么不可持续，是治疗方法还是治疗效果

dynamic change.？发展？动态变化？互动改变？

谢谢