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Tipping

the Scales
How fat has become
a weighty problem for North Carolina

Shellie Pfohl
Be Active North Carolina
Be Active North Carolina

A Statewide Initiative to
Increase Physical Activity
Just imagine…
• An ideal world
where everyone
would be in good
health.
• They’d be at a
healthy weight,
energetic, engaged
in healthy habits,
resistant to disease,
and active.
Of course in reality…
• Too many North Carolinians
suffer from ill-health or have
health and lifestyle habits that
predispose them to a host of
diseases.
• Tragically, even children are
experiencing diseases and
conditions historically have
been associated with
middle- or old-age.
Ask yourself……
• How can your county, NC and the USA
compete in a global economy with our current
trend in health care costs?
• Why would companies want to employ
Americans if they can get the same or better
quality products/services overseas for a tenth
of the cost?
• How does this impact health, health care,
education, economy in America/NC/county?
• How can we get NC moving in the right
direction?
Things to Consider…
• You know the ‘human’ cost of unhealthy
lifestyles from your CHA, BRFSS, etc.
• But how does this impact your
economy, healthcare costs, jobs….?
• Funders, sponsors, policy-makers care
about the ‘bottom line’
• Have to make the connection between
your ‘health’ data and ‘economic’ data
Need to answer….
• Why should we have more PE in
schools?
• Why do we need more bike lanes and
multi-use trails?
• Why do we need policies for healthy
snacks in vending machines?
• Why do we need safe routes to
schools? …… Focus on ECONOMY
Our study found that…
• Too few North Carolinians
are taking steps to improve
their health habits and
lifestyles.
• And the costs of treating the
diseases and conditions that
often result from their
choices are escalating.
Poor health impacts finances…
• Adults and children who have
one or more of several common
health risk factors cost North
Carolina money — big money.
• Medical treatment, prescription
drug and lost productivity costs
associated with these factors
totaled $XX.XX billion in 2006 for
adults alone.
…and drains resources
• If all our resources are
siphoned off to pay for
these problems, we will
have significantly less
money left for investment
in infrastructure, capital
projects, education and
job creation.
Risk Factors Analyzed
ADULTS YOUTH
• Excess weight • Physical Inactivity
• Physical inactivity • Excess weight
• Type II diabetes
• Diabetes
• Low dietary consumption of
fruits and vegetables
• Hypertension (high blood
pressure)
• Abnormal blood lipid level
(high cholesterol)
• Depression
• Tobacco use
Assessing the
Eight Risk Factors
-Adults-
Excess Weight
• In North Carolina,
62.6 percent of
adults have excess
weight
• Of those, 36.7
percent are
overweight
• And 25.9 percent
considered obese
Physical Inactivity
• 57.9 percent of North Carolina
adults are physically inactive.
• 40.4 percent reported getting
some physical activity, but
less than recommended
• 22 percent reported not being
physical active at all.
Type II Diabetes
• In North Carolina, an estimated 547,000
adults, or approximately 8.5 percent of
the adult population, have been
diagnosed with Type II diabetes.
Nutritional issues
• Statistics show that 77.5 percent of
North Carolina adults eat fewer than
five daily servings of fruit and
vegetables.
Depression
• In North Carolina, 5 percent of adults
report being dissatisfied or very
dissatisfied with life, an indicator of
depression absent a clinical diagnosis.
Abnormal Blood Lipid Level
• In North Carolina, 36.3 percent of North
Carolinians reported having abnormal
blood lipid levels (high cholesterol).
Hypertension
• In North Carolina,
29.2 percent of
adults have been
diagnosed with
hypertension (high
blood pressure).
Tobacco Use
• In North Carolina,
22.6 percent of
all adults smoke
cigarettes
Tracking medical costs
• The eight risk factors
responsible for
$XX.XX billion
• XX cents of every dollar
spent on outpatient or
hospital treatment
resulted from one or
more of the eight risk
factors.
Factoring in drug costs
• In 2006, prescription
drug costs associated
with the eight risk
factors were $X.XX
billion.
• That is an estimated XX
percent of the cost of
outpatient and inpatient
care combined.
Lost workplace productivity
• An employee who is present
but performing below
expectations due to a medical
condition or injury
(presenteeism) can greatly
reduce a company’s output.
• In 2006, the lost productivity
cost owing to the eight risk
factors was $XX.XX billion
Who really pays?
• If, hypothetically, the costs associated
with the eight risk factors were borne
exclusively:
– Taxpayer’s share = $xxxx/year
– Full-time worker = $xxxx/year
– Non-farm worksite = $xxxxx
The Cost of Doing Nothing…
If we accept the status quo, expect the total
cost to rise nearly 32% over the next five
years to $XX.XX
The Good News!

• If we can achieve a 3% improvement in


the targeted risk factors, we could expect
to save over $XX.XX billion over the next
five years.
• That savings could fund (in today’s dollars)
nearly XX,000 full-time jobs in NC.
Youth - Growing Up and Out
• Children plagued with the same kind of
chronic health conditions once the purview
of middle-aged adults.
• For the first time in history, this generation of
children may be sicker and die younger than
their parents
Falling Short
• Far too many North
Carolina children
are falling short of
current physical
fitness recom-
mendations
Youth - Excess Weight
• 34 percent fall into the
excess weight
category
– 16 percent classified as
overweight
– 18 percent at risk of
overweight
Youth - Diabetes
• Until recently, children with
diabetes always had the
Type I form of the disease
• In North Carolina, approximately 1
percent of children and
adolescents have been diagnosed
with Type II diabetes or pre-
diabetic syndrome
Tallying the Toll for Youth
• The cost to treat the medical conditions
associated with the child/youth risk
factors was $XXX million in 2006
• Physical inactivity was the most
expensive risk factor, accounting for
$XX.XX million in health care costs, or
XX percent of the total tab.
The Cost of Doing Nothing…

• If we do nothing, costs are projected to


increase more than 84% by 2011 to
$xxx.xx million.
The Good News!
• If we just contain these three risk factors to
their current prevalence levels we could
save about $XX million per year.
County Data

• CHA Data
• State and National Data
• Be Active Economic Study
Using your CHA…
• Do the data from your county indicate
that there is a problem?
– Trends in county
– Compare with state, nation
• What are the implications of these data?
– Economic
Forsyth
• Overweight or Obese – Adult
– Forsyth: 57.4%
– NC: 62.9% (2006)
– US: 60.5%
• Overweight or At-risk – Youth (5-11)
– Forsyth: 18.2%
– NC: 27.3%
– US: 33% (6-11)
Forsyth
The economic cost of unhealthy
lifestyles* among adults in Forsyth
County is nearly $466 million
annually.

* “Unhealthy lifestyles” includes the risk factors of diabetes, depression,


excess weight, physical inactivity, abnormal blood lipid level, low fruit &
vegetable intake and tobacco use.
The Cost of Doing Nothing
• If we do not turn these trends around
then…
$466 million in Forsyth will grow to $653
million by 2010.
The Good News….
• If we can get just 3% of at-risk adults to
be more healthy (physically active,
manage weight, better diet…) we could
achieve a cost-savings of about $19.6
million per year.
What Could YOU Do With the
Saved $$$
• Relate the saving to new jobs……the
cost savings in Forsyth could fund about
584 new jobs (based on average salary
figures).
Forsyth Youth
• The direct medical cost of unhealthy lifestyles among
youth in Forsyth County is over $726,000 annually.
• If trends continue, the current group of inactive and
overweight youth in our country will incur medical
care and lost productivity cost of over $951 million by
the mid-point of their working years and over $8.6
billion by the time they retire.
The Good News….
• If we can get just 4% of at-risk youth in
Forsyth County to be more active, eat
nutritiously and achieve a healthy weight, we
can save nearly $41,000 annual in direct
medical costs.
No longer a personal problem
• Impacts families,
communities, cities and
businesses
• Limits companies’ ability to
boost economy
• State is less competitive,
both nationally and
globally
Working together
to make it happen
Be Active North Carolina!

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