DEATH RATES

1
DEATH RATES

• United States 100
• Missouri 100
• Northwest Missouri 100

2

2003 Leading Causes of Death in the US Public
Health Impact
Total Number of Deaths 2,443,908
3
1990 2004 Leading Actual Causes of Death in the
USHuman Behaviors
Source CDC
4
Causes of Death and Major Illnesses in the U.S.
Source CDCP, PHS, DHHS
5
Risky BusinessLarge numbers of Americans cling
to lifestyles that greatly increase their risk of
cancer, heart disease, and diabetes. Over the
past decade, the percentage of those who smoke
has remained stubbornly unchanged, while more
than one out of four has remained a couch potato
and nearly twice as many have become obese.
U.S.
Missouri
St. Joseph
45.0
40.0
35.0
30.0
25.0
20.0
15.0
10.0
5.0
0.0
1997
2001
2007
1997
2001
2007
1997
2001
2007
Current Smokers
No Leisure Time Physical Activity
Obese
Source National Center for Chronic Disease
Prevention and Health Promotion Behavioral Risk
Factor Surveillance System 2007
6
Obesity Trends Among U.S. Adults
BRFSS,
1991, 1996, 2004
(BMI
³
30, or about 30 lbs overweight for 54 person)
1996
2004
No Data lt10 10

14
15

19 20

24 gt25
Source Behavioral Risk Factor Surveillance
System, CDC.
7
Diabetes Trends Among Adults in the U.S.,
(Includes Gestational Diabetes)
BRFSS, 1990,1995 and 2001
Source
Mokdad
et al.,
Diabetes Care
2000231278
-
83
J Am Med Assoc
200128610
.
8
(No Transcript)
9
Baseline 20th Century Annual Morbidity and 1999
Provisional Morbidity from Nine Diseases with
Vaccines Recommended Before 1990 for Universal
Use in Children United States

10
Current Future Health Challenges
Infant and Child Health

• Overweight Boys
• 1963 4.0 1994 11.8 2000 16
• Overweight Girls
• 1963 4.5 1994 11.0 2000 14.5
• Early childhood education.
• Low birth weight/very low birth weight.
• High school completion.
• Teen birth rates.
• Motor vehicle crashes (with and without
  alcohol/drug factors).

• Asthma
• gt40 per 1000 children in 1982
• gt62 per 1000 children in 1996

• Healthy weight.
• overweight in 1971 4
• overweight in 1994 10.5
• overweight in 2000 15.3
• Smoking.
• Violence.
• Suicide.
• Sexually transmitted disease.

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The Dilemma

• So why are we afraid for our kids health?
• Modern childrens health issues are preventable,
  yet scary because of the illusion that science
  can fix everything like it did in the last
  century.
• Health happens at the intersection where science
  meets social, spiritual, educational, economic,
  family, behavioral and community circumstances.
• We cant give a shot to become a better parent,
  or immunize a 14 year old to make wise choices.
  Science has limits!

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The USA Ranks 37th in World Health.
World Health Report 2000 (health system and
performance in all member states, ranked by eight
measures) places the USA 37th in overall system
performance.
13
Missouri Ranks 38th in USA Health.
There are several indicators to compare on health
status. For the 2004 CDC BRFSS question How
would you rate your health in general? 84.1 of
Missourians said excellent, very good, or good to
the question. Missouri ranks 38th in the nation.
The top states are Minnesota and New Hampshire.

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People
Policy
2004 USA Deaths 2,397,615
Provider Response Individual Accountability
Healthcare Policy
Heart, Cancer, Stroke, Pulmonary, Diabetes
Public Health Organizational Policy
2000 Actual Causes of Death Human Behaviors
Individual Accountability
Tobacco, Obesity, Diet, Inactivity, Alcohol,
Motor Vehicle
Community, Economic, Education, Social Policy
Individual Community Accountability
Root Causes Human Conditions
Stress, Anger, Poverty, Economics, Education
Levels, Depression, Unemployment, Broken
Families, Environmental Factors, Emptiness,
Hopelessness, Disconnectedness
Adapted From National Civic League, Healthy
Communities Conference 1994 Updated With CDC Data
Best Practices
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HEALTHY COMMUNITIES

• The two key determinates of the health
• status of a population
• Education Levels
• Affluence (Jobs)

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If I had known I would live this long, I would
have taken better care of myself. Mickey
Mantle
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With No Changes, Projected Cost Growth in Health
Care Is Large
4.5
4.0
10 Years
3.5
2.1 Trillion(100)
3.0
Annual healthexpenditures(trillions)
2.5
2.0
Official CMS projection of healthcare cost growth
1.5
1.0
.5
0
2002
2004
2006
2008
2010
2012
2014
2016
Year
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HEALTHY COMMUNITIESIDEAL APPROACH

• Individuals assume responsibility (maximum extent
  possible) for their own and their families
  health
• Healthy behaviors
• Personal financial responsibility for health
• Health insurance designed to promote and
  encourage healthy life styles and wise buying
  practices
• Encourage preventive care
• Design benefits to influence positive behavior
• Reward healthy behaviors
• Universal coverage and portability

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HEALTHY COMMUNITIESIDEAL APPROACH

• Higher premiums for non-managed care lower
  premiums for managed care.
• Comprehensive integrated health provider (like
  Heartland) that exist to serve the community
  interest