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

An Unhealthy AmericaMilken InstituteTwo Examples of the Impacts of Key Behavioral Risk FactorsOver the past quarter century, Americans have grown more aware of the links between healthy living and long-termhealth. Yet we nonetheless face several preventable “epidemics” that threaten to overwhelm the health-care systemand result in catastrophic losses to U.S. GDP.Obesity (and its links to diabetes, hypertension, and other chronic diseases) and smoking are the most dangerous riskfactors. Lower obesity rates could result in a savings of $59.7 billion in treatment costs. The productivity gains betweenbusiness-as-usual (our baseline scenarios) and improved behaviors (the optimistic scenarios) come to another $253.9billion. In terms of smoking-related conditions, we find that if the current health trends continue, the country stands tolose as much as $110.4 billion by 2023. The following charts look at our projections of cases, costs, and diminishedeconomic returns due to lost workdays and lowered productivity.2023 Projected Differences Due to Obesity2023 Projected Differences Changes Due Relative to Obesity to Baseline - Changes Relative to BaselinePRC Expenditures Total Expenditure PRC* Expenditures/PRCTotal Indirect Impact*Absolute AbsoluteAbsoluteDisease(Billions) (Millions) (Thousands)Chronic Disease (Thousands) (US$ Billions) Percent (US$ Billions) PercentCancer Cancer -1,800 48.1 -12.4 10.6 -11.4 -72.2 4.5 -12.1Breast Breast Cancer Cancer -211 5.5 -1.7 1.1 -12.3 -9.4 4.8 -12.4Colon Colon Cancer Cancer -19 3.9 -0.4 0.3-4.8 -2.2 11.5 -4.9Prostate Lung Cancer Cancer -393 6.3 -2.8 0.4 -21.5 -14.9 17.1 -21.4Other Cancers -1,178 -7.5 -10.2 -45.7 -11.3Prostate Cancer 4.3 1.0 4.1Diabetes -2,791 -9.6 -13.3 -42.8 -13.4Heart Disease Other Cancers -4,429 28.0 -27.6 7.7 -20.0 -45.63.6-20.0Hypertension Pulmonary Conditions -5,690 45.2 -8.9 49.2 -12.0 -91.20.9-12.0StrokeDiabetes -112 27.1 -1.2 13.7-4.2 -2.1 2.0 -4.2Total -14,824 -59.7 -14.2 -253.9 -13.0Hypertension 32.5 36.8 0.9* Based on Nominal GDPHeart Disease 64.7 19.2 3.4Stroke 13.6 2.4 5.6Mental Disorders 45.8 30.3 1.5Total 2023 Disease Difference 277.0 Due 162.2 to Smoking2023 Disease Difference 1.7Changes Due to Relative Smoking to Baseline - Changes Relative to BaselinePRC: Population Reporting ConditionPRC Expenditures Total Expenditure PRC* Expenditures/PRCTotal Indirect Impact*Absolute AbsoluteAbsoluteDisease(Billions) (Millions) (Thousands)Chronic Disease (Thousands) (US$ Billions) Percent (US$ Billions) PercentCancer Cancer -615 48.1 -6.7 10.6-7.2 -29.3 4.5 -5.9Colon Breast Cancer Cancer -47 5.5 -1.0 1.1 -11.4 -4.1 4.8 -8.8Lung Cancer Colon Cancer -91 3.9 -2.7 0.3 -18.4 -12.3 11.5 -16.1Other Cancers Lung Cancer -477 6.3 -3.0 0.4-4.4 -12.9 17.1 -3.5Heart Disease -1,352 -8.4 -7.1 -13.9 -7.1Prostate Cancer 4.3 1.0 4.1Pulmonary Conditions** -7,256 -12.0 -11.6 -28.5 -11.6Stroke Other Cancers -393 28.0 -4.2 7.7 -13.4 -7.3 3.6 -13.4Total Pulmonary Conditions -9,617 45.2 -31.4 49.2-9.0 -79.0.9-8.0* Based Diabetes on Nominal GDP** Only Asthma for Indirect ImpactHypertension27.132.513.736.82.00.9Heart Disease 64.7 19.2 3.4In the course of this Stroke study, we have built numerous 13.6 models to simulate 2.4 the effects of 5.6 prevention, screening, andMental Disorders 45.8 30.3 1.5treatment of chronic disease, not just in today’s numbers, but in a series of projections spanning decades outward forTotal 277.0 162.2 1.7all fifty states. We have also introduced a model that offers a powerful demonstration of the ways in which health canPRC: Population Reporting Conditioninfluence—both positively and negatively—overall economic growth.[ 165 ]