North Carolina Supplemental Cardiovascular Disease Prevention Project: Design and Objectives

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U.S. Health Care as a Percentage of the GDP
Today 15 of GDP
US Military uses 3.2
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Infant Mortality
2001, General Accounting Office, 2004
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Life Expectancy in the World
WHO, 2004
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Life Expectancy in the World
Japan
U.S.
WHO, 2004
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U.S. Health Care as a Percentage of the GDP
Today 15 of GDP
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U.S. Health Care as a Percentage of the GDP
9
U.S. Health Care as a Percentage of the GDP
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U.S. Health Care as a Percentage of the GDP
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U.S. Health Care as a Percentage of the GDP
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Doctor Day, January 1, 2226
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• Pharmaceutical companies
• Canada
• Malpractice and law suits
• High tech equipment
• Medical profession salaries
• Administration
• Waste/fraud
• Poor lifestyles

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Employer Health Benefits 2005 Annual Survey
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Bureau of Labor Statistics
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A Few Facts About Health Care

• The cost health care will continue to rise
• All health care costs are paid by individuals
• Lower health care cost for companies and
  individuals is a function of shifting who pays a
  greater portion

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Portion of Health Care Caused by Preventable
Chronic Diseases
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The Bottom Line
Unhealthy behaviors
Health risks
Chronic disease
Health care costs
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Obesity Trends Among U.S. Adults1985
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Obesity Trends Among U.S. Adults1986
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Obesity Trends Among U.S. Adults1987
23
Obesity Trends Among U.S. Adults1988
24
Obesity Trends Among U.S. Adults1989
25
Obesity Trends Among U.S. Adults1990
26
Obesity Trends Among U.S. Adults1991
27
Obesity Trends Among U.S. Adults1992
28
Obesity Trends Among U.S. Adults1993
29
Obesity Trends Among U.S. Adults1994
30
Obesity Trends Among U.S. Adults1995
31
Obesity Trends Among U.S. Adults1996
32
Obesity Trends Among U.S. Adults1997
33
Obesity Trends Among U.S. Adults1998
34
Obesity Trends Among U.S. Adults1999
35
Obesity Trends Among U.S. Adults2000
36
Obesity Trends Among U.S. Adults2001
No Data lt10 1014
1519 2024 25
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Obesity Trends Among U.S. Adults2002
(BMI ?30, or 30 lbs overweight for 54 person)
No Data lt10 1014
1519 2024 25
38
Obesity Trends Among U.S. Adults2003
No Data lt10 1014
1519 2024 25
39
Obesity Trends Among U.S. Adults2004
No Data lt10 1014
1519 2024 25
40
Obesity Trends Among U.S. Adults2004
No Data lt10 1014
1519 2024 25
41
Obesity Trends Among U.S. Adults2005
No Data lt10 1014
1519 2024 2529
30
42
Percent of adults who are overweight or obese
67
2/3 of adults are overweight or obese
43
Percent of adults who are overweight or obese
81
44
Excess Body Weight and Reduction of Lifespan
-3.1
-3.3
-5.8
-7.1
Ann Intern Med. 200313824-32
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Diabetes Among Adults in the U.S.,BRFSS 1990
46
Diabetes Among Adults in the U.S.,BRFSS 1992
47
Diabetes Among Adults in the U.S.,BRFSS 1994
48
Diabetes Among Adults in the U.S.,BRFSS 1996
49
Diabetes Among Adults in the U.S.,BRFSS 1997
50
Diabetes Among Adults in the U.S.,BRFSS 1998
51
Diabetes Among Adults in the U.S.,BRFSS 1999
52
Diabetes Among Adults in the U.S.,BRFSS 2000
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Diabetes Among Adults in the U.S.,BRFSS 2001
54
Diabetes and Reduction in Lifespan
-14.3 yrs
-11.6 yrs
JAMA 20032901884-1890
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Lifetime Risk of Diabetes for Children Born in
2000
49
Venkat Narayan, JAMA 20032901884
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Lifetime Risk for Chronic Diseases
49
NCI 2006 Lancet 199935389
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How People Died in 2005
Cancer 24
Accidents Suicide Infections Kidney failure Lung
failure Others 40
Cardiovascular Disease 36
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How People Died in 2005
CVD
Cancer
Other
Up to 70 of all causes of death are lifestyle
related and preventable
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Percent of Chronic Diseases That Are Caused by
Poor Lifestyle
91
82
71
70
Sources Stampfer, 2000 Platz, 2000 Hu, 2001
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National prevalence of health risks
80
78
CDC, BRFSS, 2002
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How did we get this way?
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5-a-day 1 million
Food Marketing 25 Billion
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Texas Double Whopper
67
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Individual Behavior

• Awareness/education
• Motivation
• Tools, strategies
• Policy and environment

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Individual
70
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16 oz
32 oz
44 oz
52 oz
64 oz
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Individual
Family
78
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Individual
Family
Worksite
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Individual
Family
Worksite
Community
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Nation/ world
Individual
Family
Worksite
Community
91
Percent of adults who are overweight or obese by
country
US 74
Russia 50
Percent
India 16
WHO, 2007
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Nation/ world
Individual
Family
Worksite
Community
93
Employee Health
94
Typical Employee Distribution
30
50
20
95
Typical Employee Cost Distribution
15 of Employees 85 of Costs
85 of Employees 15 of Costs
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Typical Employee Cost Distribution
59 of next years cost group
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Employee Health
98
Health and Productivity Management (HPM)
99
1,500-3,500 in Excess Claims for Each
Additional Health Risk
Source Dee Edington, Health Management Research
Center
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Average 2003 Medical Care Costs
N1,706
Source StayWell Health Management
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Days Absent in 2003
N941
Source StayWell Health Management
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Percent with Workers Comp Claims in 2003
N23,916
Source StayWell Health Management
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Percent with STD Claims in 2004
N23,916
Source StayWell Health Management
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Evidence That SupportsWorksite Health Promotion
Activities

• David Anderson, Ph.D. StayWell Health Management

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Return on Investment (ROI)
32 studies
14 studies
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Highlight current expenditures directed at health
and productivity management programs

• medical benefits
• short and long term disability
• workers compensation
• disease management
• demand management
• absence management
• human resources

• employee relations
• staff recruitment and training
• employee assistance programs
• work/life
• organizational development
• health promotion

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Leading by Example
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Commit to collaborate

• No more silos
• Form a wellness committee
• Work across departments
• Safety
• Medical
• EAP
• Facilities
• Benefits, etc

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Successful Programs

• Educate / create awareness
• Motivate
• Build skills
• Change the employees environment

110
Fairview Health Services
-13
-2
15
N3,577
Source StayWell Health Management
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DaimlerChrysler/UAW National Wellness Program
-4.0
0.0
4.0
N5,390
Source StayWell Health Management
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Why Should I Care?
Morbidity
Lifespan in years
76
0
critical illness
Ann Intern Med, 2003139455-459
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Morbidity
Lifespan in years
0
?
76
86
critical illness
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End of Life Benefits
Morbidity
Lifespan in years
10-20 Years
Morbidity
Lifespan in years
118
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