Healthcare Outlook - Genes, Environment, and Lifestyle

Goals

To obtain insights on how genes, the environment, and lifestyle will impact future health costs for the purposes of creating a presentation.

Early Findings

Preliminary research indicates that genes, the environment, and lifestyle currently have a major impact on health costs and will continue to do so in the future unless interventions are made.

GENES

  • According to a research study published in Nature, "pediatric inpatients with diagnostic codes linked to genetic disease have a significant and disproportionate impact on resources and costs in the US health-care system." This suggests that genetic diseases will continue to cost more than other health issues.
  • Patients with suspected genetic diseases are "high utilizers of health care" and correspond to an additional $12,000 to $77,000 per discharge compared with people who do not have genetic diseases.
  • Overall, patients with indications of genetic disease "showed a mean incremental total cost per discharge of $13,999, suggesting that more complex cases result in higher health-care utilization."
  • Of pediatric discharges in 2012, 2.6% to 14% were for genetic disease, but the costs associated with those discharges represented 11% to 46% of the pediatric "national bill."
  • While gene therapy could potentially "positively affect millions of lives," they are expected to be "costly, particularly if they are administered as single or short-term treatments, and are likely to pose major affordability challenges."
  • Health budgets of public insurers are already strained and "based on the initial pricing experience with gene therapy in Europe, should a growing number of gene therapies come into use at costs of US$1–2 million, the cumulative budget impact would be very substantial, and perhaps unsustainable."
  • Even if cost savings with gene therapy are realized over time by preventing long-term care, "the health system will be confronted with the challenge of absorbing upfront treatment prices over US$1 million per patient for even a relatively small number of patients."

ENVIRONMENT

  • A 2018 study indicated that there will be 2.5 million cases of non-communicable diseases associated with air pollution by 2035, which makes "air pollution an important public health priority."
  • Air pollution is currently the "leading environmental cause of early death—contributing to the equivalent of 5% of all deaths globally and an estimated 40,000 premature deaths each year in the UK."
  • In the UK, healthcare costs related to air pollution are estimated to be between £8.5 billion and £20.2 billion per year.
  • In 2015, "diseases caused by air, water and soil pollution were responsible for 9 million premature deaths, that is 16% of all global death."
  • Almost all of these deaths (92%) were in poorer nations, but the global financial costs of pollution are estimated at $4.6 trillion per year.

LIFESTYLE

  • U.S. health care costs for chronic diseases such as heart disease, cancer, diabetes, and Alzheimer’s reached $1.1 trillion in 2016.
  • The lifestyle factors of being overweight or obese accounted for 47% of the total chronic health care costs, while 8.7% was attributed to cigarette smoking, and 1% was attributed to excessive alcohol drinking.
  • As of 2015, nearly 40% of Americans are considered obese and another 33% are considered overweight. Research has "established a strong link between obesity and chronic diseases such as heart disease, kidney disease, and several types of cancers."
  • The Partnership to Fight Chronic Disease estimates that 83 million Americans will have three or more chronic conditions by 2030.
  • A 2017 study found that healthy lifestyles lead to an increased utilization of preventive health services, and did not show a significant decrease in outpatient visits.
  • According to the Centers for Disease Control and Prevention, in 2010, 86% of all healthcare spending "went toward people with one or more chronic conditions."
  • The Complete Health Improvement Program (CHIP), which is an initiative that promotes a health lifestyle, reduced outpatient medical visits of participants between 11% and 25% over a year when implemented as a workplace program.
  • According to Steve Burd, founder and CEO of Burd Health, indicated he was able to lower his company's healthcare costs by 40% and cut employees' costs by 10% with the implementation of "voluntary, company-wide wellness initiatives that provided monetary incentives for maintaining healthy lifestyles."
  • A study funded by the National Dairy Council found that increasing Americans' adherence to healthy diet patterns by 20% could "save more than $20 billion in direct and indirect costs."
  • Meal delivery programs like Meals on Wheels reduce the healthcare costs in Medicare and Medicaid beneficiaries.

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