North Carolina Supplemental Cardiovascular Disease Prevention Project: Design and Objectives

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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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Infant Mortality
2001, General Accounting Office, 2004
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Life Expectancy in the World
WHO, 2004
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Life Expectancy in the World
Japan
U.S.
WHO, 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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• Pharmaceutical companies
• Canada
• Malpractice and law suits
• High tech equipment
• Medical profession salaries
• Administration
• Waste/fraud
• Poor lifestyles

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1,200 CEOs were asked What cost is your
companys greatest concern?
Business Roundtable Survey, 2006
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Employer Health Benefits 2005 Annual Survey
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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

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Portion of Health Care Caused by Preventable
Chronic Diseases
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The Bottom Line
Unhealthy behaviors
Health risks
Chronic disease
Health care costs
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Obesity Trends Among U.S. Adults1985
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Obesity Trends Among U.S. Adults1986
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Obesity Trends Among U.S. Adults1987
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Obesity Trends Among U.S. Adults1988
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Obesity Trends Among U.S. Adults1989
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Obesity Trends Among U.S. Adults1990
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Obesity Trends Among U.S. Adults1991
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Obesity Trends Among U.S. Adults1992
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Obesity Trends Among U.S. Adults1993
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Obesity Trends Among U.S. Adults1994
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Obesity Trends Among U.S. Adults1995
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Obesity Trends Among U.S. Adults1996
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Obesity Trends Among U.S. Adults1997
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Obesity Trends Among U.S. Adults1998
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Obesity Trends Among U.S. Adults1999
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Obesity Trends Among U.S. Adults2000
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Obesity Trends Among U.S. Adults2001
No Data lt10 1014
1519 2024 25
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Obesity Trends Among U.S. Adults2002
(BMI ?30, or 30 lbs overweight for 54 person)
No Data lt10 1014
1519 2024 25
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Obesity Trends Among U.S. Adults2003
No Data lt10 1014
1519 2024 25
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Obesity Trends Among U.S. Adults2004
No Data lt10 1014
1519 2024 25
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Obesity Trends Among U.S. Adults2004
No Data lt10 1014
1519 2024 25
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Obesity Trends Among U.S. Adults2005
No Data lt10 1014
1519 2024 2529
30
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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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Percent of adults who are overweight or obese
81
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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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Diabetes and Reduction in Lifespan
-14.3 yrs
-11.6 yrs
JAMA 20032901884-1890
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Lifetime Risk of Diabetes for Children Born in
2000
49
Venkat Narayan, JAMA 20032901884
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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
91
82
71
70
Sources Stampfer, 2000 Platz, 2000 Hu, 2001
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National prevalence of health risks
80
78
CDC, BRFSS, 2002
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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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Texas Double Whopper
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Employee Health
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Typical Employee Distribution
30
50
20
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Typical Employee Cost Distribution
15 of Employees 85 of Costs
85 of Employees 15 of Costs
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Typical Employee Cost Distribution
59 of next years cost group
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Health and Productivity Management (HPM)
78
Average 2003 Medical Care Costs
N1,706
Source StayWell Health Management
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Average 1997-1999 Medical Care Costs
N43,687
Source StayWell Health Management
80
Days Absent in 2003
N941
Source StayWell Health Management
81
Percent with Workers Comp Claims in 2003
N23,916
Source StayWell Health Management
82
Percent with STD Claims in 2004
N23,916
Source StayWell Health Management
83
Fairview Health Services
-13
-2
15
N3,577
Source StayWell Health Management
84
DaimlerChrysler/UAW National Wellness Program
-4.0
0.0
4.0
N5,390
Source StayWell Health Management
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Return on Investment (ROI)
32 studies
14 studies
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What caused these savings?
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The Bottom Line
Unhealthy behaviors
Health risks
Chronic disease
Health care costs
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Its All About Behavior Change

• Educate
• Motivate
• Build skills
• Change the environment

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Individual
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16 oz
32 oz
44 oz
52 oz
64 oz
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Childhood Obesity

• 27 of children are overweight (CDC, 2003)

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Individual
Family
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Individual
Family
Worksite
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Individual
Family
Worksite
Community
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Nation/ world
Individual
Family
Worksite
Community
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Percent of adults who are overweight or obese by
country
US 74
Russia 50
Percent
India 16
WHO, 2007
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Why Should I Care?
Morbidity
Lifespan in years
76
0
critical illness
Ann Intern Med, 2003139455-459
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Morbidity
Lifespan in years
0
?
76
86
critical illness
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End of Life Benefits
Morbidity
Lifespan in years
10-20 Years
Morbidity
Lifespan in years
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