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 ...

    1. 1. 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
    2. 2. Chronic Diseases <ul><li>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. </li></ul>Chronic disease epidemiology and control, 2 nd Edition
    3. 3. Chronic Diseases <ul><li>Characteristics of Chronic Diseases </li></ul><ul><ul><li>Uncertain etiology </li></ul></ul><ul><ul><li>Multiple risk factors </li></ul></ul><ul><ul><li>A long latency period </li></ul></ul><ul><ul><li>A prolonged course of illness </li></ul></ul>Chronic disease epidemiology and control, 2 nd Edition
    4. 4. Major Chronic Diseases <ul><li>Cardiovascular Disease </li></ul><ul><li>Cancer </li></ul><ul><ul><li>Lung Cancer </li></ul></ul><ul><ul><li>Colorectal Cancer </li></ul></ul><ul><ul><li>Breast Cancer </li></ul></ul><ul><ul><li>Cervical Cancer </li></ul></ul><ul><ul><li>Prostate Cancer </li></ul></ul>
    5. 5. Major Chronic Diseases <ul><li>Chronic Lung Diseases </li></ul><ul><ul><li>Asthma </li></ul></ul><ul><ul><li>Chronic Obstructive Pulmonary Disease </li></ul></ul><ul><li>Diabetes </li></ul><ul><li>Arthritis and Other Musculoskeletal Diseases </li></ul><ul><ul><li>Osteoarthritis </li></ul></ul><ul><ul><li>Rheumatoid Arthritis </li></ul></ul><ul><ul><li>Osteoporosis </li></ul></ul><ul><li>Chronic Neurologic Disorders </li></ul><ul><ul><li>Alzheimer’s Disease </li></ul></ul><ul><ul><li>Parkinson’s Disease </li></ul></ul>
    6. 6. Chronic Diseases in the U.S. <ul><li>According to CDC, more than 90 million people in the U.S. live with a chronic illness.  </li></ul><ul><li>Chronic diseases—such as heart disease, cancer, and diabetes —are the leading causes of death and disability. </li></ul><ul><li>Chronic diseases account for 7 out of every 10 deaths. </li></ul><ul><li>The treatment of chronic diseases accounts for 75% of total health care cost each year. </li></ul>
    7. 7. Leading Causes of Death in Missouri, 2004 Septicemia Source: DHSS-MICA Source: DHSS-MICA
    8. 8. Missouri is among the States with Highest CVD Deaths in the Nation <ul><li>More than 1 in 5 Missourians have some form of CVD. </li></ul><ul><li>More than 21,000 CVD deaths occur each year. </li></ul><ul><li>CVD deaths remained high compared to other states. </li></ul>
    9. 9. CVD Hospitalization Rates* in Missouri, 1994-2004 *Age Adjustment Uses 2000 Standard US Population Source: DHSS-MICA. * CVD as the principal diagnosis
    10. 10. CVD Inpatient Hospitalization Charges* in Missouri, by Pay Sources, 1994-2004 Source: DHSS-MICA. * CVD as the principal diagnosis
    11. 11. 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
    12. 12. CVD Mortality Rates* in Missouri, 1990-2004 Age Adjustment Uses 2000 Standard US Population Source: DHSS-MICA. * CVD as the underlying cause
    13. 13. 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
    14. 14. Cancer- Missourians Most Concerned Diseases <ul><li>Cancer affects three out of four Missouri families. </li></ul><ul><li>More than 28,000 new cases are diagnosed each year in Missouri. </li></ul><ul><li>Over 12,000 cancer deaths occur each year. </li></ul>
    15. 15. All Cancer Incidence Rates* in Missouri, 1996-2002 *Age Adjustment Uses 2000 Standard US Population Data Source: Missouri Cancer Registry
    16. 16. All Cancer Hospitalization Rates* in Missouri, 1994-2004 *Age Adjustment Uses 2000 Standard US Population Data Source: DHSS-MICA
    17. 17. 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
    18. 18. All Cancer Mortality Rates* in Missouri, 1990-2004 * Age Adjustment Uses 2000 Standard US Population Data Source: DHSS-MICA
    19. 19. Breast Cancer Mortality Rates* Among Women in Missouri, 1990-2004 * Age Adjustment Uses 2000 Standard US Population Data Source: DHSS-MICA
    20. 20. Breast Cancer Mortality Rates* in Missouri, 1990-2004 * Age Adjustment Uses 2000 Standard US Population Data Source: DHSS-MICA
    21. 21. Lung Cancer Mortality Rates* in Missouri, 1990-2004 * Age Adjustment Uses 2000 Standard US Population Data Source: DHSS-MICA
    22. 22. Lung Cancer Mortality Rates* in Missouri, by Sex, 1990-2004 * Age Adjustment Uses 2000 Standard US Population Data Source: DHSS-MICA
    23. 23. Diabetes is on the rise in Missouri <ul><li>In 2005, 7.7% of adults aged 18 or older have physician diagnosed diabetes. </li></ul><ul><li>About 1/3 of all persons with diabetes are unaware of their condition. </li></ul><ul><li>The number of children with type 2 diabetes is increasing. </li></ul><ul><li>Minorities and people with low SES are disproportionately affected. </li></ul>
    24. 24. Diabetes is a severe illness <ul><li>Without appropriate management, diabetes can lead to </li></ul><ul><ul><li>Kidney failure </li></ul></ul><ul><ul><li>Blindness </li></ul></ul><ul><ul><li>Amputations </li></ul></ul><ul><ul><li>Cardiovascular diseases </li></ul></ul><ul><ul><li>Death due to flu and pneumonia complications. </li></ul></ul>
    25. 25. Prevalence of Self-reported Physician Diagnosed Diabetes in Missouri, 1990-2005 Data Source: Missouri BRFSS
    26. 26. Diabetes Inpatient Hospitalization Rates* in Missouri, 1993-2001 Age Adjustment Uses 2000 Standard US Population Source: DHSS-MICA. * Diabetes as the principal diagnosis
    27. 27. Diabetes* Emergency Room Visit Rates in Missouri, 1994 - 2004 Age Adjustment Uses 2000 Standard US Population Source: DHSS-MICA. * Diabetes as the principal diagnosis
    28. 28. 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
    29. 29. Diabetes Mortality Rates* in Missouri, 1990-2004 *Age Adjustment Uses 2000 Standard US Population Source: DHSS-MICA. * Diabetes as the underlying cause
    30. 30. Arthritis: the Leading Cause of Disability <ul><li>In 2005, 32.1% of Missourians have physician diagnosed arthritis. </li></ul><ul><li>About 15.5% of Missourians have certain activity limitation due to arthritis or joint symptoms. </li></ul>
    31. 31. Prevalence of Physician-diagnosed Arthritis, 2005
    32. 32. Arthritis Hospitalization Rates* in Missouri, 1993-2003 *Age Adjustment Uses 2000 Standard US Population Source: DHSS-Community Data Profile
    33. 33. 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
    34. 34. Asthma: Leading Cause of Hospitalization among Children <15 Yrs <ul><li>More than 30,000 ER visits each year in Missouri </li></ul><ul><ul><li>More than 1/3 by children < 15 yrs </li></ul></ul><ul><li>More than 7,000 hospitalizations each year </li></ul><ul><ul><li>More than 1/3 by children < 15 yrs </li></ul></ul><ul><li>Adults with current asthma in 2005: 9% </li></ul>
    35. 35. Asthma Inpatient Hospitalization Rates* in Missouri, 1994-2004 *Age Adjustment Uses 2000 Standard US Population Source: DHSS-Community Data Profile
    36. 36. 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
    37. 37. Asthma ER Rates in Missouri, 1994-2004 Age Adjustment Uses 2000 Standard US Population Source: DHSS-MICA. * Asthma as the principal diagnosis
    38. 38. Opportunities <ul><li>Chronic diseases are preventable. </li></ul><ul><li>Prevention is cost-effective. </li></ul><ul><li>Public health interventions work. </li></ul><ul><li>Infrastructure for chronic disease prevention and control exists. </li></ul>
    39. 39. 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
    40. 40. Challenges <ul><li>High prevalence of risk factors </li></ul><ul><li>Lack of support for prevention </li></ul><ul><li>Lack of funding for prevention </li></ul><ul><li>Sustained multi-sectoral commitments needed </li></ul><ul><li>Social determinants of chronic diseases </li></ul><ul><li>Aging Population </li></ul>
    41. 41. Risk Factors among Missouri Youth, 2003 <ul><li>Overweight prevalence </li></ul><ul><ul><li>High school students 12.1 </li></ul></ul><ul><ul><li>Middle school students 15.9% </li></ul></ul><ul><li>Tobacco use prevalence </li></ul><ul><ul><li>High school students 24.8% </li></ul></ul><ul><ul><li>Middle school students 8.8% </li></ul></ul><ul><li>Not meeting CDC physical activity recommendations </li></ul><ul><ul><li>High school students 28.4% </li></ul></ul><ul><ul><li>Middle school students 26.1% </li></ul></ul><ul><li>No vigorous or moderate physical activity </li></ul><ul><ul><li>High school students 8% </li></ul></ul><ul><ul><li>Middle school students 7.3% </li></ul></ul>
    42. 42. Prevalence of Smoking among Adults in Missouri
    43. 43. Obesity Prevalence among Adults in Missouri, 1990 - 2002
    44. 44. Prevalence of No Leisure-time Physical Activity among Missouri Adults, 1990-2002
    45. 45. Aging population
    46. 47. Thank You

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