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Cdphe cd presentation for ccpd 10 14 11a
This document presents information on risk factors and outcomes related to chronic diseases. It discusses factors that influence health status such as lifestyle, environment and genetics. It provides data on leading causes of death in Colorado and risk factors among both adults and youth such as obesity, physical inactivity, smoking and high blood pressure. It also examines screening rates and disparities. Reducing risk factors like smoking and lowering cholesterol and blood pressure can help reduce diseases like cancer, cardiovascular disease, COPD and diabetes.
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Cdphe cd presentation for ccpd 10 14 11a
- 1. Select Risk Factorsand Outcomes Related to Chronic Diseases Presented to 10/14/2011 The Cancer, Cardiovascular and Pulmonary Disease Grants Committee
- 2. Acknowledgements Renee Calanan, PhD ChronicDisease Epidemiologist, PHS & Stephanie Kuhn Barbara Gabella Indira Gujral Ashley Juhl
- 3. Factors Influencing HealthStatus Biology 20% Lifestyle 51% Smoking Obesity Health Care Nutrtion 10% Alcohol Use Environment 19% Source: McGinnis, J.M and Foege, W.H. (1993). ―Actual Causes of Death in the United States,‖ Journal of the American Medical Association.
- 4. Determinants of Health (Evans- Stoddart Model) Social Physical Genetic Environment Environment Environment Individual Response – Behavior – Biology Health Disease Health & & & Medical Function Injury Care Well – Being Prosperity Paul Simon, MD, MPH, UCLA, 2007
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- 6. Number of deathsfor the fifteen leading causes of death — Colorado residents, 2010 Cancer (Malignant neoplasms) 7029 Heart Disease 6029 Chronic Lower Respiratory Disease 2199 Unintentional injuries 2102 Cerebrovascular Disease 1605 Cause of death Alzheimer's Disease 1336 Suicide 867 Diabetes Melitus 721 Chronic Liver Disease and Cirrhosis 598 Influenza and Pneumonia 549 0 1000 2000 3000 4000 5000 6000 7000 8000 Source: CDPHE, Health Statistics Number of deaths Section. Vital Records. Death statistics obtain via CoHID Oct 10, 2011
- 7. Percent of totaldeaths for the leading causes of death — Colorado residents, 2008 1.9% 1.7% 2.3% Influenza and Pneumonia 2.8% Chronic Liver Disease and Cirrhosis 4.3% 26.7% Diabetes Melitus 5.1% Suicide 6.7% Alzheimer's Disease Cerebrovascular Disease 7.0% Unintentional injuries Chronic Lower Respiratory Disease 22.4% Heart Disease 19.2% Cancer (Malignant neoplasms) Source: CDPHE, Health Statistics Section. Vital Records. Death statistics All other causes obtain via CoHID Oct 10, 2011
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- 9. How many peopleare affected? • 751,000 had hypertension(22%) • 307,000 had current asthma (8%) • 190,000 were cancer survivors (4%) • 113,000 had coronary artery disease (3%) • 219,000 had diabetes (6%) • 70,000 had a stroke (2%) Cover this blue placeholder with your program logo
- 10. Select outcomes byrace/ethnicity and income, Colorado adults, 2009 Outcome Race/ethnicity Income Asthma No disparity No disparity Coronary artery disease No disparity Most lower incomes > $75k+ Hypertension Black>White>Hispanic Lower incomes > $75+ Diabetes Black, Hispanic > White Most lower incomes > $75k+ Cancer Not assessed Not assessed
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- 12. Prevalence of selectedrisk factors, Colorado adults, 1997-2010 BRFSS 40 35 30 25 20 15 10 5 0 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Overweight High cholesterol Current smokers Hypertension Physical inactivity Obesity Data source: Behavioral Risk Factor Surveillance System, Health Statistics Section, Colorado Department of Public Health and Environment
- 13. Percent of Coloradoadult smokers, 1996-2009 25 22.8 22.3 19.8 20 17.1 16 Percent 15 Healthy People 2020 Objective: 12% 10 5 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Source: Colorado Behavioral Risk Factor Surveillance System, Health Statistics Section, Colorado Department of Public Health and Environment
- 14. Prevalence of obesityamong adult Coloradans, 1997-2010 BRFSS 25 20 15 10 Healthy People 2020 Objective: 30% 5 0 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Obesity Data source: Behavioral Risk Factor Surveillance System, Health Statistics Section, Colorado Department of Public Health and Environment
- 16. Prevalence of selectrisk factors, Colorado adults, 2009 (in pct.) 100 90 80 70 57 60 50 40 35 30 25 22 19 18 17 20 10 0 Fruit/vegetables High blood High cholesterol Obesity Meet physical Physically Current smoker 5+ times per day pressure activity recs inactive Data source: Behavioral Risk Factor Surveillance System, Health Statistics Section, Colorado Department of Public Health and Environment
- 17. High blood pressureby race/ethnicity and income, Colorado adults, 2009 50 50 45 45 40 40 34 35 35 30 29 28 30 25 25 25 23 25 21 20 18 20 18 15 15 10 10 5 5 0 0 White non-Hispanic Black non-Hispanic Hispanic Data source: Behavioral Risk Factor Surveillance System, Health Statistics Section, Colorado Department of Public Health and Environment
- 18. High cholesterol byrace/ethnicity and income, Colorado adults, 2009 50 50 45 45 41 40 40 37 36 37 35 36 35 34 33 35 35 30 30 25 25 20 20 15 15 10 10 5 5 0 0 White non-Hispanic Black non-Hispanic Hispanic Data source: Behavioral Risk Factor Surveillance System, Health Statistics Section, Colorado Department of Public Health and Environment
- 19. Obesity by race/ethnicityand income, Colorado adults, 2009 50 50 45 45 40 40 35 35 31 30 30 26 25 22 25 23 22 19 20 20 18 20 17 15 15 10 10 5 5 0 0 White non-Hispanic Black non-Hispanic Hispanic Data source: Behavioral Risk Factor Surveillance System, Health Statistics Section, Colorado Department of Public Health and Environment
- 20. Physical activity byrace/ethnicity and income, Colorado adults, 2009 100 100 90 90 80 80 70 70 63 59 55 55 58 60 56 60 51 51 50 50 50 40 40 30 30 20 20 10 10 0 0 White non-Hispanic Black non-Hispanic Hispanic Data source: Behavioral Risk Factor Surveillance System, Health Statistics Section, Colorado Department of Public Health and Environment
- 21. Physical inactivity byrace/ethnicity and income, Colorado adults, 2009 50 50 45 45 40 40 35 35 33 30 29 30 28 28 25 25 23 20 20 20 14 14 15 15 9 10 10 5 5 0 0 White non-Hispanic Black non-Hispanic Hispanic Data source: Behavioral Risk Factor Surveillance System, Health Statistics Section, Colorado Department of Public Health and Environment
- 22. Current smoking byrace/ethnicity and income, Colorado adults, 2009 50 50 45 45 40 40 35 35 30 30 28 28 27 25 25 20 20 20 20 18 17 16 15 15 9 10 10 5 5 0 0 White non-Hispanic Black non-Hispanic Hispanic Data source: Behavioral Risk Factor Surveillance System, Health Statistics Section, Colorado Department of Public Health and Environment
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- 24. Prevalence of preventivescreening, Colorado adults, 2008 100 90 84 80 76 76 73 70 62 60 50 40 30 20 10 0 Cholesterol within 5 years (18+ Colorectal cancer (50+ years) Cervical cancer within 3 years Breast cancer within 2 years Breast cancer within 2 years years) (18+ years) (50+ years) (40+ years) Colorectal cancer: colonoscopy within 10 years, sigmoidoscopy within 5 years, or FOBT within 1 year Data source: Behavioral Risk Factor Surveillance System, Health Statistics Section, Colorado Department of Public Health and Environment (cholesterol screening, 2009)
- 25. Cholesterol screening by race/ethnicity and income, Colorado adults, 2009 100 100 90 90 86 79 78 80 80 77 78 68 70 70 70 61 62 60 60 50 50 40 40 30 30 20 20 10 10 0 0 White non-Hispanic Black non-Hispanic Hispanic Data source: Behavioral Risk Factor Surveillance System, Health Statistics Section, Colorado Department of Public Health and Environment
- 26. Colorectal cancer screeningby race/ethnicity and income, Colorado adults aged 50+ years, 2008 100 100 90 90 80 80 72 68 70 64 70 64 64 59 60 54 60 56 50 50 47 40 40 30 30 20 20 10 10 0 0 White non-Hispanic Black non-Hispanic Hispanic Data source: Behavioral Risk Factor Surveillance System, Health Statistics Section, Colorado Department of Public Health and Environment
- 27. Cervical cancer screeningby race/ethnicity and income, Colorado women aged 18+ years, 2008 100 100 93 87 89 90 86 90 84 81 79 80 80 80 71 70 70 60 60 50 50 40 40 30 30 20 20 10 10 0 0 White non-Hispanic Black non-Hispanic Hispanic Data source: Behavioral Risk Factor Surveillance System, Health Statistics Section, Colorado Department of Public Health and Environment
- 28. Breast cancer screeningby race/ethnicity and income, Colorado women aged 50+ years, 2008 100 100 90 82 90 80 80 78 80 77 76 72 70 70 70 61 60 60 50 50 40 40 30 30 20 20 10 10 0 0 White non-Hispanic Black non-Hispanic Hispanic Data source: Behavioral Risk Factor Surveillance System, Health Statistics Section, Colorado Department of Public Health and Environment
- 29. Disparities in Screening •Hispanics had a lower prevalence of cholesterol screening and colorectal cancer screening than Whites and Blacks. • In general, screening increased as annual household income increased.
- 30.
- 31. Select risk factorsand outcomes, Colorado adolescents, 2009 100 90 80 78 70 60 50 40 30 27 24 20 12 10 0 Healthy weight Recommended physical activity Fruit/vegetables 5+ times/day Current smoker Data source: Colorado Youth Risk Behavior Survey, Colorado Department of Education; analyzed by Colorado Department of Public Health and Environment Current smoking data source: Healthy Kids Colorado Survey on Tobacco and Health, Colorado Department of Public Health and Environment, analyzed by Amendment 35 Program Evaluation Group (APEG), University of Colorado Cancer Center
- 32. Select risk factorsand outcomes, Colorado children, 2009 100 90 80 70 65 60 50 48 45 40 31 30 20 16 10 9 10 0 Healthy weight (5- Eat fruit 2+ times and Drink sweetened Active everyday for Watch TV >2 hours Sunburn in past 12 Current asthma (1- 14y) vegetables 3+ times drinks 1+ times per 60+ minutes (5-14y) per day (1-14y) months (1-14y) 14y) per day (2-14y) day (1-14y) Data source: Colorado Child Health Survey, Colorado Department of Public Health and Environment
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- 34. Reducing Cigarette Smoking Cancers CVD • 80-90% of lung • 2-4 x risk of coronary heart • 30-50% of colon disease • 75% of oral (w/ alcohol) • 2 x risk of sudden cardiac • Cancers of the bladder death cervix, esophagus, larynx, • Abdominal aortic aneurysm kidney & pancreas • Strokes • Atherosclerosis & congestive heart failure COPD • 90% of Chronic Diabetes Obstructive Pulmonary •Leads to neuropathy & Disease peripheral artery disease •Smoking increases the risk of amputation by 2 – 10 times 34
- 35. Lowering cholesterol &hypertension CVD • 30-40% of coronary CVD heart disease • 20-30% of coronary heart disease • 10-20% of stroke • 20-50% of stroke Type 2 Diabetes • End stage renal • 65% of people with diabetes die from heart disease or stroke 35
- 36. Nutrition & PhysicalActivity Cancers • 30% of cancer deaths Cancer • Nutrition: Cancers of • 22% of colon cancers the mouth, pharynx, • Cancers of breast, colon, and esophagus, larynx, kidney, possibly endometrial & colon, rectum, ovary, & prostate bladder CVD CVD • 12% of hypertension • heart disease by 20-40% • stroke by 30% Type 2 Diabetes Diabetes • 12% of diabetes 36
- 37. Reducing Obesity CVD • Increased likelihood of heart 50-100% greater risk of disease and stroke premature death Cancers Diabetes • Cancers of the colon, • Increased risk of Type 2 breast, kidney, Diabetes gallbladder, prostate, cervix, ovaries, & esophagus 37
- 38. Thank you GabrielKaplan, PhD., MPA, Director EPE | Epidemiology, Planning and Evaluation | Branch Prevention Services Division Colorado Department of Public Health and Environment [email protected]