The Culprit and The Cure

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The Culprit and The Cure

• Steven Aldana, Ph.D.

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Obesity Trends Among U.S. AdultsBRFSS, 1985
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Obesity Trends Among U.S. AdultsBRFSS, 1986
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Obesity Trends Among U.S. AdultsBRFSS, 1987
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Obesity Trends Among U.S. AdultsBRFSS, 1988
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Obesity Trends Among U.S. AdultsBRFSS, 1989
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Obesity Trends Among U.S. AdultsBRFSS, 1990
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Obesity Trends Among U.S. AdultsBRFSS, 1991
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Obesity Trends Among U.S. AdultsBRFSS, 1992
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Obesity Trends Among U.S. AdultsBRFSS, 1993
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Obesity Trends Among U.S. AdultsBRFSS, 1994
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Obesity Trends Among U.S. AdultsBRFSS, 1995
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Obesity Trends Among U.S. AdultsBRFSS, 1996
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Obesity Trends Among U.S. AdultsBRFSS, 1997
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Obesity Trends Among U.S. AdultsBRFSS, 1998
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Obesity Trends Among U.S. AdultsBRFSS, 1999
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Obesity Trends Among U.S. AdultsBRFSS, 2000
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Obesity Trends Among U.S. AdultsBRFSS, 2001
No Data lt10 1014
1519 2024 25
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Obesity Trends Among U.S. AdultsBRFSS, 2002
(BMI ?30, or 30 lbs overweight for 54 person)
No Data lt10 1014
1519 2024 25
Source Behavioral Risk Factor Surveillance
System, CDC
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Obesity Trends Among U.S. AdultsBRFSS, 2003
No Data lt10 1014
1519 2024 25
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Obesity Trends Among U.S. AdultsBRFSS, 2004
No Data lt10 1014
1519 2024 25
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Percent of adults who are overweight or obese
67
2/3 of adults are overweight or obese
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Excess Body Weight and Reduction of Lifespan
-3.1
-3.3
-5.8
-7.1
Ann Intern Med. 200313824-32
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Diabetes Among Adults in the U.S.,BRFSS 1990
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Diabetes Among Adults in the U.S.,BRFSS 1992
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Diabetes Among Adults in the U.S.,BRFSS 1994
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Diabetes Among Adults in the U.S.,BRFSS 1996
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Diabetes Among Adults in the U.S.,BRFSS 1997
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Diabetes Among Adults in the U.S.,BRFSS 1998
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Diabetes Among Adults in the U.S.,BRFSS 1999
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Diabetes Among Adults in the U.S.,BRFSS 2000
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Diabetes Among Adults in the U.S.,BRFSS 2001
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Lifetime Risk of Diabetes for Children Born in
2000
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Venkat Narayan, JAMA 20032901884
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Diabetes and Reduction in Lifespan
-14.3 yrs
-11.6 yrs
JAMA 20032901884-1890
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Life Expectancy in the U.S.
2-5 year decline in life expectancy
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U.S. Health Care as a Percentage of the GDP
Today 15 of GDP
US Military uses 3.2
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In 2001, US Spends More Than the Rest
2001, General Accounting Office, 2004
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US Has the Worst Health Outcomes
2001, General Accounting Office, 2004
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U.S. Health Care as a Percentage of the GDP
Today 15 of GDP
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U.S. Health Care as a Percentage of the GDP
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U.S. Health Care as a Percentage of the GDP
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U.S. Health Care as a Percentage of the GDP
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U.S. Health Care as a Percentage of the GDP
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Doctor Day, January 1, 2226
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Health Care Costs for Each Person
Centers for Medicare and Medicaid Services
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Health Care Costs for Each Person
6,423
Centers for Medicare and Medicaid Services
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A Few Facts About Health Care

• The cost health care will continue to rise
• All health care costs are paid by individuals
• Lower health care cost for companies and
  individuals is a function of shifting who pays a
  greater portion
• Lifestyle change can impact health care costs,
  but it is not the solution

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Whats Driving the Costs Up?

• Just Follow the Money

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• Pharmaceutical companies
• Canada
• Malpractice and law suits
• High tech equipment
• Medical profession salaries
• Administration
• Waste/fraud

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Health and Productivity Management (HPM)
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Employee Health and Productivity Continuum
Unhealthy Low Productivity
Healthy High Productivity
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Unhealthy Low Productivity
Healthy High Productivity
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Health and Productivity Management (HPM)
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Health and Productivity Management (HPM)
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Health and Productivity Management (HPM)
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Portion of Health Care That is Related to Health
Risk
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Health Care Costs by Health Risks
StayWell data analyzed by U of Michigan (N
43,687)
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-4
4
N5390
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-13
-2
15
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What is the Impact of Lifestyle on Employee Costs

• absenteeism
• health care costs
• disability
• workers compensation
• productivity

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Health Promotion Programs and Health Care Costs

• Only 4 of the 32 studies failed to report lower
  health care costs
• Cost benefit ratios from this literature ranged
  from a low of 2.3 to a high of 5.9 (average was
  3.48)

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Its All About Behavior Change
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How People Died in 2003
Cancer 24
Accidents Suicide Infections Kidney failure Lung
failure Others 40
Cardiovascular Disease 36
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How People Died in 2003
CVD
Cancer
Other
Up to 70 of all causes of death are lifestyle
related and preventable
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Percent of Chronic Diseases That Are Caused by
Poor Lifestyle
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Sources Stampfer, 2000 Platz, 2000 Hu, 2001
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How did we get this way?
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5-a-day 1 million
Food Marketing 25 Billion
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• Behavior Change Simplified

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• Educate
• Motivate
• Build skills
• Change the environment

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Our Current (Western) Lifestyle

• Little Physical Activity
• Red meat
• Processed meat
• Butter
• Potatoes
• Refined grains
• High fat dairy foods

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Difference in Years of Life Between High and Low
Health Risk
Frazier, Arch Intern Med. 20011611645
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Low vs High Health Risks and Life Expectancy
(cumulative)
Age
Frazier et al,Arch Intern Med. 20011611645
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Life Span in 7th Day Adventists
?
?
Fraser et al. Arch Intern Med, 20011611645-1652
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Life Span in 10,000 California Mormons
?
?
Mormon High Priests and Wives, Enstrom, UCLA, 1989
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What Can I Expect if I Reduce My Health Risks?
10 to 20 years of extended, high-quality living
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Compression of Morbidity
Morbidity
Lifespan in years
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0
Chronic disability
Ann Intern Med, 2003139455-459
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Compression of Morbidity
Morbidity
Lifespan in years
0
?
76
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Chronic disability
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End of Life Benefits
Morbidity
Lifespan in years
10-20 Years
Morbidity
Lifespan in years
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