How will we create a new ecosystem?

I wanted to share with you a fascinating New York Times blog post that reveals some interesting facts about physician reimbursement rates between primary care doctors and specialists. As a nation, we’re very reactive in managing our health. In other words, we wait until a specific condition ails us before we go see a doctor. Typically, it’s a specialist who fixes our immediate problem, and we move forward with our daily routine until the next condition flares up and we’re forced to see another specialist, and so on. The result: there is a much higher value placed on specialist services relative to primary care services.

But there’s more behind the curtain than simple supply and demand. As the article points out, $60 billion of our tax dollars are allotted for Medicare physician payment, and since many private insurers and Medicaid programs model their fee structures after Medicare, our tax dollars actually have a significant bearing on determining physician incomes in this country. So you might be surprised to learn that an “expert committee” of 29 men and women (mostly specialists) determine how that $60 billion gets allotted.

Read the entire post about the RUC committee’s role in setting physician reimbursement rates, and let me know what you think about such a small group of people holding power without transparency over billions of dollars that involve their own self-interest. Perhaps if primary care doctors received a more equitable slice of the reimbursement pie, they wouldn’t need to cram as many patients into their daily schedule and building a medical home with a trusted physician would become a little easier, thus allowing for a more proactive and collaborative approach to health management in the U.S.

I look forward to your comments and thoughts.

Today you might notice something a little different about our page design; it’s a subtle yet important change in more ways than one. We’re changing the blog name to Building a WellMovement and its URL to www.wellmovement.com. But we’re still committed to contributing to the conversation on how we, as a nation, can build a new economic system based on health and sustainable consumption, overcome our dependence on products and services that hinder good health and in the process revitalize our economy.

There are a couple reasons for the change. One, we introduced a Facebook page a few months back titled WellMovement.  This is our vehicle for getting participants involved in taking daily steps toward better health and providing encouragement and ideas for those within our social community who strive to lead healthier lifestyles. The overall missions between the blog and Facebook page are similar, so for the sake of providing consistency to both readers and followers it made sense to align our social media presence for both audiences.

Second, changing the name reflects a broader concept that entails a grass roots movement encompassing entire communities that I see taking shape across the nation. It’s a movement devoted to better health and sustainable consumption, and my hope is that I and our guest contributors can promote these efforts and provide meaningful ideas toward that goal. So while our name is changing, the goal remains the same: further the discussion on how we can become a Well Nation through a WellMovement.

We need your input; I hope you will continue to join me in the discussion, both here and on our WellMovement Facebook page.
Note: Please bookmark this new URL, www.wellmovement.com.

This is the third and final installment in our series of posts with Dr. Ray Fabius, Chief Medical Officer with Thomson Reuters. Be sure to read parts I and II if you haven’t already. Today’s post focuses on the importance of medical homes and provides guidance for organizations looking to build a culture of health.

Previously, you shared that 40% of the population who visited a Walgreens on-site clinic is medically “homeless.” What constitutes a medical home?

The study you are referring to was done by asking people who visited a retail clinic. In other words, visiting a nurse at one of the Walgreens sites, it was in the nurse’s and Walgreens best interest that a report be sent back to the patient’s primary care doctor, and 40% of the patients cared for didn’t have any place to send the report. The term that’s been coined around those people is “medically homeless.” They have no primary care office they consider their medical center or home where a report on care they received from other places could be sent to.

Why do you think that is?

The American population, perhaps more so than any other industrialized nation, interacts with the healthcare system on a “reactive” basis, rather than a proactive one. They believe they can receive excellent care at the point when they need it, and are often shocked if there are problems getting access. But at least a subset of the population believes they really don’t need to see any clinician until they actually have a medical problem.

If someone has a primary care provider they are much more likely to engage in behavior change programs, even outside of disease management. Some of the quintessential research shows that if a primary care doctor spends five minutes talking to a patient about stopping smoking, there’s between an 8% – 11% success rate in getting the patient to stop smoking. The best smoking cessation programs in the country brag about a 20% – 22% quit rate, so you get half way there in just five minutes of discussion between a patient and trusted clinician. The power of a trusting and caring provider expressing to a patient how important it is to do something is a very powerful lever that is underutilized in the American healthcare system.

So you’re advocating one should find and listen to someone in a position of health authority?

Yes, but it’s particularly true where you’ve established a prior relationship. If you have a long-standing relationship with a trusted clinician established as part of your medical home, that doctor’s message is powerful and is much more likely to be heeded over the long haul.

What I tell employers when they ask me why their healthcare costs are going up is that for starters, they are likely supporting “random access to care.” In the world of GE, where I came from, we talked about Six Sigma; random access to care is Zero Sigma. Research shows that the average American is no more likely to get the right doctor for the problem they have than chance, particularly if they have not first consulted with a trusted clinician. If they go to their trusted medical home first they’re much more likely to access the appropriate specialist or hospital. If they don’t access their primary doctor first, or don’t have one, they hit the closest ER which sometimes leads them into what are not the best options.

I’m a healthy person except for the occasional cold, etc. Should I still establish a relationship?

The answer is overwhelmingly “Yes,” but you have to buy into a couple of things. For example, does it make sense to engage in certain procedures and services because they will extend your period of wellness further, actually prevent a disease, or at least pick things up early so that they can be treated more successfully? The classic example is do we wait until we actually feel a lump in your breast or make sure you get periodic mammograms? We know if a mass is picked up early, a woman can have a lumpectomy instead of a mastectomy. You save a life but the woman loses a breast, or you can save a life and save a breast. You have to believe that’s worth doing, and the data is pretty clear in many cases there should be things done periodically even if you’re healthy.

This supports the idea, particularly for large employers, of having health centers on-site where employees can establish a relationship.

I am a huge supporter of engaging in every method that you can to bring, especially primary, care to the patient and to look for places where there is a high concentration of patients and put the doctor or nurse practitioner there.

In closing, if employers want to create a culture of health how do they begin the process?

I’m part of a Change Agent Work Group that built a roadmap for employers. In that roadmap we proposed a series of seven steps. The first is to create a vision and mission that’s incorporated into the business at the highest level, and the next step is to secure clear corporate leadership to champion your efforts. From there it’s a matter of looking at the policies and procedures of the organization so that you’re supporting healthy options.

Early on it’s important to do a comprehensive assessment of where you are in your culture of health relative to benchmark organizations, find out where you are relative to benchmark, and identify the gaps between what you’re doing and what the best companies are doing. You can organize those gaps by deciding which of them you want to resolve first and in what order of priority. This will lead you to a corporate roadmap in building a culture of health for your organization.

This is the second in a series of posts about our discussion with Dr. Ray Fabius, Chief Medical Officer with Thomson Reuters. Part I, which can be viewed here, centers on how to successfully build a culture of health. Today’s post discusses the differences, and similarities, of building a culture of health in blue collar and white collar work environments.

Is it more difficult to create a culture of health in a blue collar environment than a white collar environment?

No, for a long time blue collar companies have embraced a culture of safety. In general, they are further along in developing a culture of health because they’ve already experienced success building a culture of safety. They’re comfortable in the belief it can be done. On the other hand, white collar companies that haven’t had experience with a culture of safety may be less convinced they can build a culture of health.

We’ve been able to make a tie between health and safety, which is intuitive, but statistically a worker who is in good physical and mental condition is much less likely to have an occupational mishap. So that’s allowed us to take a company who has had success building a culture of safety and move them on the path to a culture of health. When I was at GE the employees who had recurring accidents at work were almost always those who had significant behavioral health or medical problems.

Many employees struggle paycheck to paycheck, and buy fast food or other unhealthy offerings because it’s economically feasible. How do you reconcile that with an employer saying “we need a culture of health?”

I cannot deny there is a direct correlation between one’s income and one’s state of health. There are many experts, some colleagues of mine, who believe the best way to improve a worker’s health is to pay them more money over time. To me this leads to the consideration that if you could control the healthcare costs of your workforce you might be able to give them more of a raise, because right now the only raise employees are getting is the additional amount of money an employer is paying for the same benefits. It’s a chicken and egg scenario. When I sit down with unions to get them to move to a culture of health I tell them that one of the benefits is that if you slow the company’s healthcare costs perhaps the additional revenue generated can be re-distributed toward better raises.

That being said, many blue collar workers eat a couple of meals everyday at the workplace, and some employer cafeterias are subsidized as a benefit or a good will gesture to the workforce. That’s a tremendous opportunity to exert a healthy culture and subsidize healthy foods in lieu of unhealthy ones. It could also be an educational tool to teach people what they need to know about eating right.

Do you find health education information is well-received in blue collar environments?

The best way to incorporate it is to make it part of the daily living process. What you could do in a cafeteria is just a simple posting of how much a meal is in terms of calories and fat content. You could take it further and provide salt content, amount of carbohydrates or proteins and over time you’ll get more people understanding what makes up food and what’s health and unhealthy.

Can you point to specifics where this kind of effort couldn’t be adopted in a white collar setting?

No matter where you embark on a culture of health you need to appreciate that it takes time. You need to be committed to a process and that you’re not going to be deterred in accomplishing your goal. Once you’ve decided that a healthy workforce is going to be an important part of your company – alongside its vision to deliver excellent products or services – it doesn’t matter if it’s blue collar or white collar. It’s just a matter of time before you make that achievement.

On the white collar side you generally have more stress and behavioral health issues and the blue collar environment generates more muscular/skeletal issues. Everything else is pretty similar in terms of incidence of high blood pressure, diabetes, and heart disease. Neither population is making good choices around their health often enough, and they are typically different unhealthy choices. A blue collar population may consume more alcohol and a white collar population may submit themselves to greater levels of stress and perhaps have a harder time with work-life balance issues.

It sounds like companies really need to understand who their audience/workforce is?

Absolutely, it really starts to move you toward understanding the tenets of population health management and speaks to the importance of understanding what’s challenging your employee population, their spouses, and dependents.

In our next, and final, post with Dr. Fabius, we discuss the importance of having a medical home and establishing a relationship with a trusted clinician.

Recently WellNation sat down for a discussion with Dr. Ray Fabius, Chief Medical Officer with Thomson Reuters, a technology and news organization that employs more than 55,000 people worldwide and delivers critical information to decision makers in the financial, legal, accounting, healthcare, and science markets. Dr. Fabius has a long and impressive history of helping large organizations build a culture of health, so we wanted to get his feedback on a range of health-related topics. This is the first in a series of posts that captures the highlights of our discussion.

You write that you are passionate about building a culture of health in the workplace. Can you share what “culture of health” means?

I would define culture of health as an environment that actually makes good health choices the easiest ones to make; to do that you need a collection of policies, facilities, social networks, and leaders all pointing in the same direction of cultivating wellness.

Health is such a personal matter; does that conversation really belong in the workplace?

We know a healthy worker is a more productive worker. I think if we could markedly improve the health and wellness of the American workforce, we could implement another “Bull Run” in the market, similar to the last one which many believe were the technology enhancements that led to great advancements in productivity.

Once you’re under the belief and passionate commitment that a healthy workforce is a competitive advantage, it makes it easier to understand why you wouldn’t want to separate a workforce’s personal health from their productive responsibilities.

Are employers embracing the idea that health in the workplace equals better productivity?

I’ve been beating this drum since at least 1996 and I’ve never been more optimistic than I am now. I do believe there’s an increasing number of employers who have the enlightened realization that they should really commit to advancing the health of their workforce, not because it’s a nice thing to do, or because it might get them to be thought of as an employer of choice, but because it’s a very important part of a successful economic formula.

What are you seeing employers do now to promote a culture of health they weren’t doing back in 1996?

There are a collection of employers that have publically announced their healthcare costs are going down. So when President Obama speaks to the notion of bending the cost curve, he’s really speaking about those corporations whose healthcare costs are not just experiencing a slowing of the escalation rate, but actually going down. When companies start to hear there are other companies who have done a good job of building a culture of health and their healthcare costs are going down, it starts to attract attention from leaders outside the human resources department. It attracts the attention of the CEO and CFO.

It’s always been about proof of concept. When we first spoke about the notion that building a culture of health could mitigate rising healthcare costs, it was theoretical until I was able to do it as Global Medical Leader at General Electric. During my tenure healthcare costs were rising at about 3% while our peer companies were experiencing a 7%-8% increase in costs. That was thought of as state-of-the-art as it existed, there weren’t any companies in the early 2000s I was aware of that actually announced healthcare costs were going down. Once companies say publically their healthcare costs are going down, it becomes a very attractive consideration because most large employers are self-insured. As you’re probably aware, in a self-insured environment, when healthcare costs go down the difference in what you spent last year and what you spend this year goes right to the bottom line.

Are there specific things those in leadership roles need to be doing to help drive a culture of health?

Benchmark companies that have established a culture of health have done so with active support from leadership at the top of their company. It’s essential for people in the executive suite to be committed to building a culture of health inside the organization and also “walk the talk.” Not only do they have to support the concept with communications, but they have to eat right, exercise, not smoke and be a good example of an employee making healthy choices. They must be champions and ambassadors of better health.

On the flipside, what are some things employers are doing today that contribute to poor health?

One is fostering an environment that makes it difficult for people to eat right, exercise, or have periods of reduced stress. In some cases they actually create an environment where working becomes a real problem to one’s physical and mental health by not supporting a reasonable work/life balance. A classic example is shift work; the human body is not designed to quickly shift to different work cycles. Yet so many factories, sometimes with the negotiated choice of the unions, have workers two days on day shift, two days on evening shift, two nights on the graveyard and then three days off – and then do it again.

In the next post Dr. Fabius will share his thoughts on the differences – and similarities – in building healthy cultures in blue collar and white collar working environments.

I was sitting in the locker room at my gym after a workout and stumbled upon a FOX-TV program debating whether a fast food company should be allowed to advertise in schools, and the role of policy versus parenting in children’s health. As the rapid-fire style program continued, a guest doctor made a point about the criticality of managing the obesity epidemic by setting better nutrition policies at schools, including not allowing fast food chains to advertise in schools, similar to banning cigarette advertising.

Children eating fast food is part of what causes a sick economyWithin seconds the other guests jumped in, one calling the doctor a “Liberal,” another saying that too much sunlight is bad so we should ban it too, and a third made the point about the number of jobs that would be lost if McDonald’s went out of business.  Finally, the host chimed in that he should be allowed to take his son for a burger every day if he wanted.

When the segment ended, I realized that arguing about our nation’s health dilemma from traditional political viewpoints is not only a waste of time, but a wasted opportunity.  It’s not about liberty and jobs versus policy and health. It’s about how we can achieve both—economic vitality and a healthier population.

Good health is non-partisan

While dramatic, partisan debate might make for interesting television programming, it does nothing to address the fact that all of us—Democrats, Republicans, and Independent alike—will pay for the future cost of obesity, and the resulting diabetes, due to our unhealthy eating habits. Put differently, we all have a vested interest in improving personal health, the health of our children, and the health of our economy.

Daily Caloric Intake ChartThe question we need to collectively answer is “How can we use policy to spur a healthy economy and a healthy population?”  We need to take a strong stance on public health policy—especially for our kids—and concentrate on becoming more knowledgeable about food and nutrition.  In parallel, we need to provide incentives to those businesses that support the principles of a WellNation.

What are your thoughts and ideas on how we can overcome partisan politics and create a WellNation economy? I look forward to your comments.

 

I wanted to share something here that we originally posted on our WellMovement Facebook page just a few days ago. I’ve written quite a bit about the roles that various stakeholders play in creating and supporting a WellNation, and this story exemplifies how legislators and policy makers might work together to create programs that improve health and simultaneously provide economic benefits.

Smiling Girl - Well MovementAn Oregon farm bill (Oregon HB 2800) provides incentives to deliver fresh local foods to schools. The bill, if enacted, would reimburse schools up to .15 cents per lunch and .7 cents per breakfast, for purchasing Oregon food products. It also provides education grants to schools that support teaching gardens and nutrition education activities that teach children about local food production and increases their preference for fruits and vegetables. This in and of itself is good news (and policy), but the real story lies in the health impact assessment (HIA) that delves into the broader economic impact of the proposed legislation.

Shaping children’s preferences for healthy food

The HIA is part of a national initiative between the Robert Wood Johnson Foundation and The Pew Charitable Trusts. These studies explore the health impact of proposed projects, plans, or policies that might not otherwise take into account its health implications. The HIA for HB 2800 concluded it would:

  • Create at least 800 new agriculture jobs over the next five – ten years in both rural and urban areas;
  • Potentially increase students’ satisfaction with school meal offerings, which in turn could mean more children from economically disadvantaged families would get nutritious meals at school; and
  • Have a moderate long-term impact on childhood obesity by increasing fruit and vegetable consumption as well as increase physical activity through participation in the school-based garden program.

The co-author of the study put it simply, “We found that this bill would offer the state of Oregon an economic benefit and, at the same time, provide a number of important health benefits – for example, shaping children’s preferences for healthy foods.”

It’s also a shining example of how policy makers can support the well economy through job creation that also benefits good health.  Please read about it in more detail here, and let me know what you think.

Three billion dollars is a lot of pie

There is a food economy effort simmering in Louisville, KY that just might serve as a model for cities searching for ways to minimize food deserts and increase healthy consumption. With a metro population of approximately 1.25 million, Louisville’s consumer food demand comes to approximately $3 billion per year. That’s a pretty big slice of pie no matter how you cut it. In addition to being a major economic force for the city, the public health ramifications of food are enormous. Incidence of diabetes, heart disease, and obesity are trending the wrong way, and studies show that in cities and towns across the country the food choices that many people make are shaped by the choices they have.

Tractor in a field - Food Economy - WellNationRecently WellNation had a conversation with Stephen Reily of www.vibrantnation.com. Reily is an entrepreneur who volunteers as Mayor Greg Fischer’s point person tasked with capitalizing Louisville’s local food economy into a competitive advantage for the city. He pointed out that one of the most difficult tasks in building out a viable economic model is connecting the dots between various stakeholders in the private, public, and non-profit sectors.

It takes a village

During our conversation, Reily mentioned LIFE ZONE (Local Food Enterprise Zone), which is an initiative that may help “connect the dots.” The Mayor’s office commissioned a University of Louisville graduate-level urban planning class to study the viability of creating a district within the city that would incentivize and support consumers, companies, farmers markets, community-supported agriculture, restaurants, and schools  interested in healthy food production, distribution, and consumption. Like a logistics industry focused around an airport, this model creates a localized hub of businesses devoted exclusively to growing and sustaining the local food economy.

Eggs - WellNationGrasshopper’s Distribution is a private company that started as an economic development project of Community Farm Alliance. Created in 2005 by Kentucky farmers seeking an alternative to tobacco, Grasshoppers came together as a way to market and distribute locally produced meats, eggs, vegetables, fruits, and cheeses. Currently, Grasshoppers sells fresh, high quality food to individuals via membership distributed through a dozen pick-up locations. It also has a corporate program, where employees conveniently pick-up their weekly produce order at work.

A not-for-profit enterprise called Seed Capital Kentucky provides micro-loans to farmers who need help with special equipment purchases, capitalization, or assistance in producing secondary or off-season crops. Most banks are not equipped to make the small-scale loans that many farmers need periodically, so Seed Capital is supporting farmers by making sure they have a means to grow their business when an opportunity arises.

It’s a start

Reily believes there is uncovered demand in Louisville if more people were made aware of local food availability. “There’s really no reason to buy food that’s grown more than a couple hundred miles from here and eat really well,” he said. “If every community were to do that, we’d have a much more self-sustaining, healthy economy. Farmers would do better, tax money would be kept in the community, and people would be healthier.”

I’m looking forward to hearing more about LIFE ZONE and the committee’s recommendations.  Creating or revitalizing a new ecosystem based on local food consumption and distribution takes effort and ingenuity by the public, private, non-profit, urban, and rural sectors all working together to build a WellNation. I’m genuinely excited at the prospect of our community finding ways to connect the dots.

I’ll be writing more about these efforts, and I’d like to hear your thoughts and ideas about Louisville’s initiatives – or what your city is doing – to promote a healthy food economy.  Also, don’t forget to join our WellMovement discussion on Facebook.

Recently I had the pleasure of chatting with Sara Suchy from HealthCentral, an information health portal and online community that provides information and discussion on a wide range of topics, literally from acid reflux to wellness. Our topic was obesity.

Heading in the wrong direction

 

We discussed many facets of the obesity epidemic; from our “sick care” mentality to lifestyle factors and the role of personal responsibility. The author opened the story with a startling statistic: Our thinnest state in 2009 (Colorado – 19% obesity rate) is fatter than what our fattest state was in 1980 (Mississippi – 15% obesity rate)!  Clearly, we have an obesity epidemic on our hands and this is not just a U.S. phenomenon but a world-wide one. I believe that through WellNation principles we can, and must, start to reverse the trend.

Click here to read the story in its entirety, or visit www.healthcentral.com and click on the obesity link.  Thanks to HealthCentral for giving me an opportunity to talk about WellNation.

And I encourage you to participate in the health discussion at our WellMovement page on Facebook; we post new information daily.

My daughter came home from gymnastics practice recently and informed us that one of the 9-year old girls at her gym had decided to “retire” from the sport. Apparently, the time commitment and pressure to perform had become too much for the young girl, and the sheer fun of the sport that induced her to get started in the first place had faded. Unfortunately, for many of our youth today’s choices for participating in sports are black or white: either commit oneself to the time and rigors of advanced competition designed to prepare you for the next level, or sit on the sidelines and watch.

Worshipping the virtual athlete

This week, millions will sit around and watch the NFL draft, or portions of it, anticipating how their favorite team will fare in its pursuit of the best college talent. It’s an event that only whets our appetite for the real competition come fall – where millions more will honor their gridiron heroes by parking their behinds on the couch and spending hours in front of the TV on Sunday afternoon having pizza, soft drinks, and beer. Football, basketball, and baseball are just the main courses offered year-round on a myriad of sports-themed networks that thrive because we’ve become a nation of spectators with a voracious appetite for professional and college sporting events – and loads of admiration for its participants.  It seems that “spectating” professional and college events has become a sport in its own right for a large portion of our population. If that isn’t enough, we can also buy the latest video game and simulate ourselves as LeBron James or Tiger Woods. Unfortunately, being a virtual athlete does little for our body, mind, or self-esteem.

Everyone deserves a relaxation outlet for working hard all week, but our sports mania comes at a price.  We look at professional athletes as larger-than-life figures and measure our return on investment in kids sporting activities on whether they will make it at the next level. We teach them that with the proper dose of dedication, coaching, talent, hard work, and a dash of good luck, they too might someday enjoy the rewards of celebrity and multi-million dollar contracts. As a result, the pressure on children and parents is enormous. I have heard stories of the hockey dad or the soccer mom yelling from the sidelines, and in some cases even getting into fights with other parents.

And while I strongly support creating opportunities for skilled young athletes, the unintended consequence is that there is virtually no place for kids who are not as skilled as others. There are too few programs that allow kids to focus on the simple love of exercise and build a life-long habit towards being active. In fact, the average PE time at most schools is a fraction of what kids need and many kids don’t live in neighborhoods where they can play.

Anyone for “Steal the Ball?”

 

Where are the games that we played as kids where the final score was less important than the fun of the game itself? During last year’s Fall Festival at my kids’ school I watched them run up and down a field playing “Steal the Ball,” a game their PE instructor invented. It was some combination of tag and dodgeball played on an open field. They tried explaining the rules to me, but I never fully caught on – and it didn’t matter. They were running around having fun and enjoying exercise. No one will ever win the Steal the Ball Super Bowl or World Series, but the passion for exercise displayed by those children, if instilled in others, would certainly create a healthier and more productive society.

 More than anything else, kids want to fit in. So if you’re not as skilled as your peers, how long will you put up with an ultra-competitive environment that rewards the best athlete?  I think we need a new physical education model in our schools, one that rewards the activity and the participation rather than just the skills of the best athletes. Schools in California and Illinois emphasize physical activity as part of their daily curriculum, and student test scores are up. There is a lot of evidence that supports the link between exercise and learning, its benefits include;

 

  • Better test scores
  • Healthier individuals
  • Less depression
  • Less medications needed for conditions such as ADD

Having healthy, happy, well-adjusted children is a goal that every parent strives for, and developing exercise and activity as fun at a young age is an important step to get there. There will always be a place to revere the super athlete, however, the question we need to ask as a society is: how do we get the fun back into exercise for all?

I’d love to hear your thoughts on how we can engage more of our youth in activities for the sake of being active. Share your thoughts here or on our WellMovement Facebook page.

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  • The average daily calorie intake for Americans is 3,760. Approximately 73 million adults in the U.S. were obese in 2008.

    A 20-year-old white woman with a body mass index of 45 or more is estimated to lose eight years of life due to obesity.

    A 20-year-old white male with a body mass index of 45 or more is estimated to lose 13 years of life.

    Loss of life (two to five years) is estimated to occur even at moderate levels of obesity.

    From 1987 to 2001, diseases associated with obesity accounted for 27% of the increases in U.S. medical costs. Obese persons had estimated medical costs that were $1,429 higher than persons of normal weight.

    Childhood obesity has more than tripled in the past 30 years.

    A child with two obese parents has an 80 percent risk of becoming overweight.

    If you’re an 18-year-old obese person in the U.S., you can expect to save $549,907.35 during your lifetime if you reach a normal weight in the next 3-12 months.

    Thirty percent of kids
    today eat fast food...
    every single day
    of the year.

    Obese children are four times as likely to suffer from depression.

    The U.S. spends approximately $6,100 per capita on health expenditures; Canada, $3,200; United Kingdom, $2,600; Japan, $2,300.

    Total economic costs (direct medical and lost productivity) associated with cigarette smoking are estimated at $10.47 per pack of cigarettes sold in the U.S.

    U.S. consumers spent an estimated $90 billion in 2006 on tobacco products.

    Last year alone, treating adult obesity-related illnesses cost the U.S. $147 billion.

    23.5 million people over the age of 20 have diabetes, and 1.6 million new cases of diabetes are diagnosed each year.

    Recent revenue projections for the five biggest hamburger chains exceeded $40 billion dollars a year.

    Last year Americans spent $68.1 billion on carbonated soft drinks.

    Alcohol dependence and alcohol abuse cost the U.S. an estimated $220 billion in 2005.

    Total U.S. sales for in-home alcohol consumption was nearly $80 billion in 2009.

    Doctors estimate between 65% and 85% of the world’s population fail to take enough exercise.

    A lack of vigorous physical activity is the main contributor to obesity for adolescents between 11 and 15 years old.

    Insufficient physical activity and too much time spent on sedentary behaviors may equal, or even exceed, diet quality as contributors to being overweight in adolescence.

    About $19 billion are spent on statins yearly.

    Lipitor has earned Pfizer close to $50 billion in revenue since 2000.

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