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Physical Activity & Tobacco Prevention as the Keys for Health Promotion

Physical Activity & Tobacco Prevention as the Keys for Health Promotion. Mohammad R. Torabi, PhD, MPH, CHES Interim Dean & Chancellor’s Professor School of Health, Physical Education, and Recreation Indiana University – Bloomington. Outline. Leading Causes of Death Paradigm Shift

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Physical Activity & Tobacco Prevention as the Keys for Health Promotion

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  1. Physical Activity &Tobacco Prevention as the Keys for Health Promotion Mohammad R. Torabi, PhD, MPH, CHES Interim Dean & Chancellor’s Professor School of Health, Physical Education, and Recreation Indiana University – Bloomington

  2. Outline • Leading Causes of Death • Paradigm Shift • Economics of Prevention • Actual Causes • Opportunities • Conclusions

  3. Leading Causes of Death

  4. 3 Leading Causes of Death, 1900(Transmissible Diseases) Source: Centers for Disease Control Prevention, National Center for Health Statistics, National Vital Statistics System and unpublished

  5. 3 Leading Causes of Death, 2000 (Non-Transmissible Diseases) Source: Minino et al. Deaths: final data for 2000. Natl Vital Stat Rep. 2002; 50:1-120.

  6. Top 3 Actual Causes of Death, 2000 (Lifestyle Related) 435,000 400,000 85,000 (Numbers of Death Shown in Red) Source: JAMA, March 10, 2004; 291(10): 1238-1246

  7. Mortality rates due to major causes of death, Thailand, 1967-2006

  8. Diseases and risk factors among Thai males, 2004 Source: Working Group on Burden of Disease and Risk Factors in Thailand, International Health Policy Programme, 2006.

  9. Diseases and risk factors among Thai females, 2006 Source: Working Group on Burden of Disease and Risk Factors in Thailand, International Health Policy Programme, 2006.

  10. We are killing ourselves by... • You, the individual, can do more for your own health and well being than any doctor, any hospital, any drug, or any exotic medical device. Joseph A. Califano: (former secretary of the US Department of Health and Human Service) • our own careless habits, • carelessly polluting the environment, & • permitting harmful social conditions to persist – conditions like poverty, hunger, and ignorance which destroy health.

  11. Paradigm Shift

  12. Control of infectious disease paralleling the emergence of chronic disease

  13. Percentage of causes of disability-adjusted life years (DALY) lost of Thai people by age group, 2004 Source: Working Group on Burden of Disease and Risk Factors, Thailand. International Health Policy Programme, 2006.

  14. Paradigm Shift Lifestyle+Health Education/ Promotion+Environment Treatment+Quarantine+Hygiene

  15. Economics of Prevention

  16. Annual Economic & Health Burden of Chronic Disease Source: http://www.cdc.gov/NCCdphp/press/index.htm

  17. During the Past 30 Years the Percentage of the GDP Consumed by Health Care Doubled

  18. The Cost of Health Care Threatens the Ability of the U.S. to Compete Economically with Other Nations

  19. Proportion of health expenditure going to the population-wide core functions of public health vs. medical treatment Proportion of early deaths that could be prevented by population – wide public health approaches vs. medical treatment Is This a Rational Investment Strategy?

  20. Actual Causes

  21. Major Causes of Morbidity & Mortality #1 Tobacco Use - Cigarette: the Gateway Drug -

  22. Dose-Response Relationship Between Cigarette Smoking and Other Drug UseBy Indiana Students in Grades 5-12 Source: Torabi et al.

  23. Dose-Response Relationship Between Cigarette Smoking and Other Drug UseBy Indiana Students in Grades 5-12 Source: Torabi et al.

  24. Cigarette Smoking Among US Men, Women, High School Students, and Mothers during Pregnancy, 1965 – 2003 Source: Centers for Medicare & Medicaid Services, Office of the Actuary, National Health Statistics Group

  25. If you are a smoker, your life… -14.5 yrs -13.2 yrs Source: MMWR 1997;46:444-51

  26. If smoking relaxes you, then don’t quit. Being dead is very relaxing.

  27. Major Causes of Morbidity & Mortality #2 Overweight/Obesity

  28. No Data <10% 10%–14% Obesity Trends Among U.S. AdultsBRFSS, 1985 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman) Source: Behavioral Risk Factor Surveillance System, CDC

  29. No Data <10% 10%–14% Obesity Trends Among U.S. AdultsBRFSS, 1990 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman) Source: Behavioral Risk Factor Surveillance System, CDC

  30. Obesity Trends Among U.S. AdultsBRFSS, 1995 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman) No Data <10% 10%–14 15%–19% Source: Behavioral Risk Factor Surveillance System, CDC

  31. No Data <10% 10%–14% 15%–19% ≥20 Obesity Trends Among U.S. AdultsBRFSS, 2000 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman) Source: Behavioral Risk Factor Surveillance System, CDC

  32. Obesity Trends Among U.S. AdultsBRFSS, 2005 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30% Source: Behavioral Risk Factor Surveillance System, CDC

  33. Obesity Trends Among U.S. AdultsBRFSS, 2009 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30% Source: Behavioral Risk Factor Surveillance System, CDC

  34. Source: National Health and Nutrition Examination Survey, 2004

  35. Source: National Health and Nutrition Examination Survey, 2004

  36. Why Has Caloric Intake Increased? • More food available • Cheaper • Greater variety • Easier to acquire • Heavily marketed by more effective media • More calorie dense foods • High-fructose corn syrup • Super-sized • More people who model increased caloric intake

  37. Why Has Caloric Output Decreased? • Fewer occupations require physical labor • Fewer physical household chores • Less need and opportunities for manual transportation (walking, biking) • More attractive sedentary leisure-time activities • Less physical education and other physical activity • More people who model decreased caloric output

  38. Why does it take six weeks to lose five pounds, but only one day to gain it all back?

  39. Major Causes of Morbidity & Mortality #3 Lack of Physical Activity

  40. Benefits of Physical Activity Physical activity can lower the risk of: • Coronary heart disease • Stroke • Type II diabetes mellitus • High blood pressure • Colon cancer by 30–50% • Active people have lower premature death rates than people who are the least active

  41. Adults with 30+ minutes of moderate physical activity 5 or more days per week Source: Behavioral Risk Factor Surveillance System, 2007

  42. Adults with 20+ minutes of vigorous physical activity 3 or more days per week Source: Behavioral Risk Factor Surveillance System, 2007

  43. 2007 National Average: Recommended Physical Activity by Age Source: Centers for Disease Control and Prevention, 2007

  44. Opportunities

  45. Progress • Slowly prevention getting attention of policy makers • Funding for tobacco settlements • New funding for nutrition and physical activities

  46. Smoking Prevention in Thailand

  47. What fits your busy schedule better, exercising one hour a day or being dead 24 hours a day?

  48. Conclusions

  49. What Does Prevention Do for Us? • 10 to 20 years of extended life • Improved quality of life • Reduced chronic disease • Less medications/hospital visit/surgery • Postponed disability • Save money

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