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

More documents

Recommendations

Info

An Unhealthy AmericaMilken InstituteBehavioral and Other Risk Factor Assumptions 32Numbers of Overweight/Obese AmericansOverweight and obese Americans face far-reaching consequences for their quality and length of life. The risingnumbers of overweight and obese Americans threaten to create an epidemic of chronic disease. The stronglinks between high body mass index (BMI) and diabetes, cancer, cardiovascular disease, and psychologicaldisturbances (including depression) mean that treatment costs are likely to escalate.Obesity was responsible for some 400,000 deaths in 2004, according to a CDC report, and will overtake smokingas the top preventable cause of death in the country. 33 Increases in body mass index and obesity have beenobserved across all racial, ethnic, gender, and age groups. Hispanic and African-American girls and womenhave seen the greatest increases in obesity, but the nationwide total of overweight and obese children hasdoubled since 1980 and tripled for adolescents. Among children, type 2 diabetes has increased tenfold since1980. 34 Among adults, the prevalence of obesity has soared from 14.4 percent in the period1976–1980 to 30.5 percent by 1999–2000. Over the same time, the population share of overweight individualsincreased from 46 percent to 64.5 percent. More than one-third of American women over 45 are obese. 35To obtain historical times-series information (1984–2003) at the national level consistent with state-level data,we refer to the CDC’s Behavioral Risk Factor Surveillance System (BRFSS). The BRFSS was established toovercome the deficiencies of national studies since state health agencies assume the primary roles of targetingresources to reduce behavior risks. However, the BFRSS data contain self-reported bias, and true BMI, particularlyfor females, is often under-reported.Baseline assumptions: The baseline scenario calls for the rate of obesity to moderate and begin to plateauaround 2015. We assume that the prevalence of overweight conditions grows at about half the historicalincrease, or 43.6 percent, in 2023. Obesity increases to 28.7 percent in 2023.Optimistic assumptions: A change in unhealthy behaviors, combined with therapeutic-compound effects, willsignificantly influence the upward trends of obesity. Wellness programs will affect BMI through diet, exercise,leisure activities, and education. Overweight prevalence will drop to 32.2 percent of the population in 2023,and obesity will fall to 19.4 percent.32. Other risk factors, such as red meat consumption, and diets high in sodium and fat, were examined but were notincluded in our models due to limited data.33. Cigarette Smoking-Attributable Morbidity: United States, 2000. Morbidity and Mortality Weekly Report. 2003; 52(35):842-844. See: http://www.cdc.fog/mmwr/preview/mmwrhtml/mm5235a4.htm.34. National Center for Chronic Disease Prevention and Health Promotion. Obesity Trends: U.S. Obesity Trends 1985–2003.Atlanta, Georgia: Centers for Disease Control and Prevention. See: http://www.cdc.gov/nccdphp/ dnpa/obesity/trend/maps/index.htm35. American Obesity Association. www.obesity.org.[ 75 ]
An Unhealthy AmericaMilken InstituteObesity (BMI>30) - As Percent of PopulationObesity (BMI>30)As Percent of PopulationPercentExpenditures PRC* Expenditures/PRC30Disease(Billions) (Millions) (Thousands)BaselineCancer Optimistic 48.1 10.6 4.5Breast 25 Cancer 5.5 1.1 4.8Colon Cancer 3.9 0.3 11.5Lung 20Cancer Prostate Cancer6.34.30.41.017.14.1Other Cancers 28.0 7.7 3.6Pulmonary 15 ConditionsDiabetes45.227.149.213.70.92.0Hypertension 10Heart Disease32.564.736.819.20.93.4Stroke History 13.6Forecast2.4 5.6Mental5Disorders 1988 1993 1998 45.8 2003 2008 30.3 2013 2018 2023 1.5Total Sources: BRFSS, Milken Institute 277.0 162.2 1.7PRC: Population Reporting ConditionWe assume that male and female obesity will follow the same trends. Obesity prevalence will decline to 19.7percent for men and 19.2 percent for women in 2023.SmokingCigarette smoking, like obesity, serves as a primary behavioral risk factor for various chronic diseases, namely,lung and colon cancer, heart disease, stroke, and asthma. Substantial taxation and other recent increases intobacco prices have helped cut smoking rates. But the most significant drops in smoking took place after 1966,in the wake of the surgeon general’s 1964 report on the negative health effects of tobacco. 36 In 1966, adultsmokers constituted 43 percent of the population. From 1985 to 2004, adult smoking fell from 30.1 percent to20.9 percent, a drop of 31 percent. In the forty years from 1965 to 2004, the decline in smoking was slightlymore than 50 percent. 37Baseline assumptions: Smoking declines at the same rate it fell between 1985 and 2005. The percentage of “atrisk” smokers (individuals who smoke at least 100 cigarettes over their lifetime and who still smoke) will fall to19 percent in 2023. 38Optimistic assumptions: Smoking declines at the same rate it dropped between 1965 and 2004. In 2023,approximately 15.4 percent of the adult population will smoke.36. Jasper Womach, “U.S. Tobacco Production, Consumption, and Export Trends,” (Congressional Research Services, 2003).37. “Smoking 101 Fact Sheet,” American Lung Association, http://www.lungusa.org/site/pp.asp?c=dvLUK9O0E&b=39853.(Accessed May 3, 2007).38. Smoking statistics come from a BRFSS survey question.[ 76 ]
Page 8:
An Unhealthy AmericaMilken Institut
Page 11 and 12:
iitime of the analysis show that th
Page 13 and 14:
Existing estimates of the economic
Page 16 and 17:
Page 18 and 19:
Page 20:
Page 23 and 24:
Page 25 and 26:
Page 28 and 29:
Page 30 and 31:
Page 32 and 33:
Page 34 and 35:
Page 36:
Page 39 and 40: An Unhealthy AmericaMilken Institut
Page 44: An Unhealthy AmericaMilken Institut
Page 138 and 139:
Page 140 and 141:
Page 142 and 143:
Page 144 and 145:
Page 146 and 147:
Page 148 and 149:
Page 150 and 151:
Page 152 and 153:
Page 154 and 155:
Page 156 and 157:
Page 160 and 161:
Page 162:
Page 165 and 166:
Page 167 and 168:
Page 169 and 170:
Page 171 and 172:
Page 173 and 174:
Page 175 and 176:
Page 177 and 178:
Page 180 and 181:
Page 182 and 183:
Page 184 and 185:
Page 186 and 187:
Page 188 and 189:
Page 190 and 191:
Page 192 and 193:
Page 194 and 195:
Page 196 and 197:
Page 198 and 199:
Page 200 and 201:
Page 202 and 203:
Page 204 and 205:
Page 206 and 207:
Page 208 and 209:
Page 210 and 211:
Page 212 and 213:
Page 214 and 215:
Page 216 and 217:
Page 218 and 219:
Page 220 and 221:
Page 222 and 223:
Page 224 and 225:
Page 226 and 227:
Page 228 and 229:
Page 230 and 231:
Page 232 and 233:
Page 234 and 235:
Page 236 and 237:
Page 238 and 239:
Page 240 and 241:
Page 242 and 243:
Page 244 and 245:
Page 246 and 247:
Page 248 and 249:
Page 250 and 251:
Page 252:
1250 Fourth Street • Santa Monica
show all

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

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?