The Burden of Chronic Diseases in Missouri: Opportunities and ...
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  • Increased significantly from 211.6 to 246.8 per 10,000. Increased by 16.7%
  • Decreased 7.9%

The Burden of Chronic Diseases in Missouri: Opportunities and ... The Burden of Chronic Diseases in Missouri: Opportunities and ... Presentation Transcript

  • The Burden of Chronic Diseases in Missouri: Opportunities and Challenges for Public Health Shumei Yun, MD, PhD Chronic Disease Public Health Epidemiologist Office of Epidemiology
  • Chronic Diseases
    • Chronic diseases can be defined as diseases that have a prolonged course, that do not resolve spontaneously, and which a complete cure is rarely achieved.
    Chronic disease epidemiology and control, 2 nd Edition
  • Chronic Diseases
    • Characteristics of Chronic Diseases
      • Uncertain etiology
      • Multiple risk factors
      • A long latency period
      • A prolonged course of illness
    Chronic disease epidemiology and control, 2 nd Edition
  • Major Chronic Diseases
    • Cardiovascular Disease
    • Cancer
      • Lung Cancer
      • Colorectal Cancer
      • Breast Cancer
      • Cervical Cancer
      • Prostate Cancer
  • Major Chronic Diseases
    • Chronic Lung Diseases
      • Asthma
      • Chronic Obstructive Pulmonary Disease
    • Diabetes
    • Arthritis and Other Musculoskeletal Diseases
      • Osteoarthritis
      • Rheumatoid Arthritis
      • Osteoporosis
    • Chronic Neurologic Disorders
      • Alzheimer’s Disease
      • Parkinson’s Disease
  • Chronic Diseases in the U.S.
    • According to CDC, more than 90 million people in the U.S. live with a chronic illness. 
    • Chronic diseases—such as heart disease, cancer, and diabetes —are the leading causes of death and disability.
    • Chronic diseases account for 7 out of every 10 deaths.
    • The treatment of chronic diseases accounts for 75% of total health care cost each year.
  • Leading Causes of Death in Missouri, 2004 Septicemia Source: DHSS-MICA Source: DHSS-MICA
  • Missouri is among the States with Highest CVD Deaths in the Nation
    • More than 1 in 5 Missourians have some form of CVD.
    • More than 21,000 CVD deaths occur each year.
    • CVD deaths remained high compared to other states.
  • CVD Hospitalization Rates* in Missouri, 1994-2004 *Age Adjustment Uses 2000 Standard US Population Source: DHSS-MICA. * CVD as the principal diagnosis
  • CVD Inpatient Hospitalization Charges* in Missouri, by Pay Sources, 1994-2004 Source: DHSS-MICA. * CVD as the principal diagnosis
  • CVD Inpatient Hospitalization Charges* in Missouri, by Pay Sources, 1994-2004 Source: DHSS-MICA. * CVD the principal diagnosis Taking into account population change and CPI medical component
  • CVD Mortality Rates* in Missouri, 1990-2004 Age Adjustment Uses 2000 Standard US Population Source: DHSS-MICA. * CVD as the underlying cause
  • CVD Death Rates in the US , 1999 Source: http://www.cdc.gov/nccdphp/bb_heartdisease/index.htm Age-adjusted Death Rates per 100,000 Population
  • Cancer- Missourians Most Concerned Diseases
    • Cancer affects three out of four Missouri families.
    • More than 28,000 new cases are diagnosed each year in Missouri.
    • Over 12,000 cancer deaths occur each year.
  • All Cancer Incidence Rates* in Missouri, 1996-2002 *Age Adjustment Uses 2000 Standard US Population Data Source: Missouri Cancer Registry
  • All Cancer Hospitalization Rates* in Missouri, 1994-2004 *Age Adjustment Uses 2000 Standard US Population Data Source: DHSS-MICA
  • All Cancer Inpatient Hospitalization Charges* in Missouri, by Pay Sources Source: DHSS-MICA. * Cancer as the principal diagnosis Taking into account population change and CPI medical component
  • All Cancer Mortality Rates* in Missouri, 1990-2004 * Age Adjustment Uses 2000 Standard US Population Data Source: DHSS-MICA
  • Breast Cancer Mortality Rates* Among Women in Missouri, 1990-2004 * Age Adjustment Uses 2000 Standard US Population Data Source: DHSS-MICA
  • Breast Cancer Mortality Rates* in Missouri, 1990-2004 * Age Adjustment Uses 2000 Standard US Population Data Source: DHSS-MICA
  • Lung Cancer Mortality Rates* in Missouri, 1990-2004 * Age Adjustment Uses 2000 Standard US Population Data Source: DHSS-MICA
  • Lung Cancer Mortality Rates* in Missouri, by Sex, 1990-2004 * Age Adjustment Uses 2000 Standard US Population Data Source: DHSS-MICA
  • Diabetes is on the rise in Missouri
    • In 2005, 7.7% of adults aged 18 or older have physician diagnosed diabetes.
    • About 1/3 of all persons with diabetes are unaware of their condition.
    • The number of children with type 2 diabetes is increasing.
    • Minorities and people with low SES are disproportionately affected.
  • Diabetes is a severe illness
    • Without appropriate management, diabetes can lead to
      • Kidney failure
      • Blindness
      • Amputations
      • Cardiovascular diseases
      • Death due to flu and pneumonia complications.
  • Prevalence of Self-reported Physician Diagnosed Diabetes in Missouri, 1990-2005 Data Source: Missouri BRFSS
  • Diabetes Inpatient Hospitalization Rates* in Missouri, 1993-2001 Age Adjustment Uses 2000 Standard US Population Source: DHSS-MICA. * Diabetes as the principal diagnosis
  • Diabetes* Emergency Room Visit Rates in Missouri, 1994 - 2004 Age Adjustment Uses 2000 Standard US Population Source: DHSS-MICA. * Diabetes as the principal diagnosis
  • Diabetes Inpatient Hospitalization Charges* in Missouri, by Pay Sources, 1994-2004 * Diabetes as the principal diagnosis Taking into account population change and CPI medical component
  • Diabetes Mortality Rates* in Missouri, 1990-2004 *Age Adjustment Uses 2000 Standard US Population Source: DHSS-MICA. * Diabetes as the underlying cause
  • Arthritis: the Leading Cause of Disability
    • In 2005, 32.1% of Missourians have physician diagnosed arthritis.
    • About 15.5% of Missourians have certain activity limitation due to arthritis or joint symptoms.
  • Prevalence of Physician-diagnosed Arthritis, 2005
  • Arthritis Hospitalization Rates* in Missouri, 1993-2003 *Age Adjustment Uses 2000 Standard US Population Source: DHSS-Community Data Profile
  • Osteoarthritis Inpatient Hospital Charges* in Missouri, by Pay Sources, 1994-2004 Source: DHSS-MICA. * Osteoarthritis as the principal diagnosis Taking into account population change and CPI medical component
  • Asthma: Leading Cause of Hospitalization among Children <15 Yrs
    • More than 30,000 ER visits each year in Missouri
      • More than 1/3 by children < 15 yrs
    • More than 7,000 hospitalizations each year
      • More than 1/3 by children < 15 yrs
    • Adults with current asthma in 2005: 9%
  • Asthma Inpatient Hospitalization Rates* in Missouri, 1994-2004 *Age Adjustment Uses 2000 Standard US Population Source: DHSS-Community Data Profile
  • Asthma Inpatient Hospitalization Charges* in Missouri, by Pay Sources Source: DHSS-MICA. * Asthma as the principal diagnosis Taking into account population change and CPI medical component
  • Asthma ER Rates in Missouri, 1994-2004 Age Adjustment Uses 2000 Standard US Population Source: DHSS-MICA. * Asthma as the principal diagnosis
  • Opportunities
    • Chronic diseases are preventable.
    • Prevention is cost-effective.
    • Public health interventions work.
    • Infrastructure for chronic disease prevention and control exists.
  • Evidence-Based Interventions Topics     Alcohol    Cancer     Diabetes     Mental Health     Motor Vehicle     Nutrition     Oral Health Physical Activity        Pregnancy     Sexual Behavior    Social Environment     Substance Abuse     Tobacco    Vaccines    Violence http://www.thecommunityguide.org/alcohol/default.htm
  • Challenges
    • High prevalence of risk factors
    • Lack of support for prevention
    • Lack of funding for prevention
    • Sustained multi-sectoral commitments needed
    • Social determinants of chronic diseases
    • Aging Population
  • Risk Factors among Missouri Youth, 2003
    • Overweight prevalence
      • High school students 12.1
      • Middle school students 15.9%
    • Tobacco use prevalence
      • High school students 24.8%
      • Middle school students 8.8%
    • Not meeting CDC physical activity recommendations
      • High school students 28.4%
      • Middle school students 26.1%
    • No vigorous or moderate physical activity
      • High school students 8%
      • Middle school students 7.3%
  • Prevalence of Smoking among Adults in Missouri
  • Obesity Prevalence among Adults in Missouri, 1990 - 2002
  • Prevalence of No Leisure-time Physical Activity among Missouri Adults, 1990-2002
  • Aging population
  •  
  • Thank You