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Diabetes

Diabetes, the US’s seventh-leading cause of death, has 3 major types: type 1, type 2, and gestational. Type 2 accounts for 90% to 95% of all cases and is a largely preventable progressive disease managed through lifestyle modifications and health care interventions. Type 2’s onset can be prevented through improving diet, increasing physical activity, and losing weight; study participants losing an average 12 pounds lowered risk 58% in 3 years. Diabetics’ medical expenses are 2.3 times higher than if they did not have diabetes. Costs of type 1, type 2, gestational and undiagnosed diabetes, and prediabetes exceeded $322 billion in 2012.

Data source: Behavioral Risk Factor Surveillance System, 2014 For details: www.americashealthrankings.org/ALL/Diabetes


Measure: Diabetes, 2015 Annual Report
Measure: Diabetes, 2015 Annual Report

Why does this matter?

Diabetes was the nation’s seventh-leading cause of death in 2019, accounting for 87,647 deaths annually. Those with diabetes are twice as likely to have heart disease or a stroke than those without diabetes. There are three types of diabetes: Type 1, Type 2, and gestational (diabetes while pregnant). Type 2 diabetes accounts for 90%-95% of all cases. 

Diabetes is the leading cause of kidney failure, nontraumatic lower-limb amputations and blindness among adults. In 2018, 34.1 million adults were estimated to have diabetes, 26.8 million of which were diagnosed and 7.3 million were undiagnosed. 

Direct medical costs and lost productivity attributable to diagnosed diabetes was estimated to be $327 billion in 2017.

Source:
  • CDC, Behavioral Risk Factor Surveillance System, 2014


Poor Mental Health Days

The number of poor mental health days is a predictor of future health, forecasting 1-month and 12-month office visits and hospitalizations. Poor mental health in extreme cases can lead to suicide, the 10th-leading cause of death for all ages and the second-leading cause of death for adults aged 25 to 34. US medical costs of mental illness are not far behind those of heart disease and traumatic injury. The 2013 annual direct and indirect costs of untreated serious mental illness were estimated to be $300 billion annually, an increase of $200 billion from 2003 estimates.

Data source: Behavioral Risk Factor Surveillance System, 2014 For details: www.americashealthrankings.org/ALL/MentalHealth


Measure: Poor Mental Health Days, 2015 Annual Report
Source:
  • CDC, Behavioral Risk Factor Surveillance System, 2014


Poor Physical Health Days

Poor physical health days are an indicator of the population’s health-related quality of life. The number of poor physical health days reveals information about all-cause morbidity within the population regardless of disease or health condition. Poor physical health days and poor mental health days provide insight into overall health. Poor physical health not only indicates current health status, but it also predicts future health and future medical care; it has been shown that poor physical health is a predictor of 1-month and 12-month hospitalizations and office visits.

Data source: Behavioral Risk Factor Surveillance System, 2014 For details: www.americashealthrankings.org/ALL/PhysicalHealth
Measure: Poor Physical Health Days, 2015 Annual Report
Source:
  • CDC, Behavioral Risk Factor Surveillance System, 2014

Disparity in Health Status

Education improves health, and this disparity measure showcases the importance of keeping students in school through high school and beyond. Reducing health disparities between US adults with less education and those with college education would result in savings of more than $1 trillion annually, according to the National Bureau of Economic Research. Education is a socioeconomic indicator associated with longer life regardless of age, gender, or race. It may improve health directly (healthier lifestyles, better stress-coping, more effective chronic disease management) and indirectly (better work and economic conditions and social-psychological resources). Each increase in education level generally improves health status.

Data source: Behavioral Risk Factor Surveillance System, 2014 For details: www.americashealthrankings.org/ALL/healthstatus_disparity


Measure: Disparity in Health Status, 2015 Annual Report
Measure: Disparity in Health Status, 2015 Annual Report

Why does this matter?

This measure looks at differences in self-reported high health status between two educational attainment levels. Educational attainment is a strong predictor of future health outcomes. The connection between education and health is well documented, with lower educational attainment among adults being associated with poorer health. Higher educational attainment is associated with better jobs, higher earnings, increased health knowledge, better self-reported health and fewer chronic conditions. An additional four years of education reduces the probability of reporting fair or poor health status by 6 percentage points.

 

Research shows that those with a high self-reported health status (i.e. excellent or very good) have lower rates of mortality from all causes than those with a low self-reported health status (i.e. fair or poor). The association between health status and mortality makes this measure a good predictor of future mortality rates and future use of health care. A 2013 report found that if half of adults who did not graduate from high school had graduated, the United States would have saved over $7 billion in Medicaid costs alone.

Source:
  • CDC, Behavioral Risk Factor Surveillance System, 2014


Infant Mortality

The US infant mortality rate is higher than that of other developed countries, and geographic and racial disparities persist. Infant mortality in non-Hispanic black infants is more than twice that of non-Hispanic white infants, and the majority of states with the worst infant mortality are in the South. Infant mortality is an indicator of maternal health, prenatal care, and access to quality health care. Congenital malformations, low birthweight, and sudden infant death syndrome account for 58% of infant mortality. Prevention strategies include improving women’s pre-conception health, access to quality prenatal care, and reducing elective deliveries before 39 weeks.

Data source: National Vital Statistics System, 2012 to 2013 For details: www.americashealthrankings.org/ALL/IMR


Measure: Infant Mortality, 2015 Annual Report
Measure: Infant Mortality, 2015 Annual Report

Why does this matter?

Losing an infant is devastating for parents, families and communities and can result in extreme and persistent sadness that does not get better with time. Parents that have lost a child also have increased risks of many poor health outcomes such as post traumatic stress disorder, depression, psychiatric hospitalizations, guilt and heart attacks.

In 2017, over 22,000 infants died in the United States. According to the Centers for Disease Control and Prevention, the leading causes were:

  • Birth defects
  • Low birthweight and preterm birth
  • Maternal pregnancy complications
  • Sudden Infant Death Syndrome (SIDS)
  • Injuries

 

The United States infant mortality rate is consistently higher than other developed countries, 1.5 times higher than the average (3.8 deaths per 1,000 live births) among Organization for Economic Co-operation and Development countries. Within the United States, significant disparities persist in infant mortality among different racial and ethnic groups, with the most striking disparity between babies born to black women and babies born to white women.

Research indicates socioeconomic inequality in the United States is likely a primary contributor to its higher infant mortality, along with reporting methods that differ from state to state. Considerable progress has been made in the United States over the past 50 years to reduce infant mortality, however, more needs to be done.

Source:
  • ,

“From 1915 through 1997, the infant mortality rate declined greater than 90%…, and from 1900 through 1997, the maternal mortality rate declined almost 99%.” - Morbidity and Mortality Weekly Report

Cardiovascular Deaths

Heart disease and stroke are the US’s leading and fifth-leading death causes, respectively, and leading causes of disability with 85.6 million people living with cardiovascular disease or stroke effects. Heart disease causes 1 in 4 deaths. Among stroke victims, 90% have residual disability contributing to direct medical costs and lost productivity. Black adults are twice as likely to have a stroke and more likely to die from stroke than white adults, and American Indian and Alaska Natives experience cardiovascular death before age 65 at twice the national rate. Cardiovascular disease equals 17% of medical spending and 30% of Medicare spending.

Data source: National Vital Statistics System, 2011 to 2013 For details: www.americashealthrankings.org/ALL/CVDdeaths


Measure: Cardiovascular Deaths, 2015 Annual Report
Measure: Cardiovascular Deaths, 2015 Annual Report

Why does this matter?

Cardiovascular diseases (CVD) refer to a number of conditions related to the heart and blood vessels, namely heart disease and stroke. An estimated 121.5 million U.S. adults, 48% of those ages 20 and older, have at least one type of CVD. Hypertension is the most common component of CVD, with only 9% of adults reporting the other major components – coronary heart disease, heart failure and stroke. Heart disease and stroke, are the nation’s leading and fifth-leading causes of death, respectively — accounting for 647,457 and 146,383 deaths in 2017. Symptoms of CVD often include fatigue and shortness of breath, these symptoms and their accompanying diagnosis can have dramatic effects on people's lives.

 

While CVD rates overall have been declining for decades, recent increases in conditions that can lead to CVD (i.e. obesity and diabetes) have resulted in rising CVD rates in high-risk populations. These increases in CVD rates will likely contribute to rising costs as well. The estimated direct medical costs and lost productivity attributable to CVD was $555 billion in 2016, and are projected to reach $1.1 trillion by 2035.

Source:
  • CDC WONDER, Multiple Cause of Death Files, 2011-2013

“Every day, 2,200 people die from cardiovascular diseases— that’s nearly 800,000 Americans each year.” —Million Hearts

Cancer Deaths

Cancer is the US’s second-leading death cause. Most common sites in 2011 were breast, prostate, and lung. More than 1.7 million new cancer cases and 589,430 cancer deaths occur annually. Direct medical cancer costs were $88.7 billion in 2011. Prostate cancer disproportionately affects black men. Breast cancer is the most common cancer among adult women; white women have the highest incidence, but mortality risk is 44% greater for black women. World Cancer Research estimates 25% to 33% of new cancers relate to obesity, physical inactivity, and nutrition. Every US adult losing 2.2 pounds would prevent 100,000 new cancer cases annually.

Data source: National Vital Statistics System, 2011 to 2013 For details: www.americashealthrankings.org/ALL/CancerDeaths


Measure: Cancer Deaths, 2015 Annual Report
Measure: Cancer Deaths, 2015 Annual Report

Why does this matter?

Cancer is the second-leading cause of death in the United States behind heart disease. The most common cancers in the nation — breast, prostate, lung and bronchus, and colorectal cancer — are also responsible for the most deaths. Lung cancer accounts for the largest number of cancer deaths among men (26%) and women (25%).

 

According to the American Cancer Society’s Cancer Facts & Figures 2019 report, there will be an estimated 1,762,450 new cases of cancer and 606,880 cancer deaths in 2019. The age-adjusted U.S. cancer death rate has been declining steadily from its peak in 1991, with more than 2.6 million fewer cancer deaths between 1991 and 2016. The decrease in cancer deaths can be attributed to reductions in smoking as well as improved detection and treatment of cancer.

 

In 2017, the national cost of cancer care was approximately $147.3 billion. Assuming incidence and survival trends remain constant, that number is expected to increase to nearly $157.8 billion by 2020, due to a growing number of aging Americans — as the population ages cancer prevalence increases. In addition, the estimated cost of lost productivity from cancer mortality is projected to be $147.6 billion in 2020.

Source:
  • CDC WONDER, Multiple Cause of Death Files, 2011-2013

“Forty-two states have enacted legislation limiting minors’ access to indoor tanning facilities, including restricting access by age or requiring parental permission and/or a physician’s order.” —American Cancer Society

Premature Death

Premature death reflects the difference between the age of death and age 75. Young people’s deaths are more likely to be preventable than senior deaths and often indicate health care system failures and/or lifestyle factors. Heart disease, cancer, unintentional injuries, suicide, and perinatal deaths are the US’s top 5 causes of premature death. Many causes are preventable. Examples: 88% of adult smokers began by age 18 even though smoking decreases life expectancy by at least 10 years compared with nonsmokers. Also, heart disease is tied to several modifiable risk factors such as obesity, diabetes, and physical inactivity.

Data source: National Vital Statistics System, 2013 For details: www.americashealthrankings.org/ALL/YPLL
Measure: Premature Death, 2015 Annual Report
Measure: Premature Death, 2015 Annual Report

Why does this matter?

Premature death is a measure of years of potential life lost due to death occurring before the age of 75. Deaths at younger ages contribute more to the premature death rate than deaths occurring closer to age 75. For example, a person dying at age 70 would lose five years of potential life, whereas a child dying at age five would lose 70 years of potential life. 

According to the National Center for Health Statistics WISQARS Years of Potential Life Lost (YPLL) Report, cancer, unintentional injury, heart disease, suicide, deaths in the perinatal period and homicide were the leading causes of years of potential life lost before age 75 in 2019. Since 2000, increases have occurred in suicide and drug deaths, both contributing to the rise in premature death. 

Many premature deaths may be preventable through lifestyle modifications such as smoking cessation or healthy eating and exercise. The Centers for Disease Control and Prevention (CDC) estimate that 20-40% of premature deaths are preventable.

Source:
  • CDC WONDER, Multiple Cause of Death Files, 2013







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