By Peter Galvin, MD
Recently, two separate government agencies released some disconcerting information regarding the U.S. population. First, in May, the U.S. Census Bureau reported that we are collectively getting older. By that I mean that the median age in the U.S. has risen to 38.8 years. People are living longer (in truth, life expectancy is falling, but this is due to the high rate of drug ODs in younger people) due to better health care while the birth rate is falling. But, as a rule of thumb, the longer a person lives, the more likely he/she is to have chronic disease. So, lo and behold, the CDC (which should be the CDCP, or Centers for Disease Control and Prevention) revealed that by 2030, the number of U.S. residents struggling with at least one chronic disease is expected to surpass 170 million. That is more than half of the projected 2030 population. Not only that, but the expanding older population and adults are not the only age group seeing an uptick in chronic disease. The CDC reports that 40% of children and adolescents have at least one chronic disease.
The cost of this is huge. Chronic disease cost is responsible for a large segment of U.S. health care costs: of the $4.1 trillion in annual health care expenses, chronic disease and mental health conditions account for about 90% of that figure. Current estimates place the annual cost of chronic disease treatment at more than $6,000 per patient. For example, a person with type II diabetes checks their blood sugar several times a day, takes prescription medications, and (should) visit their doctor at least every two to three months. All that adds up quickly. And that doesn’t include time off from work for the patient to visit the doctor and possibly their caregiver as well. Conditions with some of the highest direct health care costs in the U.S. include diabetes, at $189.6 billion a year, Alzheimer’s disease at $185.9 billion, and osteoarthritis at $115.5 billion.
Unfortunately, many of these diseases and conditions are not only self-inflicted, but many are also totally avoidable. They are the byproduct of unhealthy lifestyle choices, diet, and excessive stress. One study asserts that noncommunicative diseases that are chronic account for 70% of all global deaths each year. Heart disease and obesity fall under the heading of “lifestyle diseases”, as do many cases of chronic obstructive pulmonary disease (COPD), diabetes, inflammatory conditions, and asthma. According to the CDC, the main factors contributing to the subset of “lifestyle diseases” are tobacco use, poor nutrition, a sedentary lifestyle, and excessive alcohol use. A big contributor in the last two decades is the sharp rise in ultra-processed food consumption (see May 17 “Ask the Doc”). An 18-year study by NYU showed that consumption of processed foods climbed steadily over that period, accounting for 57% of America’s daily calories by 2018.
Some researchers place the blame for the rise in chronic disease squarely on the shoulders of a lethargic medical industry. A 2020 study by the National Library of Medicine concluded that “the medical profession and its leadership did not recognize or respond appropriately to the rising prevalence of chronic disease. As a consequence, a health care crisis emerged.” Well, don’t say you weren’t warned.
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