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 20th and 21st Centuries

2000 heart disease cancer stroke lung disease diabetes 1900 pneumonia influenza tuberculosis

Current* Causes of Death in Oregon

Heart Disease & Stroke All Others Chronic Lower Respiratory Disease Diabetes Cancer

*2009 Oregon Vital Statistics data

Oregon Hospital Discharge Index, 2009

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

Behavior Disease

Heart Disease Stroke Cancers Diabetes Tobacco Use Physical Inactivity Diet

Actual Causes of Death, 2003

200 200 400 500 600 700 1,000 1,400 7,000 1000 2000 3000 4000 5000 6000 7000 8000 Illicit Use of Drugs Sexual behavior Firearms Motor Vehicles Microbial Agents Toxic Agents Alcohol Diet/Activity Patterns Tobacco Deaths

* Includes alcohol-related crashes Source: CD Summary, May 17, 2005,

• Vol. 54, No. 10

Up to 39% of the 30,813 deaths were attributable to behavioral causes

*

Tertiary Care Secondary Care Primary Care Population Based Community Health Services Social and Economic Conditions In Which People Can Be Healthy

Percent of Health Care Dollars Spent 95 5 Contribution to Overall Health

Self-Reported Condition

• r Risk Factor

Percent /Number 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)

Living Well Participants by Condition & Risk Factor, 2011

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

Hospitalization Type 2001 2009

Rheumatoid arthritis (RA) as principal diagnosis

119 141

Osteoarthritis (OA) as principal diagnosis

6,208 11,072

RA or OA involving replacement of major joint

5,754 10,723

Cost of hospitalizations involving joint replacement among those with RA or OA as principal diagnosis

$177,938,000 $397,956,245

Arthritis Hospitalizations in Oregon

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
• f 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

Source: Oregon Behavioral Risk Factor Surveillance System * At risk for depression uses data from 2007

10 20 30 40

At Risk for Depression* Heavy Drinker Fair or Poor Health Status Current Smoker 7+ Days Physical /Mental Health Not Good High Blood Pressure Insufficient Sleep High Cholesterol

Percentage with Risk Factors Male Female