Chronic Diseases Make for a Perfect Storm; Mental Health and Substance Use Care Providers Have a Role in Combating Them

By Manderscheid, Ronald W. | Behavioral Healthcare, October 2008 | Go to article overview

Chronic Diseases Make for a Perfect Storm; Mental Health and Substance Use Care Providers Have a Role in Combating Them


Manderscheid, Ronald W., Behavioral Healthcare


The premature death of public mental health clients is caused principally by untreated chronic diseases. Hence, it is critical for us to develop a better understanding of the current status of chronic diseases in the United States.

The new Partnership to Fight Chronic Disease (www.fightchronicdisease.com) was formed because chronic diseases are perceived to be "the single greatest threat to our nation's health and to our health care system." These chronic diseases include cancers, diabetes, heart disease, hypertension, stroke, mental disorders, and pulmonary conditions, such as asthma. In the United States, these chronic diseases account for more than 75 cents of every dollar spent on healthcare, are the number-one cause of death and disability, and are the number-one driver of rising healthcare costs, according to the Centers for Disease Control and Prevention (www.cdc.gov/nccdphp/overview.htm).

A recent Milken Institute (www.milkeninstitute.org) study on chronic diseases, An Unhealthy America: The Economic Burden of Chronic Disease, had several important findings. First, more than 109 million Americans have at least one of seven chronic diseases, for a total of 162 million cases as follows:

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* Cancers, 10.6 million cases (3.6% of the population)

* Diabetes, 13.7 million cases (4.7%)

* Heart disease, 19.1 million cases (6.6%)

* Hypertension, 36.8 million cases (12.6%)

* Mental disorders, 30.3 million cases (10.4%)

* Pulmonary conditions, 49.2 million cases (16.9%)

* Stroke, 2.4 million cases (0.8%)

On our current path, the Institute predicts a 42% increase in cases of the seven chronic diseases by 2023 and $4.2 trillion in treatment costs and lost economic output.

Under a more optimistic scenario, assuming modest improvements in preventing and treating disease, the Institute found that we could avoid 40 million cases of chronic disease by 2023, and we could reduce the economic impact of disease by 27% or $1.1 trillion annually. We also could increase the nation's gross domestic product by $905 billion linked to productivity gains, and we could decrease treatment costs by $218 billion per year. Lower obesity rates alone could produce productivity gains of $254 billion and avoid $60 billion in treatment expenditures per year.

To complete this picture, several important related factors need to be considered:

* The Census Bureau projects that the elderly population age 65 and older will grow by 35 million persons by 2030. This age group is at a very high risk of chronic diseases.

* During the next 15 years, most of the baby-boomer health-care providers will retire. …

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Chronic Diseases Make for a Perfect Storm; Mental Health and Substance Use Care Providers Have a Role in Combating Them
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