The odds a dollar of health expenditures will be spent for:
SOURCE: US Centers for Medicare and Medicaid Services, Office of the Actuary, National Health Statistics Group, National Health Expenditure Projections 2010–2020, September 2011.
ODDS COUPLE
Lighter Burden
The odds a death will include HIV on the death certificate: 1 in 21,774
The odds a person will visit an emergency department due to an accident involving a golf cart in a year: 1 in 22,355
SOURCES: WK Adih, RM Selik, X Hu, “Trends in Diseases Reported on US Death Certificates That Mentioned HIV Infection, 1996–2006,” Journal of the International Association of Physicians in AIDS Care 10(1), January/February 2011: 5–11. Book of Odds calculation based on a query of 2010 data in the CPSC NEISS database.
How Much Do We Spend on Health?
The Centers for Medicare and Medicaid Services (CMS) projects health expenditures to grow from $2.6 trillion in 2010 to $2.8 trillion in 2012 and $4.6 trillion by 2020. This means total health expenditures will grow from 17% of gross domestic product in 2010 to just under 20% during that period. The CMS Office of the Actuary’s forecast assumes the Affordable Care Act will be implemented as written. Thus, the cost of health care will continue to grow faster than the US economy at least through 2020.
SOURCE: US Centers for Medicare and Medicaid Services, Office of the Actuary, National Health Statistics Group, National Health Expenditure Projections 2010–2020, September 2011.
The Odds a Person Will Be Hospitalized
The odds a person will be hospitalized in a year are 1 in 8.8.
The odds a child under 15 will be hospitalized in a year are 1 in 31.4.
The odds a person 15–44 will be hospitalized in a year are 1 in 12.5.
The odds a person 45–64 will be hospitalized in a year are 1 in 8.5.
The odds a person 65 or older will be hospitalized in a year are 1 in 3.
The odds a person will be hospitalized in a year for:
heart disease: 1 in 82.6
psychosis: 1 in 200
malignant neoplasms (solid tumor cancers): 1 in 254
pneumonia: 1 in 273
bone fracture: 1 in 276
osteoarthritis and related conditions: 1 in 292
stroke: 1 in 303
congestive heart failure: 1 in 305
septicemia: 1 in 380
cardiac arrythmia: 1 in 402
coronary atherosclerosis: 1 in 474
diabetes: 1 in 485
chronic bronchitis: 1 in 503
cellulitis or abscess: 1 in 510
heart attack: 1 in 518
urinary tract infection: 1 in 552
asthma: 1 in 699
anemia: 1 in 787
intestinal obstruction: 1 in 800
benign tumor: 1 in 917
cholelithiasis (gall bladder, including gallstones): 1 in 917
enteritis or colitis: 1 in 962
spinal disc disorders: 1 in 971
diverticulitis of the intestines: 1 in 1,031
essential hypertension (high blood pressure): 1 in 1,099
acute pancreatitis: 1 in 1,111
appendicitis: 1 in 1,124
poisoning: 1 in 1,190
acute bronchitis: 1 in 1,786
kidney stones: 1 in 1,961
SOURCE: US Centers for Disease Control and Prevention/National Center for Health Statistics, “Average Length of Stay for Discharges from Short-Stay Hospitals, by First-Listed Diagnosis and Age,” National Hospital Discharge Survey, 2010, http://www.cdc.gov/nchs/data/nhds/2average/2010ave2_dischargesage.pdf.
The odds a person will be hospitalized for complications of surgical or medical care: 1 in 303
SOURCE: US Centers for Disease Control and Prevention/National Center for Health Statistics, “Average Length of Stay for Discharges from Short-Stay Hospitals, by First-Listed Diagnosis and Age,” National Hospital Discharge Survey, 2010, http://www.cdc.gov/nchs/data/nhds/2average/2010ave2_dischargesage.pdf.
The odds a woman will be hospitalized for the delivery of one or more babies: 1 in 23.8
SOURCE: US Centers for Disease Control and Prevention/National Center for Health Statistics, “Average Length of Stay for Discharges from Short-Stay Hospitals, by First-Listed Diagnosis and Age,” National Hospital Discharge Survey, 2010, http://www.cdc.gov/nchs/data/nhds/2average/2010ave2_dischargesage.pdf.
Physician Visits
Visits to a doctor and related clinical expenditures ranked second in size (over $500 million) and accounted for 20% of total health care expenditures in 2010. The likelihood a person will have one or more physician visits in a year as well as the total number of annual visits increases with age.
The odds, during a year, an adult 18–44 will:
not visit a physician: 1 in 3.9
visit a physician once: 1 in 5.2
visit a physician 2–3 times: 1 in 4
visit a physician 4–9 times: 1 in 5.4
visit a physician 10 or more times: 1 in 8.8
The odds, during a year, an adult 45–64 will:
not visit a physician: 1 in 6.1
visit a physician once: 1 in 6.3
visit a physician 2–3 times: 1 in 3.6
visit a physician 4–9 times: 1 in 4
visit a physician 10 or more times: 1 in 6.7
The odds, during a year, an adult 65–74 will:
not visit a physician: 1 in 16.1
visit a physician once: 1 in 9.8
visit a physician 2–3 times: 1 in 3.6
visit a physician 4–9 times: 1 in 2.7
visit a physician 10 or more times: 1 in 5.2
The odds, during a year, an adult 75 or older will:
not visit a physician: 1 in 23.3
visit a physician once: 1 in 10.3
visit a physician 2–3 times: 1 in 4.4
visit a physician 4–9 times: 1 in 2.4
visit a physician 10 or more times: 1 in 4.6
SOURCE: JR Pleis, BW Ward, JW Lucas, “Summary Health Statistics for US Adults: National Health Interview Survey, 2009,” Vital Health Statistics Reports 10(249), August 2010.
Complementary and Alternative Medicine
The odds an adult used acupuncture or another form of alternative medicine in 2007: 1 in 2.6
SOURCE: PM Barnes, B Bloom, RL Nahin, “Complementary and Alternative Medicine Survey of Hospitals,” Health Forum LLC, 2008.
Prescription Drugs
The third-largest component of health care expenditures is prescription drugs, at 10%. According to a study by the National Center for Health Statistics, the use of prescription drugs continues to increase, doubling in expenditures from 1999 to 2008.
The odds a child 11 or younger will take:
1 prescription drug in a year: 1 in 7.1
2 prescription drugs in a year: 1 in 21.7
3–4 prescription drugs in a year: 1 in 37
5 or more prescription drugs in a year: 1 in 1,111
The odds an adolescent 12–19 will take:
1 prescription drug in a year: 1 in 5.8
2 prescription drugs in a year: 1 in 14.5
3–4 prescription drugs in a year: 1 in 20.8
5 or more prescription drugs in a year: 1 in 111
The odds an adult 20–59 will take:
1 prescription drug in a year: 1 in 5.1
2 prescription drugs in a year: 1 in 8.8
3–4 prescription drugs in a year: 1 in 10.6
5 or more prescription drugs in a year: 1 in 12.7
The odds an adult 60 or older will take:
1 prescription drug in a year: 1 in 8.3
2 prescription drugs in a year: 1 in 8.1
3–4 prescription drugs in a year: 1 in 3.7
5 or more prescription drugs in a year: 1 in 2.7
SOURCE: Q Gu, CF Dillon, VL Burt, “Prescription Drug Use Continues to Increase: US Prescription Drug Data for 2007–2008,” NDHS Data Brief 42, September 2010.
Complementary and Alternative Medicine
Although US expenditures on medicine are enormous, the sums accounted for are not complete without considering the many complementary and alternative medicine (CAM) therapies, approaches, healing philosophies, and remedies. These therapies are not usually taught in US medical schools. Historically they were not available in hospitals, but the American Hospital Association reports that the odds that a community hospital will offer a CAM care or service are 1 in 4.8 (2007). How much do we spend on acupuncture, chiropractic care, relaxation techniques, massage therapy, and herbal remedies among the thirty-six CAM therapies and forty-five dietary supplements the NIH tracks in its surveys? In 2007, the total spent out of pocket was $33.9 billion! A decade earlier it had been $27 billion, an annual growth rate of 2.3%.
The odds a person 18 or older used __________ for medical purposes in 2007:
nonvitamin, nonmineral, natural products: 1 in 5.6
deep breathing exercises: 1 in 7.9
meditation: 1 in 10.6
chiropractic or osteopathic manipulation: 1 in 11.6
massage: 1 in 12
yoga: 1 in 16.4
diet-based therapies: 1 in 27.8
progressive muscle relaxation: 1 in 34.5
guided imagery: 1 in 43.5
homeopathic treatment: 1 in 55.6
movement therapies: 1 in 66.7
acupuncture: 1 in 71.4
tai chi: 1 in 100
naturopathy: 1 in 333
biofeedback: 1 in 500
hypnosis: 1 in 500
SOURCES: JJ Mao, CS Palmer, KE Healy, K Desai, K Amsterdam, “Complementary and Alternative Medicine Use Among Cancer Survivors: A Population-Based Study,” Journal of Cancer Survivorship: Research and Practice 5(1), 2011: 8–17. PM Barnes, B Bloom, RL Nahin, “Complementary and Alternative Medicine Use Among Adults and Children: United States, 2007,” National Health Statistics Reports, December 12, 2008. S Ananth, “2007 Health Forum/AHA Complementary and Alternative Medicine Survey of Hospitals,” Health Forum LLC, 2008. D Eisenberg, R Davis, et al., “Trends in Alternative Medicine Use in the US,” Journal of the American Medical Association 280(18), November 11, 1998: 1569–1575.
The Number One Killer Cardiovascular Disease
Cardiovascular disease (heart disease and stroke) kills more people in the United States than cancer, accidents, and HIV combined. The prevalence of cardiovascular disease (CVD) in adults age 20 or older is 1 in 2.8, and the risk of developing it slowly rises with age.
Why are the odds of an American developing CVD so high? The American Heart Association says it is because too many of us have the risk factors associated with CVD. These include diabetes, high blood pressure, high cholesterol, obesity, and a cluster of risk factors called metabolic syndrome.
Among those 20 and older, 11% have diabetes and 37% are prediabetic. 1 in 3 of adults 20 or older have high blood pressure and 1 in 3.1 have high cholesterol. 1 in 3.7 adults 18 or older are obese, which is asscociated with 13% of cardiovascular deaths.
A person has metabolic syndrome if he or she has three of the following risk factors: elevated blood glucose, low HDL cholesterol, high triglyceride levels, being overweight or obese, and high blood pressure. 1 in 2.9 adults are considered to have metabolic syndrome.
SOURCE: Book of Odds estimates based on data in RL Veronique, AS Go, DM Lloyd-Jones, RJ Adams, JD Berry, et al., on behalf of the American Heart Association Statistics Committee and Stroke Statistics Subcommittee, “Heart Disease and Stroke Statistics—2011 Update: A Report from the American Heart Association,” Circulation 123, 2011: e18–e209.
Cardiovascular Disease by Race, Ethnicity, and Gender
The odds a man 20 or older has cardiovascular disease are 1 in 2.7.
The odds a woman 20 or older has cardiovascular disease are 1 in 2.9.
The odds a non-Hispanic white man 20 or older has cardiovascular disease are 1 in 2.7.
The odds a non-Hispanic white woman 20 or older has cardiovascular disease are 1 in 3.
The odds a non-Hispanic black man 20 or older has cardiovascular disease are 1 in 2.2.
The odds a non-Hispanic black woman 20 or older has cardiovascular disease are 1 in 2.1.
The odds a Mexican American man 20 or older has cardiovascular disease are 1 in 3.3.
The odds a Mexican American woman 20 or older has cardiovascular disease are 1 in 3.2.
SOURCE: Book of Odds estimates based on data in RL Veronique, AS Go, DM Lloyd-Jones, RJ Adams, JD Berry, et al., on behalf of the American Heart Association Statistics Committee and Stroke Statistics Subcommittee, “Heart Disease and Stroke Statistics—2011 Update: A Report from the American Heart Association,” Circulation 123, 2011: e18–e209.
Selected Heart Attack Odds
SOURCE: Book of Odds estimate based on data in RL Veronique, AS Go, DM Lloyd-Jones, RJ Adams, JD Berry, et al., on behalf of the American Heart Association Statistics Committee and Stroke Statistics Subcommittee, “Heart Disease and Stroke Statistics—2011 Update: A Report from the American Heart Association,” Circulation 123, 2011: e18–e209.
Use of Dietary Supplements
The odds an adult over 20 took supplements:
2003–2006: 1 in 1.9
1988–1994: 1 in 1.9
The odds an adult over 20 took multivitamins/multiminerals:
2003–2006: 1 in 2.6
1988–1994: 1 in 3.3
The odds a woman over 60 took supplemental calcium:
2003–2006: 1 in 1.6
1988–1994: 1 in 3.5
The odds a woman 20–39 took folic acid dietary supplements:
2003–2006: 1 in 2.9
1988–1994: 1 in 3.1
The odds a man 20–39 took vitamin D supplements:
2003–2006: 1 in 3.8
The odds a man 40–59 took vitamin D supplements:
2003–2006: 1 in 2.6
The odds a man 60 and over took vitamin D supplements:
2003–2006: 1 in 2.3
SOURCE: J Gahche, R Bailey, V Burt, J Hughes, E Yetley, J Dwyer, MF Picciano, M McDowell, C Sempos, “Dietary Supplement Use Among U.S. Adults Has Increased Since NHANES III (1988–1994),” National Center for Health Statistics Data Brief 61, April 2011.
The State in the Worst Condition?
Mississippi
According to the “State of the Heart Report,” 7 out of 8 Mississippi adults older than 45 have at least one major risk factor for developing cardiovascular disease. America’s Health Rankings has placed Mississippi among the bottom three states every year since 1990, when the rankings began, and the bottom state every year from 2002 to 2010, thanks to an obesity rate at 35% and a lifetime mortality rate among people with CVD at 373.7 deaths per 100,000. The odds a person in Mississippi will die from cardiovascular disease in a year are 1 in 287, much higher than the odds for the entire US population.
Other states with a high percentage of deaths from CVD include Alabama (1 in 302), Oklahoma (1 in 311), West Virginia (1 in 323), and Tennessee (1 in 325). The District of Columbia also has an especially high CVD death rate (1 in 307). The common thread among DC and these four states is that all rank in the bottom quintile in America’s Health Rankings’ “overall state rankings,” which considers twenty-two measures covering “determinants of health” and “health outcomes,” as well as prevalence of smoking and obesity.
SOURCES: Mississippi Department of Health, Mississippi State of the Heart Report 2005. United Health Foundation, American Public Health Association, Partnership for Prevention, America’s Health Rankings—2010 Edition. Book of Odds estimates based on National Health and Nutrition Examination Survey 2006 state death rate data, http://www.cdc.gov/nchs/nhanes.htm. KD Kochanek, J Xu, SL Murphy, AM Miniño, HC Kung, “Deaths: Preliminary Data for 2009,” National Vital Statistics Reports 59(4), March 16, 2011.
ODDS COUPLE
AKA: Heart Attack
The odds a person will die from acute myocardial infarction in a year: 1 in 265
&
nbsp; The odds an NFL kickoff will be returned for a touchdown: 1 in 270
SOURCES: KD Kochanek, J Xu, SL Murphy, AM Miniño, HC Kung, “Deaths: Preliminary Data for 2009,” National Vital Statistics Reports 59(4), March 16, 2011. Book of Odds estimate based on data compiled from the 2006–2007 season of the National Football League.
Death Odds for Major Cardiovascular Conditions or Events
The odds a person will die from:
cardiovascular disease in a year 1 in 427
coronary heart disease in a year 1 in 1,300
stroke in a year 1 in 2,571
heart failure in a year 1 in 5,917
hypertension in a year 1 in 12,987
aortic aneurysm and dissection in a year 1 in 30,303
atherosclerosis in a year 1 in 45,465
SOURCE: KD Kochanek, J Xu, SL Murphy, AM Miniño, HC Kung, “Deaths: Preliminary Data for 2009,” National Vital Statistics Reports 59(4), March 16, 2011.
ODDS COUPLE
The Telltale Heart
The odds a death will be due to heart disease: 1 in 4.2
The odds a music listener will download 11–20 songs in a month: 1 in 4.2
SOURCES: DL Hoyert, JQ Xu, “Deaths: Preliminary Data for 2011,” National Vital Statistics Reports 61(6), October 10, 2012. Lab 42, “Survey of Music Listening and Sharing Habits of Social Media Users,” http://blog.lab42.com/socialmusicsoundbytes.
Selected Heart Failure Odds
The odds an adult 20 or older has heart failure 1 in 41.7
The odds a man 20 or older has heart failure 1 in 33.3
The odds a woman 20 or older has heart failure 1 in 50
The odds a non-Hispanic white man 20 or older has heart failure 1 in 37
The odds a non-Hispanic white woman 20 or older has heart failure 1 in 55.6
The odds a non-Hispanic black man 20 or older has heart failure 1 in 22.2
The odds a non-Hispanic black woman 20 or older has heart failure 1 in 26.3
The odds a Mexican American man 20 or older has heart failure 1 in 43.5
Book of Odds Page 19