Communities Putting Prevention to Work Wayne H. Giles, MD, MS
Director Division of Adult and Community Health National Center for
Chronic Disease Prevention and Health Promotion June 8, 2010 CPPW
Action Institute, St. Louis, MO
Slide 3
Overview Why focus on chronic disease and underlying risk
factors? Why policy, systems, and environmental change strategies?
Why now?
Slide 4
Leading Causes of Death United States, 2006 Percentage (of all
deaths) Heart Disease Cancer Chronic lower respiratory diseases
Unintentional Injuries Alzheimers disease Diabetes
Pneumonia/influenza Kidney Disease Stroke National Center for
Health Statistics. Deaths: Final Data for 2006. Hyattsville, MD: US
Department of Health and Human Services; 2008.
Slide 5
Ten Great Public Health Achievements 1900 - 1999 Vaccination
Motor-vehicle safety Safer workplaces Control of infectious
diseases Decline in deaths from coronary heart disease and stroke
Safer and healthier foods Healthier mothers and babies Family
planning Fluoridation of drinking water Recognition of tobacco use
as a health hazard
Slide 6
Alarming Health Disparities Heart disease death rates 30%
higher for African- Americans than whites; stroke death rates 41%
higher Diabetes higher among American Indians and Alaska Natives
(2.3 times), African Americans (1.6 times), and Hispanics (1.5
times) About 30% of Hispanics and 20% of African Americans lack a
usual source of health care compared with less than 16% of
whites
Slide 7
Disparities in health care are among the nations most serious
health care problems. Research has extensively documented the
pervasiveness of racial and ethnic disparities. Institute of
Medicine, 2002
Slide 8
Economic Impact Chronic conditions account for 75% of the $2
trillion in health care costs Smoking costs $96 billion per year
Obesity-related costs $147 billion per year
Slide 9
Why Chronic Disease? Something Can Be Done- Preventable Risk
Factors
Slide 10
Chronic Diseases and Related Risk Factors Leading Causes of
Death* United States, 2000 Actual Causes of Death United States,
2000 Kidney disease 05101520 Tobacco Poor diet/ Physical inactivity
Alcohol consumption Microbial agents Toxic agents Firearms Sexual
behavior Motor vehicles Illicit drug use Percentage (of all deaths)
Heart Disease Cancer Chronic lower respiratory disease
Unintentional Injuries Pneumonia/influenza Diabetes Alzheimers
disease Stroke Percentage (of all deaths) 05101520253035 * Minio
AM, Arias E, Kochanek KD, Murphy SL, Smith BL. Deaths: final data
for 2000. National Vital Statistics Reports 2002; 50(15):1-120.
Mokdad AH, Marks JS, Stroup DF, Gerberding JL. Actual causes of
death in the United States, 2000. JAMA.
2004;291(10):1238-1246.
Slide 11
Growing Challenges
Slide 12
Healthy Food Has Gotten More Expensive, Junk Food Cheaper Fresh
fruits and vegetables Consumer price index Sugar and sweets
Carbonated drinks Price Index (1982-84 = 100) Data from Bureau of
Labor Statistics; represent U.S. city averages for all urban
consumers in January of each year
Slide 13
Obesity Trends* Among U.S. Adults BRFSS, 1990 (*BMI 30, or ~ 30
lbs. overweight for 5 4 person) No Data
