DEATH RATES
• United States 100%
• Missouri 100%
• Northwest Missouri 100%
0
100,000
200,000
300,000
400,000
500,000
600,000
700,000
800,000
Hea
rt D
isea
se
Can
cer
Stro
ke
Res
pira
tory
Dis
ease
Acc
iden
ts
Dia
bete
s
Pne
umon
ia/F
lu
Alz
heim
er's
Kid
ney
Dis
ease
Sept
icem
ia
0%
5%
10%
15%
20%
25%
30%
Number of Deaths Percent of Total Deaths
Total Number of Deaths = 2,443,908
2003 Leading Causes of Death in the US “Public Health Impact”
1990 & 2004 Leading Actual Causes of Death in the US—“Human Behaviors”
0.0%2.0%4.0%6.0%8.0%
10.0%12.0%14.0%16.0%18.0%20.0%
To
ba
cc
o
Po
or
Die
t/In
ac
tiv
ity
/Ob
es
ity
Alc
oh
ol
Co
ns
um
pti
on
Mic
rob
ial
Ag
en
ts
To
xic
Ag
en
ts
Mo
tor
Ve
hic
les
Fir
ea
rms
Se
xu
al
Be
ha
vio
r
Illi
cit
Dru
g U
se
1990 2004
Source: CDC
Causes of Death and Major Illnesses in the U.S.
Source: CDCP, PHS, DHHS
0%
10%
20%
30%
40%
50%
60%
Lifestyle Access to Care Genetics Environment
Risky BusinessLarge numbers of Americans cling to lifestyles that greatly increase their risk of cancer,
heart disease, and diabetes. Over the past decade, the percentage of those who smoke has remained stubbornly unchanged, while more than one out of four has remained a couch
potato and nearly twice as many have become obese.
Source: National Center for Chronic Disease Prevention and Health Promotion Behavioral Risk Factor Surveillance System 2007
0.0%
5.0%
10.0%
15.0%
20.0%
25.0%
30.0%
35.0%
40.0%
45.0%
1997 2001 2007 1997 2001 2007 1997 2001 2007
Current Smokers No Leisure Time Physical Activity Obese
U.S. Missouri St. Joseph
Source: Behavioral Risk Factor Surveillance System, CDC.
19961991
Obesity Trends* Among U.S. AdultsBRFSS, 1991, 1996, 2004
(*BMI 30, or about 30 lbs overweight for 5’4” person)
No Data <10% 10% – 14% 15% – 19% 20% –24% >25%
2004
No Data <4% 4%-6% 6%-8% 8%-10% >10%
Source:Mokdadet al., Diabetes Care2000;23:1278-83; J Am Med Assoc2001;286:10.
Diabetes Trends* Among Adults in the U.S.,(Includes Gestational Diabetes)
BRFSS, 1990,1995 and 20011990 1995
2001
Baseline 20th Century Annual Morbidity and 1999 Provisional Morbidity from Nine Diseases with Vaccines Recommended Before 1990 for Universal Use in Children –
United States
Diseases
Smallpox
Diptheria
Pertussis
Tetanus
Poliomyelitis
Measles
Mumps
Rubella
Congenital rubella
Haemophilus Influenza b
Baseline 20th
Century Annual
Morbidity
48,164
175,885
147,271
1,314
16,316
503,282
152,209
47,745
823
20,000
1999 Provisional
Morbidity
0
1
6,031
33
0
86
352
238
8
163
Percent
Decrease
100%
100%
95.9%
97.5%
100%
100%
99.8%
99.5%
99.0%
99.2%
Current & Future Health Challenges
% Overweight Boys1963 = 4.0% 1994 = 11.8% 2000 = 16%
% Overweight Girls1963 = 4.5% 1994 = 11.0% 2000 = 14.5%
• Early childhood education.
• Low birth weight/very low birth weight.
• High school completion.
• Teen birth rates.
• Motor vehicle crashes (with and without alcohol/drug factors).
Asthma>40 per 1000 children in 1982
>62 per 1000 children in 1996
Infant and Child Health
• Healthy weight.– % overweight in 1971 = 4%– % overweight in 1994 = 10.5%– % overweight in 2000 = 15.3%
• Smoking.• Violence.• Suicide.• Sexually transmitted disease.
The Dilemma
• So why are we afraid for our kids health?– Modern children’s health issues are preventable, yet
scary because of the illusion that science can fix everything like it did in the last century.
• Health happens at the intersection where science meets social, spiritual, educational, economic, family, behavioral and community circumstances.
• We can’t give a shot to become a better parent, or immunize a 14 year old to make wise choices. Science has limits!
The USA Ranks 37th in World Health.World Health Report 2000 (health system and performance in all member states, ranked by eight measures) places the USA 37th in overall system performance.
Missouri Ranks 38th in USA Health.There are several indicators to compare on health status. For the 2004 CDC BRFSS question: “How would you rate your health in general?” 84.1% of Missourians said excellent, very good, or good to the question. Missouri
ranks 38th in the nation. The top states are Minnesota and New Hampshire.
People 2004 USA
Deaths 2,397,615
Heart, Cancer, Stroke, Pulmonary,
Diabetes…
2000 Actual Causes of Death “Human Behaviors”
Tobacco, Obesity, Diet, Inactivity, Alcohol, Motor Vehicle…
Root Causes “Human Conditions”
Stress, Anger, Poverty, Economics, Education Levels, Depression, Unemployment, Broken Families,
Environmental Factors, Emptiness, Hopelessness, Disconnectedness
Provider Response & Individual Accountability
Individual Accountability
Individual & Community Accountability
Healthcare Policy
Public Health & Organizational Policy
Community, Economic, Education, & Social Policy
Adapted From: National Civic League, Healthy Communities Conference 1994 Updated With CDC Data & Best Practices
Policy
HEALTHY COMMUNITIES
The two key determinates of the health
status of a population:
• Education Levels
• Affluence (Jobs)
“If I had known I would live this long, I would have taken better care of myself.”
Mickey Mantle
0
.5
1.0
1.5
2.0
2.5
3.0
3.5
4.0
4.5
2002 2004 2006 2008 2010 2012 2014 2016
Year
Annual healthexpenditures
(trillions)Official CMS projectionof healthcare cost growth
With No Changes, Projected Cost Growth in Health Care Is Large
2.1 Trillion(100%)
10 Years
HEALTHY COMMUNITIESIDEAL APPROACH
• Individuals assume responsibility (maximum extent possible) for their own and their families’ health– Healthy behaviors
– Personal financial responsibility for health
• Health insurance designed to promote and encourage healthy life styles and wise buying practices– Encourage preventive care
– Design benefits to influence positive behavior
– Reward healthy behaviors
– Universal coverage and portability
HEALTHY COMMUNITIESIDEAL APPROACH
• Higher premiums for non-managed care – lower premiums for managed care.
• Comprehensive integrated health provider (like Heartland) that exist to serve the community interest
Top Related