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 16 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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Health Care Costs for Each Person
Centers for Medicare and Medicaid Services
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Health Care Costs for Each Person
7490
Centers for Medicare and Medicaid Services
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Nobody spends someone else's money as carefully
as he spends his own
Milton Friedman
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Employer Health Benefits 2005 Annual Survey
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Bureau of Labor Statistics
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U.S. Health Care as a Percentage of the GDP
Today 16 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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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 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
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Obesity Trends Among U.S. Adults2003
No Data lt10 1014
1519 2024 25
40
Obesity Trends Among U.S. Adults2004
No Data lt10 1014
1519 2024 25
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Obesity Trends Among U.S. Adults2004
No Data lt10 1014
1519 2024 25
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Obesity Trends Among U.S. Adults2005
No Data lt10 1014
1519 2024 2529
30
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Obesity Trends Among U.S. Adults2006
No Data lt10 1014
1519 2024 2529
30
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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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Life Expectancy in the U.S.
2-5 year decline in life expectancy
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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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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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The Bottom Line
Unhealthy behaviors
Health risks
Chronic disease
Health care costs
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Employee Population Health Management
75
Well
Risk
Urgent
Disease
76
Well
Risk
Urgent
Disease
25
77
Well
Risk
Urgent
Disease
78
Well
Risk
Disease
Urgent
5
79
Well
Risk
Urgent
Disease
80
Well
Risk
Urgent
Disease
60
81
Well
Risk
Urgent
Disease
82
Well
Risk
Urgent
Disease
10
83
Well
Risk
Urgent
Disease
84
Well
Risk
Urgent
Disease
10
60
5
25
85
Well
Risk
Urgent
Disease
10
60
5
25
Top 15 of employees with disease 85 of costs
86
Well
Risk
Urgent
Disease
10
60
5
25
The rest 15 of costs
87
Disease
25
88
Disease
59 Turnover
89
Urgent
5
90
Risk
60
91
Well
10
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Who Needs Help Adopting and Maintain Healthy
Behaviors?
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Who Needs Help Adopting and Maintain Healthy
Behaviors?
100
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Dont Forget Productivity Losses Absenteeism
and Presenteeism
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Whats the ROI on
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Whats the ROI on

• Lifestyle coaching
• Disability management
• EAP
• Nurse hotline
• Case management
• Disease management

• Wellness
• Self help materials
• Onsite health clinics
• Web based info
• Flu shots
• Preventive screenings

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Independent Evidence That They Are Cost
Effective

• Lifestyle coaching
• Disability management
• EAP
• Nurse hotline
• Case management
• Disease management

• Wellness
• Self help materials
• Onsite health clinics
• Web based info
• Flu shots
• Preventive screenings

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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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Average 1997-1999 Medical Care Costs
N43,687
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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Return on Investment (ROI)
32 studies
14 studies
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• Pharmaceutical companies
• Malpractice and law suits
• High tech equipment
• Medical profession salaries
• Administration
• Waste/fraud

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Productivity losses Recruitment and
retention Absenteeism Workers comp STD and LTD
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Relative Employee Costs Due to Poor Health
Health Care Costs
Workers Comp
Absenteeism
Presenteeism
Edington, Burton. A Practical Approach to
Occupational and Environmental Medicine
(McCunney). 140-152. 2003.
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Productivity losses

Presenteeism
Absenteeism

unable to concentrate poor quality of
interpersonal communication the need to repeat a
job work more slowly
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Value of Lost Productivity
Your Annual Health Care Costs
3 X
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Evidenced based Wellness Programming
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Culture of Health

• 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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• PUT PICTURE OF TOOL KIT HERE

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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
149
End of Life Benefits
Morbidity
Lifespan in years
150
End of Life Benefits
Morbidity
Lifespan in years
151
End of Life Benefits
Morbidity
Lifespan in years
152
End of Life Benefits
Morbidity
Lifespan in years
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