By Dr. Kent Thornburg, Senior Fellow
Many people are under the impression that the health of Americans is improving. This impression is based on factual reports in the media. For example, the life expectancy at birth increased linearly from 50 years in 1900 to 80 years in 2010. Deaths from heart disease have decreased by over 50% between 1970 to the present. The prevalence of people smoking cigarettes has decreased from 42% in 1965 to 14% in 2017. More people with high blood pressure are being treated. These improvements in population health are testament to the outstanding public health policies in the US, powerful treatment of infectious diseases and life-saving medical care for people suffering chronic diseases.
These uplifting facts represent only the tip of the health-status iceberg for people living in the US. Beneath the water where few people are looking, a more ominous picture can be seen.
Chronic Illness on the Rise
Chronic diseases have been increasing over the past 25 years. Most prominent among them are increasing rates of type 2 diabetes, obesity, heart failure and uncontrolled high blood pressure. The Center for Disease Control and Prevention estimates that if diabetes rates continue on the recent trajectory, one in 3 people in the USA would be diabetic by 2050.
In Oregon where I have invested my career of research and practice, the prevalence of obesity has doubled and diabetes has tripled since 1995. These statistics predict large increases in cardiovascular disease over the next 15 years, over which time the number of people suffering the disease could increase from its present number of about 250,000 to nearly 1 million. This prediction is based on the increased susceptibility for heart disease in the aging population and the fact that some 70% of people with diabetes die of cardiovascular disease. If the heart disease prediction were to come true, one in four Oregonians would be affected. We see similar trends across the greater Pacific Northwest.
Costly Increases
The chronic diseases that are now looming forecast more than just the number of people who must cope with disease, they predict large increases in medical costs which we will all face in our near future. In 2017, the American Heart Association predicted that the current annual cost of heart disease in the USA of $500 billion ($1.3 billion/day) will more than double to $1.1 trillion by 2035. With rapidly increasing drug prices, this prediction may be an underestimate of the financial impact of this one disease alone. This prediction does not include the costs for caring for other chronic diseases like cancer, lung disease and obesity. Based on the suffering costs of affected individuals and the crushing financial burden being predicted, we can state without exaggeration that the Pacific Northwest joins the nation in facing a health crisis.
It is surprising that rapidly rising health care costs have not been a part of a national or even a regional debate, especially since health care is a hot button for political parties. Most people are strained by their current health care costs. If costs increase as predicted, health insurance rates would have to double to care for upcoming medical demand. That is a cost that most families could not bear. Current national health care schemes have not taken on the potential for large increases in costs that exceed inflation.
The Impact of Nutrition
There are many theories regarding the causes for the increasing prevalence of obesity and diabetes. Most of these ideas have merit. People have become increasingly sedentary. Physical education requirements have been dramatically reduced in public schools. Children indulge in more screen time than ever before.
However, there is evidence that poor nutrition is also a powerful cause of these diseases. For decades, the US population has increasingly relied on industry to provide for calorie needs. In their quest for profits, the big food industries of the US have provided an easy way for people to satisfy their hunger with high calorie, low nutrient convenient foods. This leads to a condition known as high calorie malnutrition where people consume too many calories and too few nutrients. This condition becomes the basis for disease. Based on epigenetic theory which predicts that foods in the diet can change the regulation of genes, one can argue that people have become more vulnerable to disease for each of the last three generations. Children and young people are heavier that just 25 years ago, they also suffer higher rates of diabetes. The epidemiology of disease prevalence suggests that people are more vulnerable for diseases than in the past. The current culture promotes unhealthy diets for all including women who are pregnant. Because the effects of poor nutrition can be passed from mother to baby and across generations, the Pacific Northwest population is likely to see increases in the ravages of diabetes and obesity.
A Possible Solution
The good news is that we can play a role in reversing this trajectory. In fact, several organizations are already hard at work on this issue. Community-based programs that emphasize proper nutrition and access to nutrient-dense food, such as Zenger Farms, Garden City Harvest, Food for Lane County, the Oregon Food Bank, The Idaho Food Bank, Emergency Food Network of Tacoma and Pierce County, Great Falls Community Food Bank and so many others play a critical role in helping ensure all citizens can address the underlying causes of chronic illnesses.
Similarly, programs and organizations providing care to women who are about to become pregnant or who are already pregnant, such as OHSU, Bozeman Health Foundation, Tuality Healthcare, Mid-Columbia Health Foundation, Bethel Family Clinic, Teton Valley Healthcare, Community Health of Central Washington, help educate families as to proper nutrition for moms-to-be to promote a healthy pregnancy and how to ensure that newborn children receive the best possible start in life.
By investing in addressing root contributors of chronic illness through connecting individuals and families with resources that help them make positive changes to their nutritional choices, we can all help bring significant health improvements to the next generation. Postponing such action will ensure that the economists and the Oregon Health Department will see their predictions come true.
