The cause of skyrocketing healthcare costs for older Americans is simple. We live in an unhealthy society in which most people develop chronic metabolic diseases due to an unhealthy life style. We also live in a medically advanced society with a medical community that has focused on palliating and not preventing these medical conditions. Thus, we are living longer with these chronic diseases and this is expensive.
Let us focus on each of the above bold statements:
OUR SOCIETY IS UNHEALTHY
The CDC’s National Center for Health Statistics presented new data that US men and women weigh 15 pounds more than they did 20 years ago. According to the report, the average 5’9” man now weighs 195.7 pounds and the average 5’4” woman weighs 168.5 pounds. Average heights have remained unchanged. In 2011–2014, the prevalence of obesity was approximately 36% in adults and 17% in youth. Obesity is associated with chronic metabolic diseases. The Centers for Disease Control and Prevention calculates that 69% of adults over age 20 are overweight or obese. Today there is an epidemic of obesity leading to an epidemic of metabolic diseases. The National Institute of Health found that in 2009-2010:
- Two out of three adults were overweight, with a BMI of 25-29.9;
- One out of three adults were obese, with a BMI 30-39.9; and
- One out of 20 adults were morbidly obese, with a BMI of 40+.
Not every obese person has a metabolic problem, but most do, or will develop one. Asians have metabolic problems starting at a BMI of 25; Caucasians at 30; and African-Americans at 35. In general, obesity is associated with an earlier death. One interesting observation is that in many species, including primates—human beings, apes and monkeys—caloric restriction increases longevity.
MOST OLDER OVER-WEIGHT ADULTS ARE SICK ADULTS
The Centers for Disease Control and Prevention (CDC) clearly attest to this statement: lack of exercise, poor nutrition, tobacco use and alcohol cause much of the current chronic metabolic diseases, pain and early deaths. The “metabolic syndrome” is a group of medical conditions defined by the presence of any three of these conditions: high blood sugar; high triglycerides; low high-density lipoproteins (HDL); visceral obesity; and hypertension.
Approximately 34% of Americans have metabolic syndrome. Metabolic syndrome is a precursor leading to diabetes, heart disease and death. You don’t die from obesity, but you will eventually die from its resultant metabolic syndromes.
CHRONIC DISEASE IS EXPENSIVE
In the United States, chronic diseases and conditions and the health risk behaviors that cause them account for most healthcare costs. Eighty-six percent of all health care spending in 2010 was for people with one or more chronic medical conditions. The total costs of heart disease and stroke in 2010 were estimated to be $315.4 billion. Of this amount, $193.4 billion was for direct medical costs, not including costs of nursing home care.
WHAT CAN WE DO?
Healthy behaviors include a healthy diet pattern and regular physical activity. Energy balance of the number of calories consumed from foods and beverages with the number of calories the body uses for activity plays a role in preventing excess weight gain. A healthy diet pattern follows the Dietary Guidelines for Americans which emphasizes eating whole grains, fruits, vegetables, lean protein, low-fat and fat-free dairy products and drinking water.
The Physical Activity Guidelines for Americans recommends adults do at least 150 minutes of moderate intensity activity or 75 minutes of vigorous intensity activity, or a combination of both, along with 2 days of strength training per week. Having a healthy diet pattern and regular physical activity is also important for long term health benefits and prevention of chronic diseases such as Type 2 diabetes and heart disease.
Dr. Robert Drapkin