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From Concept To Combat: Fighting Chronic Disease In America

posted by Dr. Esteban López, BCBSTX Chief Medical Officer

on June 1, 2018

Chronic conditions, such as heart disease, type 2 diabetes and obesity, are increasingly common and costly in the United States. In 2014, more than 85 percent of all U.S. health care costs were attributable to chronic conditions. About six in ten adults have one or more chronic diseases, and four in ten adults have two or more conditions.

While these statistics from the Centers for Disease Control and Prevention (CDC) and RAND Corporation are shocking and scary, they also represent an opportunity. How can we truly move the needle against chronic diseases in our country?

The good news about chronic conditions is that many of them are preventable. The most clinically and financially effective way to help manage an illness is to prevent it altogether. We may prevent many chronic diseases if Americans followed three simple rules: don’t smoke, don’t be overweight, and do exercise.

While we work to adopt a culture of prevention, we must recognize the role health disparities play in chronic diseases. According to the CDC, non-Hispanic blacks are 40 percent more likely than non-Hispanic whites to have high blood pressure. The rate of diagnosed diabetes is 77 percent higher among non-Hispanic blacks and 66 percent higher among Hispanics than among non-Hispanic whites.

We should keep social determinants of health—the conditions in the places where people live, learn, work, and play that affect a wide range of health risks and outcomes—such as poverty, lack of education, racism and discrimination in mind when crafting prevention plans. Environment and community conditions (such as lack of resources that support physical activity or healthy eating options), behaviors (such as poor diet, tobacco use, and physical inactivity) and access to health care are all contributing factors to health disparities as well.

At Blue Cross and Blue Shield of Texas (BCBSTX), we are working to implement programs that encourage prevention of chronic conditions while addressing inequalities in health care. We have identified two chronic conditions that have an enormous impact on the quality of life of Texans: chronic kidney disease (CKD) and chronic obstructive pulmonary disease (COPD).

CKD, also called chronic kidney failure, describes the gradual loss of kidney function. According to the National Institutes of Health, the main risk factors for developing CKD are diabetes, high blood pressure, heart disease and a family history of kidney failure. The prevalence of diabetes has exploded to epidemic levels in the United States with more than 30 million Americans living with the disease. An estimated 11 percent of Texans are diabetic. According to BCBSTX data, diabetics are developing chronic complications such as CKD at an alarming rate.

According to the American Lung Association, chronic obstructive pulmonary disease (COPD) is a chronic lung disease that makes it hard to breathe. The disease, which includes chronic bronchitis and emphysema, is increasingly common, affecting millions of Americans. COPD is the third leading cause of death in the United States, and an estimated 5.5 percent of Texans suffer from the disease. Many with COPD go undiagnosed and enter the health care system in crisis and at an advanced stage, according to BCBSTX data.

Through BCBSTX’s Healthy Kids Healthy Families® grant program, we have partnered with 10 statewide organizations that raise awareness about prevention and early detection of CKD and COPD. As a physician-led organization, this investment is part of our ongoing effort to improve health and wellness across populations that most need it, as well as creating behavior changes that lead to improved health outcomes.

In deciding on this year’s awardees, we chose organizations that have proven success in moving the needle against CKD and COPD. I am confident that we will be able to make a difference in improving the health of Texans with our new investment strategy targeting these two chronic diseases.

But there is more work to do to combat chronic disease across the United States. Do you have ideas to reduce the burden of chronic conditions where you live? Join me at AHIP’s Institute and Expo in San Diego on June 20 for the keynote panel, The Quest for Good Health: How Do We Reduce the Burden of Chronic Disease? We’ll discuss how to foster a health care system that helps to promote prevention, address the social determinants of health, rewards wellness and result in healthier people while easing the health and economic burdens on individuals and communities. I hope to see you there!