It is no surprise that chronic disease costs, but the burden of chronic disease is staggering: pegged at $1 trillion, according to the Milken Institute’s latest report, An Unhealthy America: the Economic Burden of Chronic Disease. This report highlights the sobering statistics about this critical cost driver in our system.

The chronic diseases most burdensome to the economy including pulmonary conditions, hypertension, mental disorders, heart disease, diabetes, and cancer.
What factors are contributing to America’s heavy chronic disease burden? The Milken team identifies them as:

> Air quality
> Alcohol
> Cholesterol
> Illicit drug use
> Obesity (BMI ? 30)
> Overweight (BMI between 25 and 30)
> Physicial activity (lack thereof), and
> Smoking.

To divert ourselves from the current path — which would be a dramatic increase in chronic disease by 2023 — there are two immediate actions we can take to reduce the human and economic cost of chronic disease in America:

• To institute more incentives to promote prevention and early intervention; and,
• To commit ourselves as a nation to achieve healthy body weight.

Here’s the math according to the Milken Institute:
United States Economic Impact 2003 Annual Costs in Billions

Treatment Expenditures $277.0B
Lost Productivity $1,046.7B
Total Costs $1,323.7B

The lost productivity number should prove a compelling argument to employers for providing strong incentives to employees for weight reduction, smoking cessation, and exercise programs.

Obesity is the prime culprit among all of the risk factors. A decline in obesity rates could avoid tens of billions of dollars in treatment costs and increased productivity into the hundreds of billions of dollars.

The study breaks down the data by each of the 50 states, which yields some fascinating insights useful for state public health departments to use for strategic planning and budget allocation. Here is a map based on the report data. Note the red region which runs roughly from Maine southwest to Oklahoma. That’s the cluster of states with the highest rates of the seven common chronic diseases. Take West Virginia, in last place at #50: the level of heart disease in the state is nearly 50% greater than the U.S. average. Massachusetts has a dramatically higher rate of mental disorders, and in Kentucky, the rate of pulmonary conditions is 42% higher than the national average.

This study was jointly sponsored by The Milken Institute and The Partnership to Fight Chronic Disease, a coalition of patients, providers, community organizations, business and labor groups, and health policy experts. The study was funded by a grant from PhRMA, the Pharmaceutical Research Manufacturers of America (the prescription drug lobby).

Health Populi’s Hot Points: A bulk of America’s health care costs are attributable to conditions that are largely preventable and manageable. What can be done: more effective primary care, prevention and early diagnosis; lifestyle changes; and, access to prescription drugs, a bulk of which, with the exception of cancer, are available in generic form today (note: Wal-Mart, among other pharmacies, is selling many of these generics @ $4 a script). In the words of that great political philosopher, Pogo, “We have met the enemy and he is us.” Getting obesity rates down is Job 1. Quitting smoking is Job 1A. Staying on therapeutic drug regimens is 1B. Embracing and appreciating the blessing that is Health is Job 0.

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