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Cdphe cd presentation for ccpd 10 14 11a
 

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    Cdphe cd presentation for ccpd 10 14 11a Cdphe cd presentation for ccpd 10 14 11a Presentation Transcript

    • Select Risk Factors andOutcomes Related to ChronicDiseasesPresented to10/14/2011The Cancer, Cardiovascular and Pulmonary Disease GrantsCommittee
    • AcknowledgementsRenee Calanan, PhDChronic Disease Epidemiologist, PHS&Stephanie KuhnBarbara GabellaIndira GujralAshley Juhl
    • Factors Influencing Health Status Biology 20% Lifestyle 51% Smoking Obesity Health Care Nutrtion 10%Alcohol Use Environment 19% Source: McGinnis, J.M and Foege, W.H. (1993). ―Actual Causes of Death in the United States,‖ Journal of the American Medical Association.
    • Determinants of Health(Evans - Stoddart Model) Social Physical Genetic Environment Environment Environment Individual Response – Behavior – Biology Health Disease Health & & & Medical Function Injury Care Well – Being Prosperity Paul Simon, MD, MPH, UCLA, 2007
    • Mortality
    • Number of deaths for the fifteen leading causes of death — Colorado residents, 2010 Cancer (Malignant neoplasms) 7029 Heart Disease 6029 Chronic Lower Respiratory Disease 2199 Unintentional injuries 2102 Cerebrovascular Disease 1605 Cause of death Alzheimers Disease 1336 Suicide 867 Diabetes Melitus 721 Chronic Liver Disease and Cirrhosis 598 Influenza and Pneumonia 549 0 1000 2000 3000 4000 5000 6000 7000 8000Source: CDPHE, Health Statistics Number of deathsSection. Vital Records. Death statisticsobtain via CoHID Oct 10, 2011
    • Percent of total deaths for the leadingcauses of death — Colorado residents, 2008 1.9% 1.7% 2.3% Influenza and Pneumonia 2.8% Chronic Liver Disease and Cirrhosis 4.3% 26.7% Diabetes Melitus 5.1% Suicide 6.7% Alzheimers Disease Cerebrovascular Disease 7.0% Unintentional injuries Chronic Lower Respiratory Disease 22.4% Heart Disease 19.2% Cancer (Malignant neoplasms)Source: CDPHE, Health StatisticsSection. Vital Records. Death statistics All other causesobtain via CoHID Oct 10, 2011
    • Outcomes AmongAdults
    • How many people are affected? • 751,000 had hypertension(22%) • 307,000 had current asthma (8%) • 190,000 were cancer survivors (4%) • 113,000 had coronary artery disease (3%) • 219,000 had diabetes (6%) • 70,000 had a stroke (2%)Cover this blue placeholderwith your program logo
    • Select outcomes by race/ethnicity andincome, Colorado adults, 2009Outcome Race/ethnicity IncomeAsthma No disparity No disparityCoronary artery disease No disparity Most lower incomes > $75k+Hypertension Black>White>Hispanic Lower incomes > $75+Diabetes Black, Hispanic > White Most lower incomes > $75k+Cancer Not assessed Not assessed
    • Risk Factors AmongAdults
    • Prevalence of selected risk factors, Colorado adults, 1997-2010 BRFSS 40 35 30 25 20 15 10 5 0 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Overweight High cholesterol Current smokers Hypertension Physical inactivity ObesityData source: Behavioral Risk Factor Surveillance System, Health Statistics Section, Colorado Department of Public Health and Environment
    • Percent of Colorado adult smokers, 1996-2009 25 22.8 22.3 19.8 20 17.1 16Percent 15 Healthy People 2020 Objective: 12% 10 5 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Source: Colorado Behavioral Risk Factor Surveillance System, Health Statistics Section, Colorado Department of Public Health and Environment
    • Prevalence of obesity among adult Coloradans, 1997-2010 BRFSS 25 20 15 10 Healthy People 2020 Objective: 30% 5 0 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 ObesityData source: Behavioral Risk Factor Surveillance System, Health Statistics Section, Colorado Department of Public Health and Environment
    • Prevalence of select risk factors, Colorado adults, 2009 (in pct.)100 90 80 70 57 60 50 40 35 30 25 22 19 18 17 20 10 0 Fruit/vegetables High blood High cholesterol Obesity Meet physical Physically Current smoker 5+ times per day pressure activity recs inactiveData source: Behavioral Risk Factor Surveillance System, Health Statistics Section, Colorado Department of PublicHealth and Environment
    • High blood pressure by race/ethnicity and income, Colorado adults, 200950 5045 4540 40 3435 3530 29 28 30 25 2525 23 25 2120 18 20 1815 1510 10 5 5 0 0 White non-Hispanic Black non-Hispanic Hispanic Data source: Behavioral Risk Factor Surveillance System, Health Statistics Section, Colorado Department of Public Health and Environment
    • High cholesterol by race/ethnicity and income, Colorado adults, 200950 5045 45 4140 40 37 36 37 35 36 35 34 3335 3530 3025 2520 2015 1510 10 5 5 0 0 White non-Hispanic Black non-Hispanic Hispanic Data source: Behavioral Risk Factor Surveillance System, Health Statistics Section, Colorado Department of Public Health and Environment
    • Obesity by race/ethnicity and income, Colorado adults, 200950 5045 4540 4035 35 3130 30 2625 22 25 23 22 19 2020 18 20 1715 1510 10 5 5 0 0 White non-Hispanic Black non-Hispanic Hispanic Data source: Behavioral Risk Factor Surveillance System, Health Statistics Section, Colorado Department of Public Health and Environment
    • Physical activity by race/ethnicity and income, Colorado adults, 2009100 100 90 90 80 80 70 70 63 59 55 55 58 60 56 60 51 51 50 50 50 40 40 30 30 20 20 10 10 0 0 White non-Hispanic Black non-Hispanic Hispanic Data source: Behavioral Risk Factor Surveillance System, Health Statistics Section, Colorado Department of Public Health and Environment
    • Physical inactivity by race/ethnicity and income, Colorado adults, 200950 5045 4540 4035 35 3330 29 30 28 2825 25 23 2020 20 14 1415 15 910 10 5 5 0 0 White non-Hispanic Black non-Hispanic HispanicData source: Behavioral Risk Factor Surveillance System, Health Statistics Section, Colorado Department of PublicHealth and Environment
    • Current smoking by race/ethnicity and income, Colorado adults, 200950 5045 4540 4035 3530 30 28 28 2725 25 20 2020 20 18 17 1615 15 910 10 5 5 0 0 White non-Hispanic Black non-Hispanic HispanicData source: Behavioral Risk Factor Surveillance System, Health Statistics Section, Colorado Department of PublicHealth and Environment
    • Screening Among Adults
    • Prevalence of preventive screening, Colorado adults, 2008 100 90 84 80 76 76 73 70 62 60 50 40 30 20 10 0 Cholesterol within 5 years (18+ Colorectal cancer (50+ years) Cervical cancer within 3 years Breast cancer within 2 years Breast cancer within 2 years years) (18+ years) (50+ years) (40+ years)Colorectal cancer: colonoscopy within 10 years, sigmoidoscopy within 5 years, or FOBT within 1 yearData source: Behavioral Risk Factor Surveillance System, Health Statistics Section, Colorado Department of PublicHealth and Environment (cholesterol screening, 2009)
    • Cholesterol screening by race/ethnicity and income, Colorado adults, 2009100 10090 90 86 79 7880 80 77 78 68 7070 70 61 6260 6050 5040 4030 3020 2010 10 0 0 White non-Hispanic Black non-Hispanic Hispanic Data source: Behavioral Risk Factor Surveillance System, Health Statistics Section, Colorado Department of Public Health and Environment
    • Colorectal cancer screening by race/ethnicity and income, Colorado adults aged 50+ years, 2008100 10090 9080 80 72 6870 64 70 64 64 5960 54 60 5650 50 4740 4030 3020 2010 10 0 0 White non-Hispanic Black non-Hispanic Hispanic Data source: Behavioral Risk Factor Surveillance System, Health Statistics Section, Colorado Department of Public Health and Environment
    • Cervical cancer screening by race/ethnicity and income, Colorado women aged 18+ years, 2008100 100 93 87 89 90 86 90 84 81 79 80 80 80 71 70 70 60 60 50 50 40 40 30 30 20 20 10 10 0 0 White non-Hispanic Black non-Hispanic HispanicData source: Behavioral Risk Factor Surveillance System, Health Statistics Section, Colorado Department of PublicHealth and Environment
    • Breast cancer screening by race/ethnicity and income, Colorado women aged 50+ years, 2008 100 100 90 82 90 80 80 78 80 77 76 72 70 70 70 61 60 60 50 50 40 40 30 30 20 20 10 10 0 0 White non-Hispanic Black non-Hispanic HispanicData source: Behavioral Risk Factor Surveillance System, Health Statistics Section, Colorado Department of PublicHealth and Environment
    • Disparities in Screening• Hispanics had a lower prevalence of cholesterol screening and colorectal cancer screening than Whites and Blacks.• In general, screening increased as annual household income increased.
    • Risk Factors AmongYouth
    • Select risk factors and outcomes, Colorado adolescents, 2009 100 90 80 78 70 60 50 40 30 27 24 20 12 10 0 Healthy weight Recommended physical activity Fruit/vegetables 5+ times/day Current smokerData source: Colorado Youth Risk Behavior Survey, Colorado Department of Education; analyzed by Colorado Department of Public Health and EnvironmentCurrent smoking data source: Healthy Kids Colorado Survey on Tobacco and Health, Colorado Department of Public Health and Environment, analyzed byAmendment 35 Program Evaluation Group (APEG), University of Colorado Cancer Center
    • Select risk factors and outcomes, Colorado children, 2009100 90 80 70 65 60 50 48 45 40 31 30 20 16 10 9 10 0 Healthy weight (5- Eat fruit 2+ times and Drink sweetened Active everyday for Watch TV >2 hours Sunburn in past 12 Current asthma (1- 14y) vegetables 3+ times drinks 1+ times per 60+ minutes (5-14y) per day (1-14y) months (1-14y) 14y) per day (2-14y) day (1-14y) Data source: Colorado Child Health Survey, Colorado Department of Public Health and Environment
    • Risk Factors’Associations withOutcomes
    • Reducing Cigarette Smoking Cancers CVD • 80-90% of lung • 2-4 x risk of coronary heart • 30-50% of colon disease • 75% of oral (w/ alcohol) • 2 x risk of sudden cardiac • Cancers of the bladder death cervix, esophagus, larynx, • Abdominal aortic aneurysm kidney & pancreas • Strokes • Atherosclerosis & congestive heart failureCOPD• 90% of Chronic DiabetesObstructive Pulmonary •Leads to neuropathy &Disease peripheral artery disease •Smoking increases the risk of amputation by 2 – 10 times 34
    • Lowering cholesterol & hypertension CVD • 30-40% of coronary CVD heart disease • 20-30% of coronary heart disease • 10-20% of stroke • 20-50% of stroke Type 2 Diabetes • End stage renal • 65% of people with diabetes die from heart disease or stroke 35
    • Nutrition & Physical Activity Cancers • 30% of cancer deaths Cancer • Nutrition: Cancers of • 22% of colon cancers the mouth, pharynx, • Cancers of breast, colon, and esophagus, larynx, kidney, possibly endometrial & colon, rectum, ovary, & prostate bladder CVDCVD • 12% of hypertension• heart disease by 20-40%• stroke by 30% Type 2 Diabetes Diabetes • 12% of diabetes 36
    • Reducing Obesity CVD • Increased likelihood of heart50-100% greater risk of disease and strokepremature deathCancers Diabetes• Cancers of the colon, • Increased risk of Type 2breast, kidney, Diabetesgallbladder, prostate,cervix, ovaries, &esophagus 37
    • Thank you Gabriel Kaplan, PhD., MPA, Director EPE | Epidemiology, Planning and Evaluation | Branch Prevention Services Division Colorado Department of Public Health and Environment gabriel.kaplan@state.co.us