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

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An Unhealthy AmericaMilken InstituteCaliforniaCaliforniaDirect Costs2003 2023Avoidable Costs(US$ Billions)Projections - Level Projections - DifferencePRC (Thousands) Expenditure per PRC ($) Total Expenditure(US$ Billions) PRC (Thousands) Expenditure perPRC ($)Baseline Optimistic Baseline Optimistic Baseline Optimistic Absolute Percent Absolute Percent Absolute PercentTotal Expenditure(US$ Billions)Expenditure per PRC($)PRC(Thousands)Chronic DiseaseDiseaseExpenditures(Billions)PRC*(Millions)Cancer 48.1 10.6 4.5Breast Cancer 5.5 1.1 4.8Colon Cancer 3.9 0.3 11.5Lung Cancer 6.3 0.4 17.1Prostate Cancer 4.3 1.0 4.1Cancer 1,155 4,121 4.76 1,927 1,584 6,902 6,366 13.30 10.08 -343 -17.80 -536 -7.76 -3.22 -24.18Breast cancer 116 4,609 0.53 191 168 7,783 7,172 1.49 1.20 -24 -12.30 -611 -7.85 -0.29 -19.18Colon cancer 43 10,815 0.46 60 49 19,631 18,095 1.17 0.89 -11 -17.67 -1,536 -7.82 -0.28 -24.11Lung cancer 44 16,217 0.70 61 50 27,439 25,285 1.68 1.26 -11 -18.44 -2,154 -7.85 -0.42 -24.85Prostate cancer 108 3,755 0.40 199 156 6,459 5,952 1.28 0.93 -43 -21.48 -507 -7.84 -0.35 -27.64Other cancers 845 3,127 2.64 1,416 1,161 5,420 4,995 7.67 5.80 -255 -18.00 -425 -7.84 -1.87 -24.43Diabetes 1,573 1,904 2.99 2,586 2,242 3,281 3,023 8.48 6.78 -344 -13.30 -257 -7.84 -1.71 -20.10Heart disease 1,860 3,218 6.00 2,920 1,909 5,807 5,353 16.96 10.22 -1,011 -34.63 -454 -7.83 -6.74 -39.74Pulmonary conditions 5,301 826 4.37 6,982 6,001 1,462 1,348 10.21 8.09 -981 -14.05 -115 -7.83 -2.12 -20.79Hypertension 3,660 853 3.12 5,408 4,397 1,472 1,356 7.96 5.96 -1,011 -18.70 -115 -7.84 -2.00 -25.07Stroke 241 5,374 1.29 339 275 9,842 9,072 3.33 2.49 -64 -18.84 -770 -7.82 -0.84 -25.19Mental disorders 2,534 1,703 4.36 4,084 3,579 2,915 2,686 11.90 9.61 -504 -12.35 -229 -7.85 -2.29 -19.23Total 16,324 1,646 26.87 24,245 19,987 3,373 3,109 72.15 53.24 -4,258 -17.56 -264 -7.83 -18.91 -26.20Indirect Impacts* (US$ Billions)TotalLost Work Days Presenteeism Lost Work Days Presenteeism Projections - Level Projections - DifferenceBaseline Optimistic Baseline Optimistic Baseline Optimistic Baseline Optimistic Baseline Optimistic Absolute Percent2023Individual Caregiver2003TotalLevelChronic DiseaseCancer 29.60 5.49 4.48 92.75 55.14 0.40 0.32 8.97 5.83 107.60 65.78 -41.83 -38.87Breast cancer 3.31 0.61 0.54 10.39 6.59 0.04 0.04 1.01 0.70 12.06 7.86 -4.20 -34.84Colon cancer 2.90 0.48 0.40 8.17 4.86 0.03 0.03 0.79 0.51 9.48 5.80 -3.68 -38.82Lung cancer 4.40 0.69 0.56 11.72 6.90 0.05 0.04 1.13 0.73 13.59 8.24 -5.36 -39.41Prostate cancer 2.52 0.53 0.41 8.95 5.08 0.04 0.03 0.87 0.54 10.38 6.06 -4.33 -41.66Other cancers 16.47 3.17 2.58 53.52 31.71 0.23 0.19 5.18 3.36 62.09 37.83 -24.26 -39.08Diabetes 12.00 4.26 3.70 34.82 27.30 0.34 0.29 3.71 2.89 43.13 34.18 -8.95 -20.76Heart disease 10.17 6.78 4.43 24.64 13.47 0.67 0.43 2.38 1.30 34.47 19.64 -14.82 -43.01Asthma 10.09 5.76 4.95 20.51 16.67 0.42 0.36 1.99 1.62 28.69 23.60 -5.09 -17.74Hypertension 27.83 13.05 10.61 67.78 53.61 1.28 1.04 6.57 5.20 88.69 70.46 -18.23 -20.55Stroke 2.20 1.14 0.92 4.95 3.74 0.08 0.07 0.48 0.37 6.65 5.10 -1.55 -23.35Emotional disturbances 14.27 5.50 4.82 40.00 33.62 0.40 0.35 3.84 3.23 49.74 42.01 -7.73 -15.54Total 106.16 41.97 33.92 285.46 203.55 3.58 2.87 27.95 20.43 358.97 260.77 -98.20 -27.36* Based on Nominal GDPExpenditures/PRC(Thousands)Intergenerational Impacts2023 2023 2050 2050Projections - LevelProjections - Difference Projections - Level Projections - DifferenceOther 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 1.5Total 277.0 162.2 1.7PRC: Population Reporting ConditionPercentBaseline Optimistic Absolute Percent Baseline Optimistic Absolute1970 2003VariablesBachelor's degrees (percent) 13.40 28.93 34.12 36.35 2.23 6.54 42.38 49.74 7.36 17.36Capital stock (US$ Billions) 822.81 2564.25 5803.59 6016.15 212.56 3.64 20134.27 22092.73 1958.46 9.72Life expectancy at 65 (years) 15.52 19.29 21.09 22.31 1.22 5.78 24.12 26.45 2.33 9.64GDP* by state (US$ Billions) 243.85 1468.90 2450.61 2621.31 170.70 6.97 5188.22 6096.22 908.00 17.50*Based on Real GDP[ 191 ]
An Unhealthy AmericaMilken InstituteColoradoColoradoDirect Costs2003 2023Projections - Level Projections - DifferenceAvoidable Costs(US$ Billions)Expenditure perPRC ($)Total Expenditure(US$ Billions) PRC (Thousands)PRC (Thousands) Expenditure per PRC ($)Baseline Optimistic Baseline Optimistic Baseline Optimistic Absolute Percent Absolute Percent Absolute PercentTotal Expenditure(US$ Billions)Expenditure per PRC($)PRC(Thousands)Chronic DiseaseDiseaseExpenditures(Billions)PRC*(Millions)Cancer 48.1 10.6 4.5Breast Cancer 5.5 1.1 4.8Colon Cancer 3.9 0.3 11.5Lung Cancer 6.3 0.4 17.1Prostate Cancer 4.3 1.0 4.1Other Cancers 28.0 7.7 3.6Pulmonary Conditions 45.2 49.2 0.9Diabetes 27.1 13.7 2.0Hypertension 32.5 36.8 0.9Cancer 148 4,319 0.64 246 202 9,096 8,106 2.24 1.64 -44 -17.80 -990 -10.89 -0.60 -26.75Breast cancer 15 4,853 0.07 25 22 10,264 9,137 0.25 0.20 -3 -12.30 -1,128 -10.99 -0.06 -21.93Colon cancer 5 11,266 0.06 7 6 26,407 23,520 0.19 0.14 -1 -17.67 -2,887 -10.93 -0.05 -26.67Lung cancer 5 16,837 0.09 8 6 35,713 31,790 0.27 0.20 -1 -18.44 -3,923 -10.98 -0.07 -27.40Prostate cancer 14 3,932 0.05 26 20 8,539 7,602 0.22 0.16 -6 -21.48 -937 -10.97 -0.07 -30.09Other cancers 109 3,277 0.36 181 148 7,195 6,406 1.30 0.95 -33 -18.00 -789 -10.97 -0.35 -27.00Diabetes 132 1,904 0.25 205 178 4,146 3,691 0.85 0.66 -27 -13.30 -455 -10.97 -0.19 -22.81Heart disease 176 3,330 0.59 271 177 7,739 6,893 2.10 1.22 -94 -34.63 -846 -10.94 -0.88 -41.77Pulmonary conditions 672 842 0.56 873 750 1,904 1,696 1.66 1.27 -123 -14.05 -209 -10.95 -0.39 -23.47Hypertension 397 848 0.34 547 445 1,851 1,648 1.01 0.73 -102 -18.70 -203 -10.97 -0.28 -27.61Stroke 25 5,549 0.14 35 29 13,171 11,732 0.46 0.34 -7 -18.84 -1,439 -10.93 -0.13 -27.71Mental disorders 500 1,711 0.86 795 696 3,691 3,286 2.93 2.29 -98 -12.35 -405 -10.98 -0.64 -21.97Total 2,049 1,645 3.37 2,972 2,477 4,306 3,835 11.26 8.15 -495 -16.64 -471 -10.95 -3.11 -27.64Indirect Impacts* (US$ Billions)2023Individual Caregiver TotalLost Work Days Presenteeism Lost Work Days Presenteeism Projections - Level Projections - DifferenceBaseline Optimistic Baseline Optimistic Baseline Optimistic Baseline Optimistic Baseline Optimistic Absolute Percent2003TotalLevelChronic DiseaseCancer 3.79 0.70 0.57 11.85 7.05 0.051 0.041 1.15 0.75 13.75 8.41 -5.35 -38.88Breast cancer 0.42 0.08 0.07 1.33 0.85 0.006 0.005 0.13 0.09 1.55 1.01 -0.54 -34.85Colon cancer 0.36 0.06 0.05 1.03 0.61 0.004 0.004 0.10 0.06 1.20 0.73 -0.46 -38.80Lung cancer 0.55 0.08 0.07 1.43 0.84 0.006 0.005 0.14 0.09 1.66 1.01 -0.65 -39.42Prostate cancer 0.33 0.07 0.05 1.18 0.67 0.005 0.004 0.11 0.07 1.36 0.80 -0.57 -41.66Other cancers 2.13 0.41 0.33 6.88 4.08 0.029 0.024 0.67 0.43 7.98 4.86 -3.12 -39.08Diabetes 1.00 0.34 0.29 2.76 2.16 0.027 0.023 0.29 0.23 3.42 2.71 -0.71 -20.76Heart disease 0.96 0.63 0.41 2.29 1.25 0.062 0.040 0.22 0.12 3.20 1.82 -1.38 -43.01Asthma 1.28 0.72 0.62 2.56 2.08 0.052 0.045 0.25 0.20 3.59 2.95 -0.64 -17.74Hypertension 3.02 1.32 1.07 6.86 5.42 0.130 0.106 0.66 0.53 8.97 7.13 -1.84 -20.55Stroke 0.23 0.12 0.10 0.52 0.39 0.009 0.007 0.05 0.04 0.69 0.53 -0.16 -23.35Emotional disturbances 2.82 1.07 0.94 7.78 6.54 0.078 0.068 0.75 0.63 9.68 8.17 -1.50 -15.54Total 13.10 4.90 4.00 34.62 24.90 0.41 0.33 3.37 2.49 43.30 31.72 -11.58 -26.74* Based on Nominal GDPExpenditures/PRC(Thousands)Intergenerational Impacts2023 2023 2050 2050Projections - Level Projections - Difference Projections - Level Projections - DifferenceHeart Disease 64.7 19.2 3.4Stroke 13.6 2.4 5.6Mental Disorders 45.8 30.3 1.5Total 277.0 162.2 1.7PRC: Population Reporting ConditionBaseline Optimistic Absolute PercentBaseline Optimistic Absolute Percent1970 2003VariablesBachelor's degrees (percent) 14.90 35.63 41.03 43.71 2.68 6.52 50.41 59.18 8.77 17.40Capital stock (US$ Billions) 73.29 360.32 724.13 750.58 26.45 3.64 2396.88 2630.57 233.69 9.72Life expectancy at 65 (years) 15.71 18.83 20.59 21.78 1.19 5.77 23.54 25.81 2.27 9.66GDP* by state (US$ Billions) 18.39 189.96 274.35 293.76 19.41 7.07 516.42 607.41 90.99 17.62*Based on Real GDP[ 192 ]
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