Ebook The Cost Of Chronic Disease In Nova Scotia
Four types of chronic disease kill an estimated 5,800 Nova Scotians every year, account for nearly three-quarters of all deaths in the province, and are the major causes of premature death and hospitalization. The biggest killer is cardiovascular disease (heart disease, stroke, and atherosclerosis) which claims the lives of 2,800 Nova Scotians each year, and accounts for 36% of all deaths in the province. Cancer kills an estimated 2,400 Nova Scotians every year, accounting for 30% of all deaths in the province.
Other chronic conditions disable many more Nova Scotians. Arthritis and rheumatism afflict 20% of Nova Scotians; 16% suffer from high blood pressure; 14% have chronic back problems; 9% suffer from migraine headaches; and 6% have asthma. One-quarter of all Nova Scotians have a long-term limitation or handicap that interferes with their activity at home, school, or work – the highest rate of activity limitation in the country. Not surprisingly, Nova Scotians also have the country’s highest reported use of disability days. Chronic conditions are becoming increasingly common.
Compared to other Canadians, Nova Scotians have particularly high rates of chronic illness. Nova Scotia has the country’s highest rate of deaths from cancer and from respiratory disease; and the highest rate of arthritis and rheumatism in Canada. The province has the second highest rate of circulatory deaths and of diabetes in the country, and the second highest psychiatric hospitalization rate.
Medical care costs for people with chronic diseases account for 60% of total medical care expenditures, or $1.2 billion a year in Nova Scotia. Because of the debilitating nature of these illnesses, and because cancer and heart disease kill so many at an early age, the indirect costs of chronic illness due to productivity losses are particularly high. Premature death due to cancer alone costs the Nova Scotia economy $427 million each year, while musculoskeletal disorders like arthritis and osteoporosis cost the economy $307 million due to disability. Circulatory diseases cost Nova Scotia more than half a billion dollars a year in productivity losses (all costs in 2001$).
Combining direct medical costs ($1.24 billion) and indirect productivity losses ($1.79 billion), the total economic burden of seven types of chronic illness (cardiovascular diseases, cancer, respiratory ailments, diabetes, musculoskeletal disorders, diseases of the nervous system and sense organs, and mental illness), exceeds $3.0 billion a year.
These seven chronic diseases account for 78% of productivity losses due to premature death, 76% of productivity losses due to disability, and nearly two-thirds of the total economic burden of illness in Nova Scotia, including both direct and indirect costs. They cost the province the equivalent of 13% of provincial GDP annually. All categories of chronic disease combined are estimated to account for 70% of the total economic burden of illness in Nova Scotia. Cardiovascular diseases alone cost Nova Scotia nearly $960 million a year in direct and indirect costs, cancer costs another $580 million, and arthritis and osteoporosis add another $460 million in costs.
It is estimated that 40% of chronic illness can be prevented. Epidemiological studies indicate that 25% of all medical costs (or nearly half a billion dollars a year in Nova Scotia) are attributable to a small number of excess risk factors like smoking, obesity, physical inactivity, and poor nutrition.
Socioeconomic causes of chronic illness, such as poverty, inequality, and poor education, and environmental causes such as exposure to toxic pollutants, are also modifiable. Low-income women under the age of 40 are 62% more likely to be hospitalized than higher income women; over the age of 40, they are 92% more likely to be hospitalized. In Nova Scotia, those without a high school diploma use 49% more physician services than those with a BA, while low income groups use 43% more physician services than higher income groups. Excess physician use due to educational inequality costs the NS health care system $42.2 million a year; excess physician use due to income inequality costs $27.5 million a year.
Low income groups have higher rates of smoking, obesity, physical inactivity, and cardiovascular risk. Nova Scotia could avoid an estimated 200 deaths and save $214 million per year if all Nova Scotians were as heart healthy as higher income groups.
This report indicates that Nova Scotia’s high rates of chronic illness can be reduced through concerted health promotion initiatives that reduce risk behaviours and conditions. The evidence demonstrates that the province’s escalating health care costs can be significantly lowered by improving the health of the population and thereby reducing the need and demand for medical care.
Executive Summary
PART ONE: Costs of Chronic Disease<
1. Deaths and Costs Due to Chronic Disease in Nova Scotia
1.1 Cardiovascular Diseases
1.2 Cancers
1.3 Diabetes
1.4 Chronic Obstructive Pulmonary Diseases
1.5 Musculoskeletal Disorders
PART TWO: Chronic Disease Risk Factors and Prevention
2. Reducing Chronic Disease Risk Factors and Health Care Costs
2.1 Tobacco and Chronic Illness
2.2 Obesity, Poor Nutrition, and Chronic Illness
- 2.2.1 Secondary and Tertiary Prevention
2.2.2 Primary Prevention
2.3 Physical Inactivity
2.4 Lack of Screening
- 2.4.1 Pap Smear Tests
2.4.2 Mammogram Screening
2.4.3 Colorectal Cancer Screening
2.4.4 Prostate Cancer Screening
2.4.5 Blood Pressure Checkup
PART THREE: Socioeconomic Determinants of Chronic Disease
3. Costs of Poverty and Inequality
3.1 Poverty among Children and Single Mothers
3.2 Health Care Costs of Poverty in Nova Scotia
3.3 Costs of Homelessness
3.4 Costs of Social Exclusion and Vulnerability
4. Cost Effectiveness of Socio-economic Interventions
5. Social Networks and Social Supports
5.1 Family and Shared Households
5.2 Social Health
5.3 Volunteers
PART IV: Costs of Mental Illness
6. Costs of Mental Illness
7. Stress and Chronic Disease
8. Psychosocial Interventions to Overcome Mental Illness
PART V: The Impact of Aging on Medical Costs
9. Delaying Diseases Associated with Old Age
9.1 The Compression of Morbidity
9.2 Reducing Illness among the Elderly
PART VI: The Value of Health Promotion
10. Worksite Health Promotion
11. School-Based and Childhood Interventions
12. Clinical Preventive Services
13. Preventive Alternative Treatments
Appendix A: The Cost of Physical Inactivity In Nova Scotia
1. Physical Activity and Health
2. Physical Activity Trends in Nova Scotia
3. The Economic Cost of Physical Inactivity
Download
PDF Ebook The Cost Of Chronic Disease In Nova Scotia
Posted in :
