Chronic Disease
A Public Health Perspective
Chronic Disease Overview
• The most prevalent, costly, and preventable
chronic diseases
– cardiovascular disease (primarily heart disease
and stroke),
– cancer, and
– diabetes
Leading Causes of Death in the
U.S., 2003
Costs of Chronic Disease, U.S.
• In 2005, 133 million people, almost half of all Americans
lived with at least one chronic condition
• The medical care costs of people with chronic diseases
account for more than 75% of the nation’s $2 trillion
medical care costs.
• $17,239 expenditure per household
• Chronic diseases account for one-third of the years of
potential life lost before age 65.
• Hospitalizations for pregnancy-related complications
occurring before delivery account for more than $1 billion
annually.
• The direct and indirect costs of diabetes is $174 billion a
year.
Costs of Chronic Disease, U.S.
(Continued)
• Each year, arthritis results in estimated medical care
costs of nearly $81 billion, and estimated total costs
(medical care and lost productivity) of $128 billion.
• The estimated direct and indirect costs associated with
smoking exceed $193 billion annually.
• In 2008, the cost of heart disease and stroke in the U.S.
is projected to be $448 billion.
• The estimated total costs of obesity was nearly $117
billion in 2000.
• Cancer costs the nation an estimated $89 billion
annually in direct medical costs.
• Nearly $98.6 billion is spent on dental services each
year.
Cost-Effectiveness of Prevention
• Water fluoridation
• Smoking cessation
• Safer Choice Program (a school-based
HIV, other STD, and pregnancy prevention
program),
• Preconception care
• Arthritis Self-Help Course
• Breast cancer
CDC's Chronic Disease Programs
• CDC supports a variety of programs to improve the nation's
health by preventing chronic diseases and their risk factors.
• These programs provide national leadership
• Sample CDS Program
• Arthritis
• Cancer Control
• Diabetes
• Healthy Aging
• Healthy Youth
• Heart Disease and Stroke
• Nutrition, Physical Activity and Obesity
• Safe Motherhood
• Tobacco
Targeting Arthritis
• Improving Quality of Life for More Than
46 Million Americans
• The Nation’s Most Common Cause of
Disability
• Arthritis comprises over 100 different
diseases and conditions
• Common symptoms
Why Is Arthritis a Public Health
Problem?
• An estimated 46 million U.S. adults (about 1 in
5) reported doctor-diagnosed arthritis
• Nearly 19 million U.S. adults reported activity
limitations because of arthritis
• Work limitations attributable to arthritis affect
about 1 in 20 adults
• Arthritis results in 750,000 hospitalizations and
36 million outpatient visits
• 128 billion dollars in annual costs
• Arthritis is responsible for 9,500 deaths in the
U.S. annually
What Can Be Done to Target
Arthritis?
• Self-management education programs
• Chronic Disease Self-Management
Program
• Physical activity
• Weight control and injury prevention
• Early diagnosis and appropriate
management
What Are CDC and Its Partners
Doing About Arthritis?
• CDC is committed to leading strategic
public health efforts to promote well-being,
prevent chronic disease, and achieve
health equity.
• For example, the National Arthritis Action
Plan
What Activities Does CDC’s
Arthritis Program Support?
• The primary goal is to improve the quality
of life for people affected by arthritis.
• The program achieves this goal by
supporting the following five key activities:
– Building state programs
– Reaching the Public
– Improving the science base
– Measuring the burden of arthritis
– Making policy and systems changes
Future Directions for the CDS
• Improve the quality of life for people affected by
arthritis
• Move state programs from building capacity to
implementing programs on a wider scale
• Identify model dissemination efforts
• Develop innovative interventions that meet the
needs of diverse populations
• Work collaboratively with other chronic disease
programs at federal and state levels
CDC Funding for State Arthritis
Programs, 2008
Chronic Disease Indicators
• Ninety indicators that allows states and
territories to uniformly define, collect, and report
chronic disease data
• Seven categories:
–
–
–
–
–
–
–
Physical activity and nutrition
Tobacco and alcohol use
Cancer
Cardiovascular disease
Diabetes
Overarching conditions
Other diseases and risk factors
Tobacco Use
• The definition for each indicator includes a hyperlink to additional
information and data resources. These include—
• Behavioral Risk Factor Surveillance System (BRFSS)
• Alcohol and Public Health
• Youth Risk Behavioral Surveillance System (YRBSS)
• State Tobacco Activities Tracking and Evaluation (STATE) System
• National Program of Cancer Registries
• State Cancer Profiles
• CDC WONDER
• Health-Related Quality of Life
• United States Renal Data System (USRDS)*
• Current Population Survey, American Community Survey
• National Diabetes Surveillance System
• National Oral Health Surveillance System
Tobacco Use: Behavioral Risk Factor
Surveillance System (YRBSS)
Tobacco Use: Behavioral Risk Factor
Surveillance System (YRBSS)- California
Tobacco Use: Behavioral Risk Factor
Surveillance System (YRBSS)- California
Tobacco Use: Behavioral Risk Factor
Surveillance System (YRBSS)- California
Tobacco Use: Behavioral Risk Factor
Surveillance System (YRBSS)- California by
Income
Tobacco Use: Behavioral Risk Factor
Surveillance System (YRBSS)- California by
Race
Tobacco Use: Behavioral Risk Factor
Surveillance System (YRBSS)- California by
Education
Tobacco Use: Behavioral Risk Factor
Surveillance System (YRBSS)- California by
Gender
Current California Adults
Current California Adults Grouped
by Income
Current California Adults Grouped
by Race
Current California Adults Grouped
by Education
Current California Adults Grouped
by Gender
What Does this Information Tell
Us?
• How would you title a public health
intervention?
• How would you describe the target
population?
What You Can Do
• http://apps.nccd.cdc.gov/brfss/page.asp?cat=TU&yr=200
7&state=CA#TU
What You Can Do (Continued)
• Choose one of the other chronic diseases
• Click on the choice
• Explore the links and identify a possible
public health intervention issue and target
population