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Supplemental Measures: Outcomes

Heart Attack, 2018 Annual Report
Measure: Heart Attack, 2018 Annual Report

Why does this matter?

Having had a heart attack decreases the heart's ability to meet the demands of the body during some illnesses. People, particularly seniors, who have severe heart conditions are at higher risk of severe illness from coronavirus disease (COVID-19). For more information about COVID-19 see the Centers for Disease Control and Prevention website.

A heart attack occurs when a coronary artery is blocked limiting the flow of blood to the heart, resulting in permanent and sometimes fatal damage to the heart muscle. In 2015, an estimated 114,023 deaths were attributable to heart attack in the United States. Coronary artery disease is the most common cause of a heart attack. An estimated 720,000 heart attacks and 335,000 recurrent heart attacks occur yearly among U.S. adults. Due to modern treatments, only 10% of heart attacks are fatal, however, survivors are rarely unaffected by the experience. Survivors of a heart attack are at increased risk of experiencing more cardiac events such as heart failure, angina, arrhythmias or stroke.

People who have survived a heart attack are approximately 2.7 times more likely to report their health as fair or poor than similar people who had not had a heart attack. Survivors are also 49% more likely to report that their state of health prevented them from performing daily activities, 63% more likely to have had poor physical health and 25% more likely to have had poor mental health for at least 15 days in the past month. This can be from physical symptoms such as chest pain and shortness of breath, or from psychological consequences such as depression or anxiety.

The time between having a heart attack and receiving treatment for a heart attack can change the severity of the damage from the heart attack. It is important that patients know and recognize the symptoms of a heart attack and seek immediate medical attention. Racial and ethnic minorities are more likely to experience longer delays in receiving treatment.

The cost of heart attacks was $12.1 billion in 2013, which includes health care services, medication and lost productivity.

Source:
  • CDC, Behavioral Risk Factor Surveillance System, 2017


Heart Disease, 2018 Annual Report
Measure: Heart Disease, 2018 Annual Report

Why does this matter?

Heart disease decreases the heart's ability to meet the demands of the body during some illnesses. People, particularly seniors, who have severe heart conditions are at higher risk of severe illness from coronavirus disease (COVID-19). For more information about COVID-19 see the Centers for Disease Control and Prevention website.

Coronary artery disease, the precursor to coronary heart disease (CHD) is the most common cause of a heart attack and directly resulted in 363,452 deaths in 2016 and was a factor in 533,126 deaths. CHD is characterized by a narrowing of blood vessels that supply the heart, usually from a buildup of plaque. The most common symptom of CHD is angina – chest pain that occurs when the heart does not receive enough blood. CHD may progress into heart failure, a condition where symptoms include fatigue, shortness of breath, persistent cough, increased urination and loss of appetite. Patients with heart failure describe these symptoms as a disruption of their everyday lives and their ability to perform routine activities leading to frustration, loss of confidence and a reduction in self-esteem.

Coronary heart disease has the highest associated indirect costs of all cardiovascular diseases. Between 2011 and 2014, 16.5 million U.S. adults had CHD. The direct and indirect costs of heart disease in 2013 to 2014 was $204.8 billion, including health care services, medication and lost productivity.

Source:
  • CDC, Behavioral Risk Factor Surveillance System, 2017


High Blood Pressure, 2018 Annual Report
Measure: High Blood Pressure, 2018 Annual Report

Why does this matter?

High blood pressure, also known as hypertension, is a major risk factor for heart disease and stroke, the leading and fifth-leading causes of death, respectively. In 2018, nearly 96,000 deaths were primarily attributable to high blood pressure. 

High blood pressure often has no signs or symptoms. Once diagnosed, however, it can be controlled through a combination of diet, exercise and medication. High blood pressure is influenced by risk factors that can be changed such as smoking, obesity, physical inactivity, poor diet (eating foods high in sodium and low in potassium) and excessive alcohol use. Recently revised guidelines lowered the cutoff for what counts as high blood pressure, which means that even more people may unknowingly have it. 

In 2016-2017, the total direct cost of high blood pressure was $52.4 billion. By 2035, it is projected that the total direct costs of high blood pressure could reach $220.9 billion.

Source:
  • CDC, Behavioral Risk Factor Surveillance System, 2017


High Cholesterol, 2018 Annual Report
Measure: High Cholesterol, 2018 Annual Report

Why does this matter?

High cholesterol is a major and modifiable risk factor for heart disease and stroke, the leading and fifth-leading causes of death in the United States, respectively. High total cholesterol (≥ 240 mg/dL) doubles the risk of heart disease, including heart attack. Excess low-density lipoprotein cholesterol (“bad” cholesterol) creates a plaque that narrows arteries and reduces oxygen-rich blood flow. When a coronary artery is blocked, the result is a heart attack. In addition, restricted blood flow to the brain can cause a stroke. An estimated 28.5 million U.S. adults have high total cholesterol.

Source:
  • CDC, Behavioral Risk Factor Surveillance System, 2017


High Health Status, 2018 Annual Report
Measure: High Health Status, 2018 Annual Report

Why does this matter?

Self-reported health status is a measure of how individuals perceive their health and is used as an indicator of a population’s health. It is a subjective measure of health-related quality of life and is not limited to certain health conditions or outcomes, but includes other factors such as life experiences, the health of others in a person’s life and support from family and friends.

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 strong association between health status and mortality makes this measure a good predictor of future mortality rates and future use of health care.

Source:
  • CDC, Behavioral Risk Factor Surveillance System, 2017


Injury Deaths, 2018 Annual Report
Measure: Injury Deaths, 2018 Annual Report

Why does this matter?

Injuries are a leading cause of mortality in the United States. Unintentional injuries occur without any intention of harming oneself or others, while intentional injuries result from purposeful actions of harm.

Unintentional injuries

Among those ages 1 to 44, unintentional injuries are the leading cause of death. Unintentional injuries are the third-leading cause of death among the total population, with accidental poisonings and motor vehicle accidents as the top contributors. Accidental poisoning deaths are driven by the opioid epidemic and motor vehicle fatalities are largely associated with alcohol-impaired driving. In 2017, an average of 130 Americans died daily from opioid overdoses, and an alcohol-impaired driving fatality occurred every 48 minutes.

Intentional injuries

The most common intentional injury deaths are suicide by firearm, homicide by firearm, suicide by suffocation and suicide by poisoning. In 2017, suicide deaths were 2.5 times higher than homicide deaths. Both of these threats to health remain serious problems, accounting for more than 60,000 deaths annually.

The economic burden of fatal injury in terms of lifetime work loss and medical costs was estimated to be $214 billion in 2013. A recent analysis found that reducing the national injury death rate to that of the lowest state-specific rate would avert 48,400 injury deaths annually, save $61 billion in medical and work loss costs annually and increase average U.S. life expectancy at birth by 0.41 years.

Source:
  • CDC WONDER, Multiple Cause of Death Files, 2014-2016


Six+ Teeth Extractions*, 2018 Annual Report
Source:
  • CDC, Behavioral Risk Factor Surveillance System, 2016


Stroke, 2018 Annual Report
Measure: Stroke, 2018 Annual Report

Why does this matter?

People, particularly seniors, who have had a stroke may be at higher risk of severe illness from coronavirus disease (COVID-19). For more information about COVID-19 see the Centers for Disease Control and Prevention website.

Each year, approximately 795,000 people will experience a stroke in the United States. Of these, approximately 185,00 are people who have had at least one stroke before. Stroke causes approximately 146,383 deaths, or about 1 in 19, each year in the United States, making it the nation’s fifth-leading cause of death. For those who survive, a stroke often leads to serious long-term disability with complications that can leave a stroke survivor unable to work. 

The direct and indirect costs of strokes in 2014 to 2015 was $45.5 billion, including health care services, medication and lost productivity.

Source:
  • CDC, Behavioral Risk Factor Surveillance System, 2017


Suicide, 2018 Annual Report
Measure: Suicide, 2018 Annual Report

Why does this matter?

Suicide is a troubling public health issue that leaves a lasting impact on families and communities. Between 1999 and 2019, the suicide death rate increased 33%. There were nearly 46,000 deaths by suicide in 2020, making it the 12th-leading cause of death in the United States. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), that same year, 12.2 million adults seriously thought about suicide, 3.2 million made a plan and 1.2 million attempted suicide in the past year.

Recorded suicide attempts among older adults are usually more lethal than those among younger age groups. Older adults are nearly twice as likely to use firearms as a means of suicide, compared with adults younger than 60. Older adults may exhibit passive self-harm behaviors that can result in death, such as refusing food, medications or liquids; these are rarely recorded as suicide attempts or deaths by suicide. 

 

Suicide among adults ages 65 years and older cost more than $1.8 billion in combined medical and work-loss related expenses in 2013, averaging between $66,218 and $243,883 per decedent among older adults. 

 

Source:
  • CDC WONDER, Multiple Cause of Death Files, 2016
*The data appearing in this edition are the same that appeared in the 2017 edition.

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