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
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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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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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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
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Obesity Trends Among U.S. Adults1988
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Obesity Trends Among U.S. Adults1989
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Obesity Trends Among U.S. Adults1990
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Obesity Trends Among U.S. Adults1991
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Obesity Trends Among U.S. Adults1992
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Obesity Trends Among U.S. Adults1993
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Obesity Trends Among U.S. Adults1994
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Obesity Trends Among U.S. Adults1995
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Obesity Trends Among U.S. Adults1996
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Obesity Trends Among U.S. Adults1997
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Obesity Trends Among U.S. Adults1998
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Obesity Trends Among U.S. Adults1999
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Obesity Trends Among U.S. Adults2000
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Obesity Trends Among U.S. Adults2001
No Data 1519 2024 25
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Obesity Trends Among U.S. Adults2002
(BMI ?30, or 30 lbs overweight for 54 person)
No Data 1519 2024 25
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Obesity Trends Among U.S. Adults2003
No Data 1519 2024 25
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Obesity Trends Among U.S. Adults2004
No Data 1519 2024 25
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Obesity Trends Among U.S. Adults2004
No Data 1519 2024 25
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Obesity Trends Among U.S. Adults2005
No Data 1519 2024 2529
30
40
Percent of adults who are overweight or obese
67
2/3 of adults are overweight or obese
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Percent of adults who are overweight or obese
81
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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
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Diabetes Among Adults in the U.S.,BRFSS 1992
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Diabetes Among Adults in the U.S.,BRFSS 1994
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Diabetes Among Adults in the U.S.,BRFSS 1996
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Diabetes Among Adults in the U.S.,BRFSS 1997
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Diabetes Among Adults in the U.S.,BRFSS 1998
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Diabetes Among Adults in the U.S.,BRFSS 1999
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Diabetes Among Adults in the U.S.,BRFSS 2000
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Diabetes Among Adults in the U.S.,BRFSS 2001
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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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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
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Individual Behavior

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

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Individual
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16 oz
32 oz
44 oz
52 oz
64 oz
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Individual
Family
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Individual
Family
Worksite
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Individual
Family
Worksite
Community
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Somewhere in Florida
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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
95
Unhealthy behaviors
Health risks
Chronic disease
Health care costs
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• 1,500 to 3,000 in excess health care costs for
  each additional health risk

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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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Average 1997-1999 Medical Care Costs
N43,687
Source StayWell Health Management
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Highlight current expenditures

• 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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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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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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Build the Case for Worksite Health Promotion

• Show the connection between health and
  productivity.
• Expand the definition of productivity
• Highlight current organizational expenditures
• Compare yourself to norms and best practices.
• Commit to collaborate.

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Build the Case for Worksite Health Promotion

• Show the connection between health and
  productivity.
• Expand the definition of productivity
• Highlight current organizational expenditures
• Compare yourself to norms and best practices.
• Commit to collaborate.

Pray
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Successful Programs

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

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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
111
End of Life Benefits
Morbidity
Lifespan in years
10-20 Years
Morbidity
Lifespan in years
112
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