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Home / News & IndustryManaged Care Insight and Analysis
Updated: April 27, 2010
America Seen Strong In Treating Disease; Fails Miserably In Disease Prevention

The inability to slow preventable diseases in the U.S. population will significantly increase costs in an already unaffordable medical care delivery system.

Of the $2.4 trillion of annual healthcare expenditures in the U.S., $1.8 trillion is associated with the treatment of a chronic disease, such as diabetes, heart disease and cancer. Data supporting this trend is contained in the 20th Anniversary Edition of America’s Health Rankings.

"Unless there is urgent action across our society, our already overburdened care system will be swamped by a tsunami of cost and demands from preventable chronic disease," said Dr. Reed Tuckson, United Health Foundation (UHF) board member and executive vice president and chief of medical affairs for UnitedHealth Group. "Together, as individuals, community leaders, health care professionals, employers and elected officials, we must elevate disease prevention and health promotion to the top of our agendas."

Tobacco consumption and obesity have emerged as the two priorities threatening the health of Americans. Though tobacco usage dropped to 18.3 percent of the population in 2009 from 19.8 percent in 2008, approximately 440,000 deaths annually are still attributable to this preventable behavior.

Obesity has increased nearly 130 percent since the first edition of America’s Health Rankings were issued 20 years ago. Currently, Highmark is working with Take Care Health Systems to aid operating the health centers. (See related article in this issue).

Some 27 percent of the population is obese. Obesity is growing faster than any previous chronic health issue America has faced, the Rankings report found.

A supplemental analysis to this year’s report was conducted by Kenneth Thorpe, executive director,Partnership to Fight Chronic Disease.

Thorpe wrote in "Future Costs of Obesity," if obesity is left unchecked, 43 percent of adults will be obese and obesity will add nearly $344 billion in 2018 alone to the nation’s annual direct healthcare costs, accounting for more than 21 percent of healthcare spending.

Other findings from the rankings show that the nation has seen significant declines in crime rates, infectious disease, smoking and infant mortality rates. Challenges since 1990 include the rising uninsured rate, lack of progress in increasing high school graduation rates and the need to continue to improve access to adequate prenatal care for pregnant women.

Some States Better, Some Worse, According To Health Rankings

When it comes to a state’s health Vermont residents were the healthiest in 2009, according to America’s Health Rankings. New York state was the most improved over the 20 years that Health Rankings has ranked states.

This year, the Rankings not only provided an annual list of the healthiest and least healthy states but also determined which states had improved the most over the past 20 years in overall health and how the states compared in their progress against smoking and obesity since 1990.

Utah climbed from a ranking of fifth to second in 2009, followed by Massachusetts third, Hawaii fourth and New Hampshire fifth. For the second year in a row, Utah leads the nation as the state with the lowest prevalence of smoking and Colorado ranks as the state with the lowest prevalence of obesity.

At the other end of the scale Mississippi was ranked 50th last year, preceded by Oklahoma 49, Alabama 48, Louisiana 47 and South Carolina 46.

"Our nation’s public health professionals cannot win this battle alone … all people have to do their share," said Dr. Georges C. Benjamin, executive director of the American Public Health Association. "Unless we do, all of us will pay the price in higher healthcare costs and diminished access to care."

New York state’s improvement was driven primarily by a 60 percent reduction in violent crime and significant reductions in infant mortality and smoking rates. Other states showing the greatest improvement since 1990 include Vermont, Hawaii, New Hampshire, New Jersey and Minnesota.

States with the greatest success reducing smoking over the past 20 years are Rhode Island, Virginia, Maryland, Florida, Delaware and Vermont. States with the greatest success against obesity over the past 20 years are Connecticut, Rhode Island, Massachusetts, Wyoming and Florida.

"We will never improve the health of our states until prevention is at the forefront of what we do," said Robert J. Gould, president and CEO of Partnership for Prevention.

Partnership for Prevention is a membership organization of businesses, nonprofit organizations and government agencies advancing policies and practices to prevent disease and improve the health of all Americans.

America’s Health Rankings is an annual comprehensive assessment of the nation’s health on a state-by-state analysis. It is published jointly by UHF, the American Public Health Association andPartnership for Prevention. The data in the report comes from validated outside sources, such as the Centers for Disease Control and Prevention. The report is reviewed and overseen by a Scientific Advisory Committee, with members from academic institutions, government agencies and the private sector.

To review findings from America’s Health Rankings, visit

  This article was taken from:
The Executive Report on Managed Care

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