Burden Snapshot Living Well Business Plan Stakeholder Meeting March - PowerPoint PPT Presentation

Oregon Chronic Disease Burden Snapshot Living Well Business Plan Stakeholder Meeting March 19, 2012 Bruce Gutelius, MD, MPH Deputy State Epidemiologist Oregon Public Health Division

Leading U.S. Causes of Death at the Turn of the 20 th and 21 st Centuries 1900 2000 pneumonia heart disease influenza cancer tuberculosis stroke lung disease diabetes

Current* Causes of Death in Oregon Chronic Lower Respiratory Disease Diabetes All Others Heart Disease & Stroke Cancer *2009 Oregon Vital Statistics data

Hospitalization Costs for Common Causes of Death in Oregon Condition Hospitalization Costs Heart Disease and Stroke $1 billion Cancers $483 million Chronic Lower Respiratory Disease $86 million Diabetes $80 million Total $1.7 billion Oregon Hospital Discharge Index, 2009

Behavior Disease Tobacco Use Heart Disease Stroke Physical Inactivity Cancers Diet Diabetes

Actual Causes of Death, 2003 Tobacco 7,000 Diet/Activity Patterns 1,400 Alcohol 1,000 Toxic Agents 700 Up to 39% of the 30,813 Microbial Agents 600 deaths were attributable to * behavioral causes Motor Vehicles 500 Firearms 400 Sexual behavior 200 Illicit Use of Drugs 200 0 1000 2000 3000 4000 5000 6000 7000 8000 Deaths Source: CD Summary, May 17, 2005, * Includes alcohol-related crashes Vol. 54, No. 10

Contribution to Percent of Health Care Overall Health Dollars Spent Tertiary Care 95 Secondary Care Primary Care Population Based 5 Community Health Services Social and Economic Conditions In Which People Can Be Healthy

Living Well Participants by Condition & Risk Factor, 2011 Self-Reported Condition Percent /Number or Risk Factor Reporting Arthritis/Fibromyalgia 48% (1,002) High blood pressure 42% (890) Depression 41% (869) Chronic pain 38% (789) High cholesterol 34% (714) Diabetes 32% (667) Asthma 16% (336) Heart disease 12% (260) Cancer 11% (225) Stroke 5% (107)

Figure 1. Arthritis among Adults in Oregon, 2009 Behavioral Risk Factor Surveillance System

Health Status Among Oregon Adults with and without Arthritis, 2009 Behavioral Risk Factor Surveillance System

Arthritis Hospitalizations in Oregon Hospitalization Type 2001 2009 Rheumatoid arthritis (RA) as 119 141 principal diagnosis Osteoarthritis (OA) as 6,208 11,072 principal diagnosis RA or OA involving 5,754 10,723 replacement of major joint Cost of hospitalizations $177,938,000 $397,956,245 involving joint replacement among those with RA or OA as principal diagnosis Oregon Hospital Discharge Index

Diabetes in Oregon In 2009: • One in 12 adult Oregonians have been diagnosed with diabetes (est. = 186,000). • Another 76,000 are likely undiagnosed • Direct medical costs for diabetes were > $1.6 billion • Total estimated medical costs for diabetes were > $2.2 billion Oregonians with diabetes: • Have increased rates of coronary heart disease, heart attacks and strokes • Are twice as likely to report depression as those without • Are four times more likely to report fair or poor general health instead of good or excellent Behavioral Risk Factor Surveillance System; Oregon Hospital Discharge Index American Diabetes Association. “Economic costs of diabetes in the U.S. in 2007”. Diabetes Care 2008 Mar;31(3):596 -615

Heart Attack, Stroke & Risk Factors In 2009: • 5.3% of Oregon adults (>168,000 people) had a history of heart attack or angina • 3.0% of Oregon adults (>95,000 people) were stroke survivors • 25% of Oregon adults (>950,000 people) had a history of hypertension • 31% of Oregon adults (>1.1 million people) had a history high cholesterol In 2009: • 6,052 heart attack hospitalizations cost >$250 million • 8,007 stroke hospitalizations cost >$219 million Source: Heart Disease & Stroke in Oregon – Update 2010. Oregon Public Health Division, Office of Disease Prevention & Epidemiology

Asthma in Oregon In 2009: • One in 10 Oregonians currently has asthma • Almost 300,000 adults • Over 84,000 children • Seventy Oregonians died of asthma during 2009 • There were 2,500 hospitalizations for asthma in Oregon, costing more than $34 million Behavioral Risk Factor Surveillance System; Oregon Vital Statistics data; Oregon Hospital Discharge Index

Percentage of Oregon Adults with Chronic Disease Risk Factors, by Gender, 2009 40 Percentage with Risk Factors Male 30 Female 20 10 0 At Risk for Heavy Drinker Fair or Poor Current 7+ Days High Blood Insufficient High Depression* Health Status Smoker Physical Pressure Sleep Cholesterol /Mental Health Not Good Source: Oregon Behavioral Risk Factor Surveillance System * At risk for depression uses data from 2007