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Book of Odds

Page 21

by Amram Shapiro


  SOURCE: N Howlader, AM Noone, M Krapcho, N Neyman, R Aminou, SF Altekruse, et al., eds., SEER Cancer Statistics Review, 1975–2009 (Vintage 2009 Populations). Bethesda, MD: National Cancer Institute, http://seer.cancer.gov/csr/1975_2009_pops09/, based on November 2011 SEER data submission, posted to the SEER website, April 2012.

  Average Emergency Room Wait Times by State

  SOURCE: Press Ganey, 2010 Emergency Department Pulse Report.

  The Odds a Man Has:

  Testicular cancer: 1 in 1,425

  SOURCE: N Howlader, AM Noone, M Krapcho, N Neyman, R Aminou, SF Altekruse, et al., eds., SEER Cancer Statistics Review, 1975–2009 (Vintage 2009 Populations). Bethesda, MD: National Cancer Institute, http://seer.cancer.gov/csr/1975_2009_pops09/, based on November 2011 SEER data submission, posted to the SEER website, April 2012.

  The Odds a Woman Has:

  Uterine cancer: 1 in 500

  Cervical cancer: 1 in 1,324

  Ovarian cancer: 1 in 1,570

  SOURCE: N Howlader, AM Noone, M Krapcho, N Neyman, R Aminou, SF Altekruse, et al., eds., SEER Cancer Statistics Review, 1975–2009 (Vintage 2009 Populations). Bethesda, MD: National Cancer Institute, http://seer.cancer.gov/csr/1975_2009_pops09/, based on November 2011 SEER data submission, posted to the SEER website, April 2012.

  Chronic Conditions

  Hypertension

  Hypertension, or high blood pressure, is the measure of the force against the walls of arteries as blood is pumped through the body by the heart. Blood pressure is measured as two readings, in millimeters of mercury—for example, 120/80. The first number is the systolic pressure (the measure of force when the heart is contracting), considered high for a person if it is more than 140 most of the time and normal if it is below 120 most of the time. The bottom number is the diastolic pressure (measure of the force when the heart is relaxing), considered high for a person if more than 90 most of the time and normal if below 80 most of the time. People are more likely to be diagnosed with high blood pressure as they get older because blood vessels become stiffer as people age.

  A person has a higher risk of hypertension if he/she:

  is African American

  is obese

  eats too much salt

  has a family history of high blood pressure

  has diabetes

  smokes

  High blood pressure is a risk factor for several other conditions or events, such as atherosclerosis (buildup of plaque on the arterial walls), congestive heart failure, chronic kidney disease, heart attack, and stroke.

  SOURCES: PubMed Health, Hypertension, http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001502/. Book of Odds estimates based on National Health and Nutrition Examination Survey 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.

  Hypertension: Odds by Gender and Race

  The odds a person 20 or older has high blood pressure:

  At younger ages, more men than women have hypertension but the odds equalize at midlife and women have a higher prevalence after age 65.

  SOURCES: PubMed Health, “Hypertension,” http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001502/. Book of Odds estimates based on NHANES 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.

  When the Scale Is Scary: The Odds an 18-Year-Old Will Develop Diabetes

  The odds an underweight man age 18 will be diagnosed with diabetes in his lifetime 1 in 13.2

  The odds a normal-weight man age 18 will be diagnosed with diabetes in his lifetime 1 in 5.1

  The odds an overweight man age 18 will be diagnosed with diabetes in his lifetime 1 in 3.4

  The odds an obese man age 18 will be diagnosed with diabetes in his lifetime 1 in 1.8

  The odds a very obese man age 18 will be diagnosed with diabetes in his lifetime 1 in 1.4

  The odds an underweight woman age 18 will be diagnosed with diabetes in her lifetime 1 in 8.2

  The odds a normal-weight woman age 18 will be diagnosed with diabetes in her lifetime 1 in 5.9

  The odds an overweight woman age 18 will be diagnosed with diabetes in her lifetime 1 in 2.8

  The odds an obese woman age 18 will be diagnosed with diabetes in her lifetime 1 in 1.8

  The odds a very obese woman age 18 will be diagnosed with diabetes in her lifetime 1 in 1.3

  SOURCE: JP Boyle, EW Gregg, KMV Narayan, TJ Thompson, DF Williamson, “Effect of BMI on Lifetime Risk for Diabetes in the U.S.,” Diabetes Care 30(6), 2007: 1562–1566.

  The odds a person has undiagnosed diabetes.

  SOURCE: Book of Odds estimate based on data in National Center for Chronic Disease Prevention and Health Promotion, Division of Diabetes Translation, National Diabetes Fact Sheet, 2011.

  The Odds a Person Has Prediabetes

  Prediabetes is defined as having blood glucose levels, as measured by A1C levels, higher than normal but not high enough to be classified as diabetes.

  20–64: 1 in 2.9

  65 or older: 1 in 2

  SOURCE: National Center for Chronic Disease Prevention and Health Promotion, Division of Diabetes Translation, National Diabetes Fact Sheet, 2011.

  The Odds an Adult Diagnosed with Diabetes:

  Takes any medication: 1 in 1.3

  Takes pills only: 1 in 2.1

  Takes insulin only: 1 in 6.5

  Takes pills and insulin: 1 in 8.1

  SOURCE: National Center for Chronic Disease Prevention and Health Promotion, Division of Diabetes Translation, National Diabetes Fact Sheet, 2011.

  Diabetes

  The odds a person has been diagnosed with diabetes: 1 in 16.1

  A man: 1 in 15.2

  A woman: 1 in 20

  A black person: 1 in 11.1

  A Hispanic person: 1 in 11.9

  A white person: 1 in 17.2

  An Asian person: 1 in 16.9

  SOURCE: Centers for Disease Control and Prevention, National Diabetes Surveillance System, http://apps.nccd.cdc.gov/DDTSTRS/NationalSurvData.aspx.

  Unwanted Kidneys

  A human kidney, if properly refrigerated, will keep for up to forty-eight hours. After it is harvested from a donor, the kidney is chilled in an ice bath, flushed with a preservative solution, and placed in a carefully labeled picnic cooler to await transplantation. Of the 117,793 people awaiting organs on April 6, 2013, 95,835 (81.4%) needed new kidneys. As of year-end 2011, the percentage of transplant patients on the waiting list for a kidney had increased by 86% compared with year-end 2001—while the number of transplants performed in 2011 was 16,055 or only 18% higher than 2001 levels.

  According to the Organ Procurement and Transplantation Network and the Scientific Registry of Transplant Recipients’ annual report, the rate at which kidneys recovered for transplant are discarded has increased steadily from 12.7% in 2002 to 17.9% in 2011. The most common reason for rejection was biopsy results (37% in 2011). According to the report, “this result may be somewhat biased, since biopsies are more likely to be obtained when the donor kidney for some reason is suspected to be suboptimal.” Since biopsies have been shown to be poor predictors of graft outcomes, the report suggests they should be used less often.

  According to a study by Juanjuan Zhang of MIT’s Sloan School of Management, just 2.9% of the kidney offers made are accepted. The reason, Zhang suggests, lies in herd behavior. If a kidney is offered to the first person on the waiting list and rejected for any reason, patients further down the list assume there is something wrong with it. The organ cascades down the list, becoming like a house that has been sitting on the market too long. No one wants to claim
something that many others have pronounced lacking.

  In Zhang’s sample, the average kidney was not accepted until it reached the thirty-fourth patient. That patient had previously declined fifteen other kidneys and spent 209 days on the waiting list.

  Every minute an organ spends in storage causes incremental cell damage. Repeated rejection by patients means that each year, scores of kidneys available for transplant reach and then surpass their two-day expiration date.

  The odds someone on the kidney waiting list will die in a year are 1 in 16.7.

  SOURCES: US Department of Health and Human Services, Health Resources and Services Administration, OPTN/SRTR Annual Data Report, 2011, December 2012. The Organ Procurement and Transplantation Network Database, http://www.usrds.org/adr.htm. Health Resources and Services Administration, Organ Procurement and Transplantation Network data as of April 6, 2013, http://optn.transplant.hrsa.gov/data/. J Zhang, “The Sound of Silence: Observational Learning in the US Kidney Market,” Marketing Science Journal 29(2), 2010: 31–35. US Department of Health and Human Services, Organ Procurement and Transplantation Network, http://www.ustransplant.org/csr/current/nationalViewer.aspx?o=KI.

  Going in the Wrong Direction

  As the rate of diabetes has increased, so has the incidence of end-stage renal disease. The odds a person will be diagnosed with end-stage renal disease in a year:

  SOURCE: US Renal Data System, USRDS 2012 Annual Data Report: Atlas of Chronic Kidney Disease and End-Stage Renal Disease in the United States, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, 2012.

  SOURCE: Centers for Disease Control and Prevention, National Diabetes Surveillance System, http://apps.nccd.cdc.gov/DDTSTRS/NationalSurvData.aspx. Centers for Disease Control and Prevention/National Center for Health Statistics, “Summary Health Statistics for U.S. Adults: National Health Interview Survey, 2008,” Vital and Health Statistics Report 10(242), December 2009.

  Autoimmune Diseases and Other Miseries

  GENDER WARS

  The odds a woman will be diagnosed with an autoimmune disease in a year are 1 in 769 vs. 1 in 2,000 for a man.

  SOURCE: Autoimmune Disease Coordinating Committee, National Institutes of Health, Progress in Autoimmune Disease Research, report to Congress, March 2005.

  Psoriasis Racial Disparities

  The odds a white adult will report having psoriasis are 1 in 40 vs. 1 in 76.9 for a black adult.

  SOURCE: JM Gelfand, RS Stem, T Nijsten, SR Feldman, J Thomas, J Kist, et al., “The Prevalence of Psoriasis in African Americans: Results from a Population-Based Study,” Journal of the American Academy of Dermatology 52, 2005: 23–26.

  Sickle Cell Anemia

  Sickle cell anemia is a genetic, lifelong disease. People inherit two genes for sickle hemoglobin—one from each parent.

  According to the National Heart, Lung, and Blood Institute, sickle cell anemia is common in people whose families come from Africa, South or Central America (Panama, in particular), Caribbean islands, India, Saudi Arabia, and Mediterranean countries.

  Racial Disparities

  The odds a black person has sickle cell anemia: 1 in 500

  The odds a Hispanic person has sickle cell anemia: 1 in 36,000

  The odds a person is a sickle cell carrier: 1 in 152

  The odds a black person is a sickle cell carrier: 1 in 12

  SOURCE: National Heart, Lung, and Blood Institute, “Who Is at Risk for Sickle Cell Anemia,” http://www.nhlbi.nih.gov/health/health-topics/topics/sca/atrisk.html.

  The odds a person will report at least one symptom of eczema: 1 in 5.9

  SOURCE: JM Hanifin, ML Reed, “A Population-Based Survey of Eczema Prevalence in the United States,” Dermatitis 18(2), 2007: 82–91.

  The Odds an Adult Has Ever Had an Ulcer:

  18–44 1 in 21.1

  45–64 1 in 10.3

  65–74 1 in 7.7

  75 or older 1 in 8.5

  SOURCE: Centers for Disease Control and Prevention/National Center for Health Statistics, “Summary Health Statistics for U.S. Adults: National Health Interview Survey, 2009,” Vital and Health Statistics Report 10(249), December 2010.

  Fibromyalgia

  The odds an adult will go to the doctor in a year for treatment of fibromyalgia: 1 in 50.8

  SOURCE: United States Bone and Joint Initiative, The Burden of Musculoskeletal Diseases in the United States, 1st ed., Rosemont, IL: American Academy of Orthopaedic Surgeons, 2008.

  The Odds a Person Has:

  multiple sclerosis: 1 in 746

  Tourette’s syndrome: 1 in 1,493

  Huntington’s disease: 1 in 9,767

  amyotrophic lateral sclerosis (Lou Gehrig’s disease): 1 in 9,956

  SOURCES: Patient Education Institute, X-Plain Patient Education. National Tourette Syndrome Association, TS Fact Sheet. http://www.alsa.org/als/who.cfm. About.com, Huntington’s Disease.

  The odds a person will die from chronic constipation: 1 in 2,215,900

  SOURCE: Book of Odds estimate based on Centers for Disease Control and Prevention, Wonder Database Compressed Mortality File.

  The odds an upper endoscopy will find a foreign body or retained food: 1 in 47.6

  SOURCE: JE Everhart, ed., The Burden of Digestive Diseases in the United States (NIH Publication No. 09-6443). Washington, DC: Government Printing Office, 2008.

  Emphysema

  Racial Disparities

  The odds an adult has emphysema:

  White 1 in 42.2

  Black 1 in 76

  Hispanic 1 in 157

  Asian 1 in 182

  SOURCE: Centers for Disease Control and Prevention/National Center for Health Statistics, “Summary Health Statistics for U.S. Adults: National Health Interview Survey, 2009,” Vital and Health Statistics Report 10(249), December 2010.

  The odds a person will visit an ambulatory care facility for hemorrhoids in a year: 1 in 144

  SOURCE: JE Everhart, ed., The Burden of Digestive Diseases in the United States (NIH Publication No. 09-6443). Washington, DC: Government Printing Office, 2008.

  GENDER WARS

  The odds a man will have chronic bronchitis in a year are 1 in 34.4 vs. 1 in 17.5 for a woman.

  SOURCE: Centers for Disease Control and Prevention/National Center for Health Statistics, “Summary Health Statistics for U.S. Adults: National Health Interview Survey, 2009,” Vital and Health Statistics Report 10(249), December 2010.

  Liver Disease

  Racial/Ethnic Disparities

  The odds an adult will be diagnosed with liver disease in a year:

  White: 1 in 65.5

  Asian: 1 in 91.2

  Hispanic: 1 in 96.22

  Black: 1 in 109.5

  SOURCE: Centers for Disease Control and Prevention/National Center for Health Statistics, “Summary Health Statistics for U.S. Adults: National Health Interview Survey, 2009,” Vital and Health Statistics Report 10(249), December 2010.

  Giving Blood

  Only about 4.3%, 1 in 23.4 Americans, will donate blood in a year.

  A quick way to remember who can receive what: add “O” to a blood type, and you will have every possible type that blood can receive. For instance: type A. Add an O, to make AO—A can receive A or O blood. Or AB—add an O to make ABO—AB can receive A, B, AB, or O. O, you’ll notice, can only receive O blood but (according to the rule) may be donated to anyone.

  The Rh factor complicates donation a little, in that blood with the Rh factor present (or Rh+) can only be given to other positive blood. Rh negative blood may be given to a + or − recipient, as long as the ABO group is a match, too.

  O− is the universal donor. With very few exceptions, anyone can receive O− blood. AB+ is the universal receiver, on the other hand, and can receive blood of any type. While neither is the most common type, they aren’t the least common, either. Here is a breakdown of the odds on blood types, from common to rare.

  O+ 1 in 2.6

  A+ 1 in 2.9


  B+ 1 in 11.1

  O– 1 in 14.3

  A– 1 in 16.7

  AB+ 1 in 33.3

  B– 1 in 50

  AB– 1 in 100

  SOURCES: Department of Health and Human Services, 2007 National Blood Collection and Utilization Survey. http://www.givelife2.org/aboutblood/faq.asp.

  Hay Fever

  Make a lot of hay? You probably have the fever.

  The odds an adult with a family income of $100,000 or more will suffer from hay fever in a year are 1 in 10.4, or a little under 10%. The odds an adult with a family income below the poverty line will experience the allergy are significantly lower—1 in 14.

  An estimated 50 million Americans a year complain of allergic rhinitis, otherwise known as hay fever. Hay fever results from an overly sensitive immune system reaction, one that in this case treats pollen as a dangerous invader. And like other allergies, it has been growing in prevalence, especially in developed nations.

  For reasons that aren’t entirely clear, hay fever disproportionately plagues the wealthy. One possible explanation for this phenomenon, according to epidemiologist David P. Strachan, is the hygiene hypothesis, which states that allergies are prevented by infections in early childhood. Put simply, a dirty child will yield a healthy adult. Though Strachan’s hypothesis has not been proven, there is compelling evidence to back it up. Studies have shown that owning a dog, having multiple siblings, and living on a farm—all obvious sources of germs and infection—reduce the chance of developing skin allergies. The same could be true for respiratory ones.

 

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