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

An Unhealthy AmericaMilken InstituteII: Where We Are Headed: Two Potential ScenariosOver the next twenty years, the choices we make as individuals and as a country about strategies to prevent andmanage chronic disease will have an enormous impact on the nation’s health and well-being. To appreciate theimportance and value of acting now to prevent disease and continue to strive for health-care improvements in themost prevalent diseases, we construct two scenarios. The first is a “business-as-usual” baseline scenario thatassumes current trends continue into the future. We then compare this with an optimistic scenario that assumesimprovements in health due to more comprehensive prevention and lifestyle changes, as well as modestimprovements in early intervention. The optimistic scenario assumes that while the population continues to age,the country takes some of the steps outlined by the Department of Health and Human Services, including improvednutrition, increased physical activity, maintenance of a healthy weight, and regular health screenings, and thatthere is a slight improvement in early detection, screening, and development of medical advances. 19Our Current Course: Baseline Projections to 2023To construct our baseline projection for future rates of disease and associated treatment costs, we developestimates assuming that current trends will continue to hold for:• the aging population• behavioral risk factors and other demographic influences• improvement in early detection and medical innovationhealth-care cost changes.•20Because the risk of developing each of the seven diseases increases with age, the aging population is expected todrive a substantial increase in the number of cases of chronic disease over the next twenty years, even if other riskfactors remain unchanged. For example, in the case of prostate cancer, the ratio of the incidence rate per 100,000population in the 65–74 age group (936.1) to the 0–49 age group (5.6) is an astronomical 167.2, the highest of allcancers. This means that a man between 65 and 74Prostate cancer is so common thatmen hope to die at an advancedage with the disease eventually,but not because of it.is 167.2 times more likely to develop prostatecancer than a male under 50. In short, prostatecancer is so common that men hope to die at anadvanced age with the disease eventually, but notbecause of it. The U.S. Census Bureau projects a risein the 65-and-over share of the population from12.4 percent in 2003 to 17.4 percent by 2023 (figure 6).[ 9 ]