Diseases associated with smoking are costing Americans trillions

MINNEAPOLIS-The data contained in the 20th Anniversary Edition of America’s Health Rankings™ notes a worrisome escalation in preventable diseases that will significantly increase costs in an already unaffordable medical care delivery system. Of the $2.4 trillion of annual health care expenditures in the United States, $1.8 trillion is associated with the treatment of chronic disease, such as diabetes, heart disease and cancer.

“As our nation’s leaders discuss health care reform and address the essential challenge of providing medical care coverage for 46 million uninsured Americans, controlling the escalation in health care costs is an imperative,” said Reed Tuckson, M.D, United Health Foundation board member and executive vice president and chief of medical affairs, UnitedHealth Group. “Unless there is urgent action across our society, our already overburdened care system will be swamped by a tsunami of cost and demands from preventable chronic disease. Together, as individuals, community leaders, health care professionals, employers and elected officials, we must elevate disease prevention and health promotion to the top of our agendas.”

Tobacco consumption and obesity have emerged as the two priorities that threaten the health of the nation. While tobacco use dropped from 19.8 percent of the population last year to 18.3 percent this year, approximately 440,000 deaths annually are still attributable to this preventable behavior.

Obesity has increased nearly 130 percent since the first edition of America’s Health Rankings™ was issued 20 years ago. Currently, 27 percent of the population is obese. A supplemental analysis to this year’s report conducted by Kenneth Thorpe, Ph.D., shows America now spends $80 billion in direct health care costs associated with obesity. Left unchecked, 43 percent of adults will be obese and obesity will add nearly $344 billion in 2018 alone to the nation’s annual direct health care costs, accounting for more than 21 percent of health care spending.

America’s Health Rankings™ is an annual comprehensive assessment of the nation’s health on a state-by-state analysis. It is published jointly by United Health Foundation, the American Public Health Association and Partnership for Prevention. The data in the report comes from validated outside sources, such as the Centers for Disease Control and Prevention (CDC). The report is reviewed and overseen by a Scientific Advisory Committee, with members from leading academic institutions, government agencies and the private sector.

Results From the Nation’s Only 20-Year Scorecard

Many public health scholars believe that obesity has become equal to, and may overtake tobacco use, as the most significant risk factor for death and disease in the nation. That is in part because, while smoking has declined slightly in the past 20 years and it still exacts extraordinary health consequences on our nation, obesity is on a dangerous, and as yet unchecked, trajectory.

* Smoking — Biggest Battle of Past 20 Years: Despite focused efforts, nearly one in five Americans still smoke. Over the past year, more than 3 million people have quit smoking, suggesting that interventions such as smoke-free laws, smoking bans, increased cigarette taxes, access to smoking cessation programs and other interventions may have a positive impact.
* Obesity — Next National Health Battle: Obesity is growing faster than any previous chronic health issue our nation has faced. Today, more than one in four Americans are considered obese.
If current trends continue, 103 million American adults — or 43 percent of the population — will be considered obese by 2018.
* Other 20-Year Improvements and Challenges: Over the past 20 years, the nation has seen significant declines in crime rates, infectious disease, smoking and infant mortality rates. Challenges since 1990 include the rising uninsured rate, lack of progress in increasing high school graduation rates and the need to continue to improve access to adequate prenatal care for pregnant women.

This year’s report and data from the past 20 years are available at www.americashealthrankings.org.

Economic Impact of Obesity

United Health Foundation commissioned a unique supplemental report for this year’s Rankings to understand the financial impact of obesity. This “Future Costs of Obesity” report was written by Kenneth E. Thorpe, Ph.D., Emory University professor, Partnership to Fight Chronic Disease executive director and former Deputy Assistant Secretary for Health Policy in the U.S. Department of Health and Human Services under President Clinton. It is the first to provide projections around future health care costs directly attributable to obesity that have been individually calculated for each state, as well as the nation.

* Obesity-Related Cost Projections for 2018: Excess Pounds Creates Excess Costs: Left unchecked, obesity will add nearly $344 billion to the nation’s annual health care costs by 2018 and account for more than 21 percent of health care spending.

* Oklahoma is projected to have the highest obesity rate in the country by 2018; as a result, they are facing an estimated $3.2 billion in health care costs attributable to obesity.
* Colorado is estimated to have the lowest national obesity rate by 2018, costing the state $1.8 billion in health care costs tied to obesity.

Vermont on Top for 2009 State Rankings; New York Most Improved in 20 Years

This year, the Rankings not only provided an annual list of the healthiest and least healthy states, but also determined which states had improved the most over the past 20 years in overall health and how the states compared in their progress against smoking and obesity since 1990.

2009 State Rankings

The 2009 Anniversary Edition shows Vermont as the healthiest state this year. The state has had a steady climb in the Rankings for the past 12 years, moving up from 20th in 1990. Utah climbed from a ranking of fifth to second this year, followed by Massachusetts (3), Hawaii (4) and New Hampshire (5) to round out the Top 5 healthiest states for 2009. For the second year in a row, Utah leads the nation as the state with the lowest prevalence of smoking, and Colorado ranks as the state with the lowest prevalence of obesity.

Mississippi is ranked 50th this year, followed by Oklahoma (49), Alabama (48), Louisiana (47) and South Carolina (46). A complete listing of the 2009 state health rankings is available at www.americashealthrankings.org.

“Every state has its successes from which we can all learn, regardless of its placing in the Rankings. And every state has its challenges,” said Georges C. Benjamin, M.D., executive director of the American Public Health Association. “The take-home message from this year’s report is found in the sub-title: ‘a call to action for people and their communities.’ Our nation’s public health professionals cannot win this battle alone; all people have to do their share. Unless we do, all of us will pay the price in higher health care costs and diminished access to care.”

States With the Most Improvement Since 1990

Over the past 20 years, New York has demonstrated the most improvement in the overall health of its population. This improvement has primarily been driven by a 60 percent reduction in violent crime and significant reductions in infant mortality and smoking rates. Other states showing the greatest improvement since 1990 include Vermont, Hawaii, New Hampshire, New Jersey and Minnesota.

States with the greatest success reducing smoking over the past 20 years include Rhode Island, Virginia, Maryland, Florida, Delaware and Vermont. States with the greatest success against obesity over the past 20 years include Connecticut, Rhode Island, Massachusetts, Wyoming and Florida.

“We will never improve the health of our states until prevention is at the forefront of what we do,” said Robert J. Gould, Ph.D., president and CEO of Partnership for Prevention. “We clearly have a lot of work ahead of us if we are to have healthy states and a healthy nation. Combating the dynamic social aspects of health is difficult, but when all parties —including employers — work together effectively, we can make a real difference in the community as well as in the workplace.”

Get Informed and Take Action to Improve National Health

The 20th Anniversary Edition of America’s Health Rankings™ has more data than ever before, and the data is now easier to access, compare and share. The following tools are now available at www.americashealthrankings.org:

* e-Rankings is a searchable database that makes it possible to find out how each state — and the nation — rates now compared to 20 years ago.
* Healthy Actions Center features tips, tools and programs offered by proven experts to help everyone — from individuals to elected officials — make a difference now.
* Obesity Cost Calculator highlights national and state-specific costs of obesity today and projects how those costs could skyrocket in the future.

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