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The Honolulu Advertiser
Posted on: Wednesday, October 3, 2007

Report shows chronic diseases cost state billions

By Robbie Dingeman
Advertiser Staff Writer

The economic cost of chronic diseases — such as diabetes, hypertension and stroke — in Hawai'i grew to $1.1 billion in treatment expenses and an additional $3.9 billion in lost productivity as of four years ago, according to a just-released national study.

The Milken Institute reported that in 2003 there were 560,000 cases of seven categories of chronic diseases in Hawai'i. Nationwide, these diseases turned up in 162 million cases, resulting in $277 billion in treatment costs and more than $1 trillion in lost productivity.

The report, "An Unhealthy America: The Economic Impact of Chronic Disease," looked at the human costs and the economic burden caused by cancers, diabetes, heart disease, hypertension, stroke, mental disorders and pulmonary conditions.

Beyond the direct stress on the individuals, the report noted the conditions "shorten lives, reduce quality of life, and create considerable burden for caregivers."

Without changes in the trend, the report indicated, those expenses will increase sharply.

But the news wasn't all bad for the state. The institute reported that Hawai'i was No. 7 of states showing lower numbers of the chronic diseases. The report suggests that the trend can change even more with prevention.

That suggests the state is on the right track with an increased emphasis on prevention and nurturing healthier lifestyles, according to Danette Wong Tomiyasu, the chief of the chronic disease management and control branch of the state Department of Health.

While chronic diseases take a significant toll, those numbers can be improved, she said. "A lot of it is preventable," Tomiyasu said, even with an aging population.

The improvement comes when people heed three major messages:

  • Move more by increasing physical activity.

  • Eat better.

  • Don't smoke or use other tobacco products.

    Tomiyasu said the state has seen improvement on some health practices. She said further reductions in the number of smokers is helping. She credits the tougher smoking laws in public places and workplaces as contributing.

    The report also points to other factors: more aggressive early disease detection, slightly faster adoption of improved therapies, and less-invasive treatments.

    Milken researchers said impacts of these factors vary widely by condition — gains against diabetes depend largely on reductions in obesity, while colon cancer advances depend heavily on wider early screening.

    The optimistic scenario would cut treatment costs in 2023 by $217 billion nationwide and by $4 million in Hawai'i. State Department of Health spokeswoman Janice Okubo said the stricter law "really was a major step forward for us in terms of tobacco use."

    Tomiyasu said other community planning and support can also encourage healthier habits with more walkways, bikeways and ways to make it easy for people to be physically active.

    She acknowledges that part of life is more sedentary in general — "being behind desks and in front of computers."

    But she emphasizes that a better life quality is available to people willing to try. "Even those with chronic diseases can improve their outcomes. It's not just early prevention."

    The Milken Institute is an independent economic think tank and nonprofit organization whose mission is to improve the lives and economic conditions of diverse populations in the United States and around the world by helping business and public policy leaders identify and implement innovative ideas for creating broad-based prosperity.

    Reach Robbie Dingeman at rdingeman@honoluluadvertiser.com.

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