Chronic Disease Challenges and Solutions

Transcription

1 Chronic Disease Challenges and Solutions Janet Collins, PhD Director, Division of Nutrition, Physical Activity and Obesity, CDC Council of State Governments Kansas City, MO September 18, 2013 Centers for Disease Control and Prevention Division of Nutrition, Physical Activity, and Obesity

2 International Life Expectancy and Cost Per Capita Sources: Jeff Koplan, MD Emory School of Public Health

3 Nearly Half of Americans Have At Least One Chronic Disease 44% million Americans-- have one or more chronic diseases Source: Paez, KA, Zhao, L, & Hwang, W. Rising out-of-pocket spending for chronic conditions: a ten year trend. Health Affairs, 28,1 (2009):15-25.

4 Leading Causes of Death - United States Heart Disease Cancer COPD Stroke Unintentional Injuries Alzheimer s disease Diabetes Pneumonia/influenza Kidney Disease Percentage (of all deaths) * Minino AM, Murphy SL, Xu J, Kochanek KD. Deaths: Final data for National vital statistics reports; vol 59 no 10. Hyattsville, MD: National Center for Health Statistics

5 Disabilities Arthritis is the number one cause of disability Stroke has left 1 million Americans with disabilities Heart Disease the leading cause of premature, permanent disability in the U.S. workforce Diabetes the leading cause of kidney failure and new blindness in adults

6 Health Disparities Heart disease death rates are 30% higher for African- Americans than whites; stroke death rates are 41% higher Diabetes is higher among American Indians and Alaska Natives (2.3 times), African Americans (1.6 times), and Hispanics (1.5 times)

7 Chronic Diseases Are Costly Chronic Diseases account for 75% of the $2.2 trillion annual U.S. medical care costs 96% of Medicare spending and 83% of Medicaid spending is for people with chronic conditions Sources: National Center for Health Statistics. Health, United States, Partnership for Solutions, Chronic Conditions: Making the Case for Ongoing Care. September 2004 Update.

8 Chronic Diseases and Related Risk Factors Heart Disease Cancer Chronic lower respiratory diseases Stroke Unintentional Injuries Alzheimer s disease Leading Causes of Death United States, 2008 Actual Causes of Death United States, 2000 Tobacco Poor diet/ Physical inactivity Alcohol consumption Microbial agents Toxic agents Motor vehicles Diabetes Firearms Pneumonia/influenza Kidney Disease Percentage (of all deaths) Sexual behavior Illicit drug use Percentage (of all deaths) * Minino AM, Murphy SL, Xu J, Kochanek KD. Deaths: Final data for National vital statistics reports; vol 59 no 10. Hyattsville, MD: National Center for Health Statistics Mokdad AH, Marks JS, Stroup DF, Gerberding JL. Actual causes of death in the United States, JAMA. 2004;291(10):

9 Trends in Tobacco Use and Lung Cancer Death Rates* in the US

10 Obesity Trends Among U.S. Adults 1990, 2000, No Data <10% 10% 14% 15% 19% 20% 24% 25% 29% 30%

11 Prevalence of Obesity and Diagnosed Diabetes Among U.S. Adults Obesity (BMI 30 kg/m 2 ) No Data <14.0% 14.0% 17.9% 18.0% 21.9% 22.0% 25.9% 26.0% Diabetes No Data <4.5% 4.5% 5.9% 6.0% 7.4% 7.5% 8.9% >9.0% CDC s Division of Diabetes Translation. National Diabetes Surveillance System available at

12 Percentage of Overweight* Children and Adolescents ; * >95th percentile for BMI by age and sex based on 2000 CDC BMI-for-age growth charts **Data are from for children 6-11 years of age and from for adolescents years of age (Source: National Center for Health Statistics) Ages 6-11 Ages

13 Data for Action: Sortable Stats

14 Opportunities for Health National, state and local approaches Engagement of sectors beyond health: transportation, agriculture, housing, education, planning and economic development Maximizing impact by focusing on risk factors that maintain health

15 Health Systems High-quality screening and referral for obesity, tobacco use, high blood pressure, diabetes, breast, cervical, and colorectal cancers Electronic health records Birthing hospitals with Baby Friendly policies

16 The Community Context: Place Matters

17 Policies: Smoke-free indoor air laws Laws in effect as of November 10, 2010 Source: CDC, Office on Smoking and Health. State Tobacco Activities Tracking and Evaluation (STATE) System.

18 Number of Adult Cigarette Smokers and Smoke-free Policy

19 Improving Nutrition Nutrition/beverage standards in childcare and worksites Healthy food retail Breastfeeding policies for hospitals and worksites

20 Increasing Physical Activity Complete streets Street design for active transportation Green space and parks Joint use agreements Zoning for mixed use

21 CDC Legislative Database

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