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Chronic Illness Costs The Economy More Than $1 Trillion A Year

By Victoria Colliver, Chronicle Staff WriterSan Francisco Chronicle

October 3, 2007 - Americans who have common chronic health conditions cost the U.S. economy more than $1 trillion a year, a figure that could jump to nearly $6 trillion by 2050 unless people take steps to improve their health, a study released Tuesday found. [Total U.S. gross domestic product (GDP) in 2006 was about $12 trillion.]

According to the report by the Milken Institute, a Santa Monica think tank, the economic impact of chronic illness goes far beyond the expense of treating disease. It takes an even greater toll on economic productivity in the form of extra sick days, reduced performance by ill workers and other losses not directly related to medical care.

But veering onto a path that emphasizes changing lifestyles along with prevention and early detection of disease could reduce the number of illnesses by 40 million cases and save $1.6 trillion by 2023, the report said.

"The public is telling us the No. 1 domestic issue is health," said Dr. Richard Carmona, former U.S. surgeon general and now chairman of the Partnership to Fight Chronic Disease, in a news conference in Washington on Tuesday releasing the report. "The disease burden is mounting, the economic burden is mounting and the trajectory we're on is unsustainable."

The study looked at seven of the most costly chronic illnesses: the most common forms of cancer, hypertension, mental disorders, heart disease, diabetes, pulmonary conditions such as asthma and stroke.

"More than half of Americans suffer from chronic disease. Every year, millions of people are diagnosed, and every year millions die of these diseases," said Ross DeVol, the Milken Institute's director of health and regional economics and principal author of the report.

Treatment for those diseases, based on 2003 data, cost $277 billion. But lost productivity cost far more: $1.1 trillion.

Combined, the economic impact of the diseases added up to more than $1.3 trillion. Cost calculations, which are based on various studies of companies, also included economic losses generated by caregivers.

The study found some conditions create a greater economic burden than others, regardless of the number of diagnoses or cost of treatment.

For example, far fewer people suffer from cancer than pulmonary conditions. But the overall economic impact of cancer is greater because, while treatment is expensive, cancer patients also tend to be more debilitated and lose more work time than those suffering from many other chronic conditions, researchers said.

If the country does nothing to address the problem, the number of cases diagnosed in those seven disease categories will increase by 42 percent by 2023 for a total economic impact of $4.2 trillion, the report said.

"The data to stay the course is not a particularly attractive option," said Ken Thorpe, executive director of the Partnership to Fight Chronic Disease and a professor at Emory University.

The country needs to shift its focus from trying to reduce health expenses to lower rates of illness, Thorpe said.

Lifestyle changes could have a major impact on our country's price tag for chronic disease, the report said.

Curbing obesity alone by close to 15 million cases could translate to a savings of $60 billion by 2023 and improve the country's productivity by $254 billion, the report said. Other changes include lowering smoking rates and increasing early detection and disease- management efforts.

The report looked at the impact of geographical differences on chronic illness, which varies by habits, age and other demographic issues.

California generally is healthier than much of the rest of the country, ranking sixth in a score of all states for percentage of chronic disease by population. The lowest levels of disease were found in Utah, followed by Alaska, Colorado, New Mexico and Arizona. The sickest states in the survey were West Virginia, Tennessee, Arkansas, Kentucky and Mississippi.

Despite California's relative health ranking, the state's large population means it has both a lot to lose and a lot to gain in future costs.

"For many of the chronic diseases, California has a lower prevalence than other states, but we're such a large state -- the largest state in the country -- we have a lot to be gained in avoiding treatment of these disease as well as improving the quality of the workforce," said DeVol, the study's author.

California has the opportunity to prevent about 4.2 million cases of avoidable chronic disease by 2023, which would increase productivity by $98 billion and lower treatment costs by $18.9 billion, DeVol said.

"The cautionary tale, when I look at California, is looking at our children and obesity rates," DeVol said, adding that the rising obesity levels are especially dramatic among young Latinos. "If we don't address the rising obesity problem, we have a huge potential problem in the future."

The study was funded in part by a grant from the Pharmaceutical Research and Manufacturers Association of America, the drug industry's trade group. The Milken Institute declined to reveal the amount of the grant.

E-Mail Victoria Colliver at

Copyright 2007 Hearst Communications Inc.


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