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 16 of GDP
US Military uses 3.2
3
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Infant Mortality
2001, General Accounting Office, 2004
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Life Expectancy in the World
WHO, 2004
6
Life Expectancy in the World
Japan
U.S.
WHO, 2004
7
Employer Health Benefits 2005 Annual Survey
8
Bureau of Labor Statistics
9
U.S. Health Care as a Percentage of the GDP
Today 16 of GDP
10
U.S. Health Care as a Percentage of the GDP
11
U.S. Health Care as a Percentage of the GDP
12
U.S. Health Care as a Percentage of the GDP
13
U.S. Health Care as a Percentage of the GDP
14
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
7490
Centers for Medicare and Medicaid Services
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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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Nobody spends someone else's money as carefully
as he spends his own
Milton Friedman
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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

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Portion of Total Health Care Costs Caused by
Chronic Diseases
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The Bottom Line
Unhealthy behaviors
Health risks
Chronic disease
Health care costs
23
Obesity Trends Among U.S. Adults1985
24
Obesity Trends Among U.S. Adults1986
25
Obesity Trends Among U.S. Adults1987
26
Obesity Trends Among U.S. Adults1988
27
Obesity Trends Among U.S. Adults1989
28
Obesity Trends Among U.S. Adults1990
29
Obesity Trends Among U.S. Adults1991
30
Obesity Trends Among U.S. Adults1992
31
Obesity Trends Among U.S. Adults1993
32
Obesity Trends Among U.S. Adults1994
33
Obesity Trends Among U.S. Adults1995
34
Obesity Trends Among U.S. Adults1996
35
Obesity Trends Among U.S. Adults1997
36
Obesity Trends Among U.S. Adults1998
37
Obesity Trends Among U.S. Adults1999
38
Obesity Trends Among U.S. Adults2000
39
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
41
Obesity Trends Among U.S. Adults2003
No Data lt10 1014
1519 2024 25
42
Obesity Trends Among U.S. Adults2004
No Data lt10 1014
1519 2024 25
43
Obesity Trends Among U.S. Adults2004
No Data lt10 1014
1519 2024 25
44
Obesity Trends Among U.S. Adults2005
No Data lt10 1014
1519 2024 2529
30
45
Obesity Trends Among U.S. Adults2006
No Data lt10 1014
1519 2024 2529
30
46
Percent of adults who are overweight or obese
67
2/3 of adults are overweight or obese
47
Percent of adults who are overweight or obese
81
48
Excess Body Weight and Reduction of Lifespan
-3.1
-3.3
-5.8
-7.1
Ann Intern Med. 200313824-32
49
What about employed adults?
50
Body Weight of U.S. Workers
51
Weight and Increased Health Care Costs
N45,687 Finkelstein, AJHP, 2005
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Weight and Increased Absenteeism(days)
N45,687 Finkelstein, AJHP, 2005
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Weight and Increased Absenteeism(dollars/yr)
N45,687 Finkelstein, AJHP, 2005
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Diabetes Among Adults in the U.S.,BRFSS 1990
55
Diabetes Among Adults in the U.S.,BRFSS 1992
56
Diabetes Among Adults in the U.S.,BRFSS 1994
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Diabetes Among Adults in the U.S.,BRFSS 1996
58
Diabetes Among Adults in the U.S.,BRFSS 1997
59
Diabetes Among Adults in the U.S.,BRFSS 1998
60
Diabetes Among Adults in the U.S.,BRFSS 1999
61
Diabetes Among Adults in the U.S.,BRFSS 2000
62
Diabetes Among Adults in the U.S.,BRFSS 2001
63
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
65
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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How did we get this way?
67
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5-a-day 1 million
Food Marketing 25 Billion
69
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Texas Double Whopper
72
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The Bottom Line
Unhealthy behaviors
Health risks
Chronic disease
Health care costs
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Employee Health
75
Typical Employee Distribution
30
50
20
76
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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Employee Health
79
Population Health Management
80
Population Health Management
PROACTIVE
REACTIVE
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1,500-3,500 in Excess Claims for Each
Additional Health Risk
Source Dee Edington, Health Management Research
Center
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Average 2003 Medical Care Costs
N1,706
Source StayWell Health Management
84
Average 1997-1999 Medical Care Costs
N43,687
Source StayWell Health Management
85
Days Absent in 2003
N941
Source StayWell Health Management
86
Percent with Workers Comp Claims in 2003
N23,916
Source StayWell Health Management
87
Percent with STD Claims in 2004
N23,916
Source StayWell Health Management
88
Fairview Health Services
-13
-2
15
N3,577
Source StayWell Health Management
89
DaimlerChrysler/UAW National Wellness Program
-4.0
0.0
4.0
N5,390
Source StayWell Health Management
90
Return on Investment (ROI)
32 studies
14 studies
91
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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
94
End of Life Benefits
Morbidity
Lifespan in years
10-20 Years
Morbidity
Lifespan in years
95
End of Life Benefits
Morbidity
Lifespan in years
96
End of Life Benefits
Morbidity
Lifespan in years
97
End of Life Benefits
Morbidity
Lifespan in years
98
End of Life Benefits
Morbidity
Lifespan in years
99
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