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Chronic Disease in Kentucky Why it should matter to you!. Rice C. Leach, M.D. Commissioner Kentucky Department for Public Health May 8, 2003. Public Health Concerns. Kentucky’s general health status Obesity over the last 20 years Conditions Diabetes Cardiovascular disease (heart attacks)
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Chronic Disease in KentuckyWhy it should matter to you! Rice C. Leach, M.D. Commissioner Kentucky Department for Public Health May 8, 2003 Active Living: Leadership in Kentucky
Public Health Concerns • Kentucky’s general health status • Obesity over the last 20 years • Conditions • Diabetes • Cardiovascular disease (heart attacks) • Arthritis • Cancer • Birth Defects (heart, neural tube) • Strokes Active Living: Leadership in Kentucky
Causes • Obesity • Too many calories • High fat content • Not enough fiber (fruits and vegetables) • Lack of Exercise • Video games and television replaced playgrounds • Automobiles replaced bicycles • No more high school physical education requirement • Smoking Active Living: Leadership in Kentucky
Kentucky’s Rates • Type II Diabetes in Kentucky—doubled since1990 • Obesity in Kentucky—doubled since 1990 • Obesity in the United States—doubled since 1985 • Kentucky’s adults smoke more than any other state • Kentucky’s youth most likely to smoke every day • Kentucky’s youth unlikely to exercise every day Active Living: Leadership in Kentucky
Public Health—What helps? • Population Issues • Training • Large Groups • Small Groups • Environmental changes • School lunches • Smoke-free areas • School vending machine food • Measure Success—learn from work being done Active Living: Leadership in Kentucky
Get With The Guidelines—Why Bother? • Improved Quality of Life • Live Longer • Stay out of the nursing home • Pay less for my “golden years” • Avoid side effects of medicines • Avoid surgery Active Living: Leadership in Kentucky
Prevention—Why Bother? • What is in it for me? • Health Insurance costs • Medical Care Costs • State Budgets • State and Federal Income Taxes • Condition of Roads • Funding for Schools • College Tuition • Employment Opportunities Active Living: Leadership in Kentucky
No Data <10% 10%-14% 15-19% 20% Source: Mokdad A H, et al. J Am Med Assoc1999;282:16, 2001;286:10. Obesity Trends* Among U.S. AdultsBRFSS, 1985 (*BMI 30, or ~ 30 lbs overweight for 5’4” woman)
No Data <10% 10%-14% 15-19% 20% Source: Mokdad A H, et al. J Am Med Assoc1999;282:16, 2001;286:10. Obesity Trends* Among U.S. AdultsBRFSS, 1986 (*BMI 30, or ~ 30 lbs overweight for 5’4” woman)
No Data <10% 10%-14% 15-19% 20% Source: Mokdad A H, et al. J Am Med Assoc1999;282:16, 2001;286:10. Obesity Trends* Among U.S. AdultsBRFSS, 1987 (*BMI 30, or ~ 30 lbs overweight for 5’4” woman)
No Data <10% 10%-14% 15-19% 20% Source: Mokdad A H, et al. J Am Med Assoc1999;282:16, 2001;286:10. Obesity Trends* Among U.S. AdultsBRFSS, 1988 (*BMI 30, or ~ 30 lbs overweight for 5’4” woman)
No Data <10% 10%-14% 15-19% 20% Source: Mokdad A H, et al. J Am Med Assoc1999;282:16, 2001;286:10. Obesity Trends* Among U.S. AdultsBRFSS, 1989 (*BMI 30, or ~ 30 lbs overweight for 5’4” woman)
No Data <10% 10%-14% 15-19% 20% Source: Mokdad A H, et al. J Am Med Assoc1999;282:16, 2001;286:10. Obesity Trends* Among U.S. AdultsBRFSS, 1990 (*BMI 30, or ~ 30 lbs overweight for 5’4” woman)
No Data <10% 10%-14% 15-19% 20% Source: Mokdad A H, et al. J Am Med Assoc1999;282:16, 2001;286:10. Obesity Trends* Among U.S. AdultsBRFSS, 1991 (*BMI 30, or ~ 30 lbs overweight for 5’4” woman) Active Living: Leadership in Kentucky
No Data <10% 10%-14% 15-19% 20% Source: Mokdad A H, et al. J Am Med Assoc1999;282:16, 2001;286:10. Obesity Trends* Among U.S. AdultsBRFSS, 1992 (*BMI 30, or ~ 30 lbs overweight for 5’4” woman) Active Living: Leadership in Kentucky
No Data <10% 10%-14% 15-19% 20% Source: Mokdad A H, et al. J Am Med Assoc1999;282:16, 2001;286:10. Obesity Trends* Among U.S. AdultsBRFSS, 1993 (*BMI 30, or ~ 30 lbs overweight for 5’4” woman) Active Living: Leadership in Kentucky
No Data <10% 10%-14% 15-19% 20% Source: Mokdad A H, et al. J Am Med Assoc1999;282:16, 2001;286:10. Obesity Trends* Among U.S. AdultsBRFSS, 1994 (*BMI 30, or ~ 30 lbs overweight for 5’4” woman) Active Living: Leadership in Kentucky
No Data <10% 10%-14% 15-19% 20% Source: Mokdad A H, et al. J Am Med Assoc1999;282:16, 2001;286:10. Obesity Trends* Among U.S. AdultsBRFSS, 1995 (*BMI 30, or ~ 30 lbs overweight for 5’4” woman) Active Living: Leadership in Kentucky
No Data <10% 10%-14% 15-19% 20% Source: Mokdad A H, et al. J Am Med Assoc1999;282:16, 2001;286:10. Obesity Trends* Among U.S. AdultsBRFSS, 1996 (*BMI 30, or ~ 30 lbs overweight for 5’4” woman) Active Living: Leadership in Kentucky
No Data <10% 10%-14% 15-19% 20% Source: Mokdad A H, et al. J Am Med Assoc1999;282:16, 2001;286:10. Obesity Trends* Among U.S. AdultsBRFSS, 1997 (*BMI 30, or ~ 30 lbs overweight for 5’4” woman) Active Living: Leadership in Kentucky
No Data <10% 10%-14% 15-19% 20% Source: Mokdad A H, et al. J Am Med Assoc1999;282:16, 2001;286:10. Obesity Trends* Among U.S. AdultsBRFSS, 1998 (*BMI 30, or ~ 30 lbs overweight for 5’4” woman) Active Living: Leadership in Kentucky
No Data <10% 10%-14% 15-19% 20% Source: Mokdad A H, et al. J Am Med Assoc1999;282:16, 2001;286:10. Obesity Trends* Among U.S. AdultsBRFSS, 1999 (*BMI 30, or ~ 30 lbs overweight for 5’4” woman)
No Data <10% 10%-14% 15-19% 20% Source: Mokdad A H, et al. J Am Med Assoc1999;282:16, 2001;286:10. Obesity Trends* Among U.S. AdultsBRFSS, 2000 (*BMI 30, or ~ 30 lbs overweight for 5’4” woman)
Impact of Obesity • On people • More diabetes • More heart disease • More strokes • More kidney failure • More patients on dialysis • Earlier disability Active Living: Leadership in Kentucky
Future Health Insurance Cost Increases 2015 (*BMI 30, or ~ 30 lbs overweight for 5’4” woman)
Future Health Insurance Cost Increases 2016 (*BMI 30, or ~ 30 lbs overweight for 5’4” woman)
Future Health Insurance Cost Increases2017 (*BMI 30, or ~ 30 lbs overweight for 5’4” woman)
Future Health Insurance Cost Increases2018 (*BMI 30, or ~ 30 lbs overweight for 5’4” woman)
Future Health Insurance Cost Increases2019 (*BMI 30, or ~ 30 lbs overweight for 5’4” woman)
Future Health Insurance Cost Increases2030 (*BMI 30, or ~ 30 lbs overweight for 5’4” woman)
Future Health Insurance Cost Increases2031 (*BMI 30, or ~ 30 lbs overweight for 5’4” woman) Active Living: Leadership in Kentucky
Future Health Insurance Cost Increases2032 (*BMI 30, or ~ 30 lbs overweight for 5’4” woman) Active Living: Leadership in Kentucky
Future Health Insurance Cost Increases2033 (*BMI 30, or ~ 30 lbs overweight for 5’4” woman) Active Living: Leadership in Kentucky
Future Health Insurance Cost Increases2034 (*BMI 30, or ~ 30 lbs overweight for 5’4” woman) Active Living: Leadership in Kentucky
Future Health Insurance Cost Increases2035 (*BMI 30, or ~ 30 lbs overweight for 5’4” woman) Active Living: Leadership in Kentucky
Future Health Insurance Cost Increases2036 (*BMI 30, or ~ 30 lbs overweight for 5’4” woman) Active Living: Leadership in Kentucky
Future Health Insurance Cost Increases2037 (*BMI 30, or ~ 30 lbs overweight for 5’4” woman) Active Living: Leadership in Kentucky
Future Health Insurance Cost Increases2038 (*BMI 30, or ~ 30 lbs overweight for 5’4” woman) Active Living: Leadership in Kentucky
Future Health Insurance Cost Increases2039 (*BMI 30, or ~ 30 lbs overweight for 5’4” woman)
Future Health Insurance Cost Increases2040 (*BMI 30, or ~ 30 lbs overweight for 5’4” woman)
Impact on Public Funds • More people on disability • Fewer years in the work force • Earlier admission to nursing home • Increased demand for health care services ($3B today) • Increased demand on Medicaid and Medicare • Increased demand for public support of medical care • Decreased contribution to employee health insurance • More people without health insurance Active Living: Leadership in Kentucky
Tax Increases? (*BMI 30, or ~ 30 lbs overweight for 5’4” woman)
Tax Increases (*BMI 30, or ~ 30 lbs overweight for 5’4” woman)
Tax Increases? (*BMI 30, or ~ 30 lbs overweight for 5’4” woman)
Tax Increases? (*BMI 30, or ~ 30 lbs overweight for 5’4” woman)
Tax Increases? (*BMI 30, or ~ 30 lbs overweight for 5’4” woman)
Tax Increases? (*BMI 30, or ~ 30 lbs overweight for 5’4” woman)
Tax Increases? (*BMI 30, or ~ 30 lbs overweight for 5’4” woman) Active Living: Leadership in Kentucky
Tax Increases? (*BMI 30, or ~ 30 lbs overweight for 5’4” woman) Active Living: Leadership in Kentucky
Tax Increases? (*BMI 30, or ~ 30 lbs overweight for 5’4” woman) Active Living: Leadership in Kentucky