National Healthcare Disparities Report - LDI Health Economist

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Effectiveness of Care Lifestyle Modification Importance Mortality Number of deaths per year attributable to smoking (2000-2004)................................443,000 (MMWR, 2008) Chapter 2 Lifestyle Modification Prevalence Number of adult current cigarette smokers (2010)..............................................45.3 million (MMWR, 2011b) Number of obese adults (2007-2008)...................................................................72.5 million (MMWR, 2010b) Percentage of adults with no leisure-time physical activity (2009)......................................40% (Barnes, 2010) Percentage of children who are overweight ......................................................16.9% (Ogden & Carroll, 2010) Cost Total cost of smoking (2000-2004 est.)..................................................................$193 billion (MMWR, 2008) Total health care cost related to obesity (2008 est.)...............................................$147 billion (MMWR, 2008) Measures Unhealthy behaviors place many Americans at risk for a variety of diseases. Lifestyle practices account for more than 40% of the differences in health among individuals (Satcher & Higginbotham, 2008). A recent study examined the effects on incidence of coronary heart disease (CHD), stroke, diabetes, and cancer of four healthy lifestyles: never smoking, not being obese, engaging in at least 3.5 hours of physical activity per week, and eating a healthy diet (higher consumption of fruits, vegetables, and whole grain bread and lower consumption of red meat). Engaging in one healthy lifestyle compared with none cut the risk of developing these diseases in half while engaging in all four cut risk by 78%. Unfortunately, healthy lifestyle practices have declined over the past two decades (Ford, et al., 2009). Helping patients choose and maintain healthy lifestyles is a critical role of health care professionals. This year, the Lifestyle Modification section includes measures for both adults and children. Whenever children are mentioned in the section, the report is actually referencing the parents or guardians who were interviewed on behalf of the children. The NHDR tracks several quality measures for modifying unhealthy lifestyles, including the following six core report measures: n Counseling smokers to quit smoking. n Counseling obese adults about exercise. n Obese adults who do not exercise. n Counseling children about exercise. n Counseling obese adults about healthy eating. n Counseling children about healthy eating. 110 National Healthcare Disparities Report, 2011
Effectiveness of Care Findings Prevention: Counseling Smokers To Quit Smoking Smoking harms nearly every organ of the body and causes or exacerbates many diseases. Smoking causes more than 80% of deaths from lung cancer and more than 90% of deaths from chronic obstructive pulmonary disease (MMWR, 2008). Heart disease is the leading cause of death in the United States for both men and women (Hoyert, et al., 2005), with approximately 135,000 deaths due to smoking. Cigarette smoking increases the risk of dying from CHD two- to threefold (MMWR, 2008). Quitting smoking has immediate and long-term health benefits. The risk of a heart attack and death from CHD is reduced by 50% in the first year after smoking cessation. The risk of mortality declines most rapidly in the first 3 years after smoking cessation, taking about 3 to 5 years of abstaining from smoking for cardiovascular risk to disappear (HHS, 2010). Smoking is a modifiable risk factor, and health care providers can help encourage patients to change their behavior and quit smoking. Figure 2.44. Adult current smokers with a checkup in the last 12 months who received advice from a doctor to quit smoking, by race/ethnicity and income, 2002-2008 75 Total White Black Hispanic 75 Poor Low Income Middle Income High Income Chapter 2 Lifestyle Modification 70 70 Percent 65 Percent 65 60 60 55 55 50 Z 0 2002 2003 2004 2005 2006 2007 2008 50 Z 0 2002 2003 2004 2005 2006 2007 2008 Source: Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey, 2002-2008. Denominator: Civilian noninstitutionalized adult current smokers who had a checkup in the last 12 months. Note: Estimates are age adjusted to the 2000 standard population using three age groups: 18-44, 45-64, and 65 and over. White and Black are non-Hispanic groups. Hispanic includes all races. n From 2002 to 2008, there were no statistically significant changes in the percentage of current adult smokers who were advised to quit smoking overall or by race/ethnicity or income (Figure 2.44). National Healthcare Disparities Report, 2011 111
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