29 Oct Facts about Investing in Prevention
In 2006 the Washington Association of Naturopathic Physicians submitted excerpts from the Blue Ribbon Commission proposal: Evidence-based Chronic Disease Prevention. The following are facts excerpted from that proposal:
Adoption of a Health Lifestyle = Evidence-based, Chronic Disease Prevention (EBCDP).
- 62% of coronary events are preventable by following a healthy lifestyle (The Health Professionals Follow-up Study (n=42,847) Circulation, 2006)
- 58% of Type 2 diabetes is preventable by lifestyle modification (Diabetes Prevention Program (DPP); (New England Journal of Medicine, 2002)
- Cardiovascular disease, diabetes, and cancer are all preventable through lifestyle practices (Preventing Cancer, Cardiovascular Disease and Diabetes: A Common Agenda American Cancer Society, American Heart Association, and the American Diabetes Association, Circulation, 2004)
EBCDP is more effective than early medication for disease prevention.
- Lifestyle (58%) was superior to early metformin (34%) for the prevention of diabetes (New England Journal of Medicine, 2002)
- Lifestyle change is the only intervention proven to reverse coronary artery disease (Ornish et al., JAMA, 1998)
- Early TZD class medications were ineffective in diabetes prevention (Knowler et al. Diabetes, 2005)
Few WA State health care providers are making EBCDP recommendations in practice.
- Only 16% of adult respondents said they were advised by their doctor, nurse, or other health professional to eat fewer high fat or high cholesterol foods
- Only 20% were advised to eat more fruits and vegetables
- Only 23% were advised to be more physically active (The Burden of Heart Disease and Stroke in Washington State 2004; WA State Dept. of Health)
EBCDP programs are cost-effective.
- Chronic diseases currently accounts for 12% of all health care expenditures (Hogan, Diabetes Care, 2003)
- Preventive services are widely accepted as a cost-effective strategy to reduce disease. Research supported by the U.S. Agency for Healthcare Research and Quality shows that health education and lifestyle modification reduce the negative impacts, including costs, associated with chronic disease (Research News. Agency for Healthcare Research and Quality No 02-0018 April 2002)
- A recent demonstration project implemented the Diabetes Prevention Program lifestyle intervention in adults age 50 and prevented 37% of expected cases of diabetes over 15 years at a cost of $1288 per quality-adjusted life year (QALY). Private insurer investments in this EBCDP program showed recovery of costs in the form of medical expenses avoided after three years implementation. (Ackermann et al., Diabetes Care, 2006)
- A private payer could reimburse $655 (24%) of the $2,715 in total discounted intervention costs during the first 3 intervention years and still recover all of these costs in the form of medical costs avoided. If Medicare paid up to $2,136 in intervention costs over the 15-year period before participants reached age 65, it could recover those costs in the form of future medical costs avoided beginning at age 65 (Ackermann, Diabetes Care. 2006).
- Additional cost analysis of the Diabetes Prevention Program in high-risk populations resulted in a cost of $1,100 per QALY for the lifestyle program versus $31,300 per QALY for early prescription drug therapy (Herman, WH. Annals International Med 2005).
- A recent study aimed at getting sedentary Americans active compared lifestyle recommendation to a structured program in the gym. Results were equal but the 24 months costs were $17.15 vs. $49.31 per participant per month. Lifestyle intervention was more cost-effective than the structured intervention for most outcomes measures. (Sevick et al. American Journal Preventative Med 2000)
Ignoring EBCDP is very costly.
- Almost 60% of Washington adults are overweight or obese. Obesity is one of the primary factors in many health problems, including diabetes and heart disease. In one year alone, diabetes-related hospitalizations cost about $1.27 billion
- Escalating costs of chronic disease nationwide despite higher priced treatments
- Avoidable medical costs of amputation, blindness, dialysis, kidney transplantation, cardiovascular surgeries, and long-term hospitalization
- Avoidable human costs of blindness, amputation, work-time losses, and depression
As the above facts detail, the adoption of a healthy lifestyle would go a long way towards saving Americans a lot of money in the long term. Schedule an appointment with Dr. Naumes today to discuss what changes you can make in your life to move towards optimal wellness.
DISCLAIMER: Dr. Kate Naumes holds a Doctorate in Naturopathy and a Certificate in Midwifery from Bastyr University. The state of Texas does not license Naturopathic Doctors. As such, she holds her license in California and acts in Texas as a wellness consultant, not as a physician.