An Unhealthy America: The Economic Burden of ... - Milken Institute

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An Unhealthy AmericaMilken InstituteHowever, if we study per capita indirect impacts, the Northeast has the highest impact (except for hypertension andheart disease). The Midwest and South have almost identical impacts from hypertension and lead in regionaldistributions. The South and the Northeast feel the greatest impacts from heart disease. The West has consistently lowimpacts from all disease types, except for asthma 80 and emotional disturbances. Meanwhile, the South has the lowestper capita impacts from asthma and emotional disturbances. Studying the per capita state impacts offers a clearerpicture of regional distribution.We obtain state-level indirect impact estimates by applying the state PRC percentage of national PRC to the disease-specificnational indirect impact. Variations in historical indirect impacts between states depend primarily on two factors. Thefirst is related to variations in state wage rates and GDP, some of which are ranked in the next table.Wages and GDPWages and GDP - Per Capita, 2003Per Capita, 2003Top 5 States Expenditures PRC* Bottom 5 Expenditures/PRCStatesDisease Wages GDP (Billions) (Millions) Wages (Thousands) GDPCancerConnecticut Delaware48.1Montana10.6Montana4.5BreastNewCancerYork Connecticut5.5South Dakota1.1West Virginia4.8Colon Cancer 3.9 0.3 11.5New Jersey New York Mississippi North DakotaLung Cancer 6.3 0.4 17.1Massachusetts California North Dakota MississippiProstate Cancer 4.3 1.0 4.1California Alaska Idaho MaineOther Cancers 28.0 7.7 3.6Sources: BLS, BEAPulmonary Conditions 45.2 49.2 0.9Diabetes 27.1 13.7 2.0Hypertension 32.5 36.8 0.9The second factor Heart is PRC Disease on a per capita basis. The following 64.7 table 19.2 shows the five top- 3.4and bottom-ranked statesaccording to their 2003 Stroke per capita PRC totals. 13.6 2.4 5.6Mental Disorders 45.8 30.3 1.5Total 277.0 162.2 1.7PRC by Disease PRC by - Disease Per Capita, 2003PRC: Population Reporting Condition Per Capita, 2003States Cancer DiabetesExpendituresHypertension DiseasePRC* Expenditures/PRCStroke Disturbances AsthmaTop 5 Disease Arkansas Mississippi West Virginia (Billions) West Virginia (Millions) North Dakota (Thousands) Oregon KentuckyTennessee West Virginia Mississippi Oklahoma Arkansas Massachusetts MichiganCancer 48.1 10.6 4.5Mississippi Tennessee Alabama Mississippi Iowa Montana MaineKentucky Breast Cancer South Carolina Arkansas 5.5 Alabama 1.1 West Virginia Wisconsin 4.8 MassachusettsMaryland Colon Cancer Pennsylvania Tennessee 3.9Pennsylvania 0.3 Pennsylvania Minnesota 11.5 West VirginiaBottom 5 Arizona Colorado Utah Alaska Alaska Washington HawaiiLung Cancer 6.3 0.4 17.1New Mexico Alaska Colorado Utah Utah North Dakota NevadaProstate Hawaii Cancer Minnesota Alaska 4.3 Colorado 1.0 Colorado California 4.1New MexicoOther UtahCancersMontana New Mexico 28.0 Minnesota 7.7 New Mexico New 3.6York UtahAlaska Utah Montana New Mexico Arizona Mississippi WyomingSoures: MEPS, Milken InstitutePulmonary Conditions 45.2 49.2 0.9Diabetes 27.1 13.7 2.0Hypertension 32.5 36.8 0.9Variation among states Heart also Disease depends on the relative strength 64.7 of these 19.2 two factors. Taking 3.4cancer as an example, thefollowing figure explains Strokethe wage-based per capita impacts 13.6 in 2003. Generally, 2.4 states having 5.6 the highest impacts alsoreport high wage rates.MentalCaliforniaDisordersproves to be an exception45.8here. The30.3state has a high wage1.5rate, but a low per capitaTotal 277.0 162.2 1.7PRC for cancer. Illinois, Minnesota, and Michigan also have low per capita PRC totals for cancer. Since their wage ratesPRC: Population Reporting Conditionare above the median wage rate for all states, they fall into the highest tier.HeartEmotional80. Indirect impacts are based on NHIS data, which use the term “asthma,” a subset of pulmonary conditions.[ 133 ]
An Unhealthy AmericaMilken InstituteWage-Based per Capita Indirect Impacts of Cancer, 2003DiseaseExpenditures(Billions)PRC*(Millions)Expenditures/PRC(Thousands)Cancer 48.1 10.6 4.5Breast Cancer 5.5 1.1 4.8Colon Cancer 3.9 0.3 11.5Lung Cancer 6.3 0.4 17.1Prostate Cancer 4.3 1.0 4.1Other Cancers 28.0 7.7 3.6Pulmonary Conditions 45.2 49.2 0.9Diabetes 27.1 13.7 2.0Hypertension 32.5 36.8 0.9Heart Disease 64.7 19.2 3.4Stroke 13.6 2.4 5.6Mental Disorders 45.8 30.3 1.5LowestTotal 277.0 162.2 Third Tier 1.7PRC: Population Reporting ConditionSecond TierHighestA comparison of the historical indirect impacts of diabetes (2003) does not show much difference. The following figureillustrates the wage-based per capita indirect impacts of diabetes for 2003.Wage-Based per Capita Indirect Impacts of Diabetes, 2003DiseaseExpenditures(Billions)PRC*(Millions)Expenditures/PRC(Thousands)Cancer 48.1 10.6 4.5Breast Cancer 5.5 1.1 4.8Colon Cancer 3.9 0.3 11.5Lung Cancer 6.3 0.4 17.1Prostate Cancer 4.3 1.0 4.1Other Cancers 28.0 7.7 3.6Pulmonary Conditions 45.2 49.2 0.9Diabetes 27.1 13.7 2.0Hypertension 32.5 36.8 0.9Heart Disease 64.7 19.2 3.4Stroke 13.6 2.4 5.6Mental Disorders 45.8 30.3 1.5LowestTotal 277.0 162.2 Third Tier 1.7PRC: Population Reporting ConditionSecond TierHighestThe chief difference between diabetes and cancer is that most of the Southern states move into second tier. Tennesseeand Mississippi move to the highest tier. Other states climbing up the ladder to the highest tier include Indiana, Ohio,and Pennsylvania. On the brighter side, Minnesota moves down to the third tier in impact, even though state wage ratesare high. If we refer back to an earlier table describing per capita PRC, we see that Minnesota is among the bottom five[ 134 ]
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