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Diabetes: Public Health Implications

Diabetes: Public Health Implications. Dr. Bruce Goodrow East Tennessee State University. Burden of Chronic Disease: . More than 90 million persons in the U.S. live with chronic illness. Public Health Implications.

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Diabetes: Public Health Implications

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  1. Diabetes:Public Health Implications Dr. Bruce Goodrow East Tennessee State University

  2. Burden of Chronic Disease: • More than 90 million persons in the U.S. live with chronic illness

  3. Public Health Implications • More than 75% of the nation’s 1.4 trillion health care costs can be attributed to chronic illness.

  4. Public Health Implications • Chronic disease prevention and management must be based on behavioral change as a complement to medical intervention.

  5. Public Health Implications • Poor nutrition costs more than $33 billion per year in medical care and $9 billion in lost productivity because of heart disease, cancer, stroke, and diabetes.

  6. Public Health Implications • Smoking costs more than $75 billion per year in direct medical care and $80 billion per year in lost productivity.

  7. Public Health Implications • Physical inactivity in 2000 cost more than $76 billion.

  8. Public Health Implications • Obesity in 2000 cost $117 billion --- $61 billion in direct medical costs and $56 billion to lost productivity.

  9. Public Health Implications • Diabetes in 2002 cost 92 billion in direct medical care and 40 billion in indirect cost (disability, work loss, and premature mortality).

  10. Public Health Implications • Estimated 6.3% of U.S. population has diabetes --- 5.2 million undiagnosed.

  11. Public Health Implications • By 2050 an estimated 29 million Americans are expected to have diagnosed diabetes.

  12. Public Health Implications • Using 2002 cost estimates each case costs $13,243.

  13. Public Health Implications • Do the math $13,243 X 29 million = Health Care Costs Out of Control

  14. Public Health Implications • Diabetes does not impact all populations equally. Health disparities exist between racial groups and gender.

  15. Public Health Implications • Morbidity and mortality change radically by age group.

  16. What are the behavioral trends?

  17. No Data <10% 10%–14% Obesity Trends* Among U.S. AdultsBRFSS, 1985 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

  18. No Data <10% 10%–14% Obesity Trends* Among U.S. AdultsBRFSS, 1986 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

  19. No Data <10% 10%–14% Obesity Trends* Among U.S. AdultsBRFSS, 1987 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

  20. No Data <10% 10%–14% Obesity Trends* Among U.S. AdultsBRFSS, 1988 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

  21. No Data <10% 10%–14% Obesity Trends* Among U.S. AdultsBRFSS, 1989 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

  22. No Data <10% 10%–14% Obesity Trends* Among U.S. AdultsBRFSS, 1990 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

  23. No Data <10% 10%–14% 15%–19% Obesity Trends* Among U.S. AdultsBRFSS, 1991 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

  24. No Data <10% 10%–14% 15%–19% Obesity Trends* Among U.S. AdultsBRFSS, 1992 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

  25. No Data <10% 10%–14% 15%–19% Obesity Trends* Among U.S. AdultsBRFSS, 1993 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

  26. No Data <10% 10%–14% 15%–19% Obesity Trends* Among U.S. AdultsBRFSS, 1994 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

  27. No Data <10% 10%–14% 15%–19% Obesity Trends* Among U.S. AdultsBRFSS, 1995 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

  28. No Data <10% 10%–14% 15%–19% Obesity Trends* Among U.S. AdultsBRFSS, 1996 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

  29. No Data <10% 10%–14% 15%–19% ≥20 Obesity Trends* Among U.S. AdultsBRFSS, 1997 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

  30. No Data <10% 10%–14% 15%–19% ≥20 Obesity Trends* Among U.S. AdultsBRFSS, 1998 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

  31. No Data <10% 10%–14% 15%–19% ≥20 Obesity Trends* Among U.S. AdultsBRFSS, 1999 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

  32. No Data <10% 10%–14% 15%–19% ≥20 Obesity Trends* Among U.S. AdultsBRFSS, 2000 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

  33. Obesity Trends* Among U.S. AdultsBRFSS, 2001 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

  34. Obesity Trends* Among U.S. AdultsBRFSS, 2002 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person) (*BMI 30, or ~ 30 lbs overweight for 5’4” person) No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

  35. Obesity Trends* Among U.S. AdultsBRFSS, 2003 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person) (*BMI 30, or ~ 30 lbs overweight for 5’4” person) No Data <10% 10%–14 15%–19% 20%–24% ≥25%

  36. 1991 Obesity Trends* Among U.S. AdultsBRFSS,1991, 1996, 2003 (*BMI 30, or about 30 lbs overweight for 5’4” person) 1996 2003 No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

  37. 2003 Tennessee Youth Risk Behavior Survey (YRBS)

  38. Risk Behavior Implications • 27% rode with a drinking driver during the past month

  39. Risk Behavior Implications • 41% drank alcohol during the past month

  40. Risk Behavior Implications • 24% used marijuana during the past month

  41. Risk Behavior Implications • 36% had sexual intercourse during the past three months

  42. Risk Behavior Implications • 62% have tried cigarette smoking

  43. Risk Behavior Implications • 28% smoked cigarettes during the past month

  44. Risk Behavior Implications • 82% ate <5 servings of fruits and vegetables per day during the past 7 days

  45. Risk Behavior Implications • 76% participated in insufficient moderate physical activity

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