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POPULATION HEALTH: 678,383 ESRD patients in US (2014)

Each year, there are about 120,000 patients newly diagnosed with end stage renal disease (ESRD) and this number has been rising steadily.  Here are the exact counts of incidence – that is, new cases treated in the U.S.:

  •   77,018 new ESRD cases in 1996
  •   94,662 new cases in 2000
  • 106,662 new cases in 2005
  • 115,920 new cases in 2010
  • 120,688 new cases in 2014

The prevalence of end stage renal disease – the total number of patients who are living with the disease at any given point in time – has more than doubled during the 1996 to 2014 time period.  Here are the exact prevalence counts:

  • 303,311 total ESRD cases in 1996
  • 390,158 total cases in 2000
  • 484,935 total cases in 2005
  • 591,776 total cases in 2010
  • 678,383 total cases in 2014

What kind of treatment do ESRD patients receive?

Looking at the entire population of patients with end stage renal disease, about two-thirds are on hemodialysis – usually received in a dialysis center.   Another seven percent are on peritoneal dialysis.  The balance (30 percent) have received a kidney transplant.  These percentages are based on 2014 data.

Geographic differences

There are substantial differences in the incidence of kidney failure in different parts of the country.  Areas with the highest rates of new end stage renal disease patients include Texas and Southern California, while New England states have the lowest rates.

Source: United States Renal Data System. (2016). Incidence, prevalence, patient characteristics, and treatment modalities. In Annual data report 2016: Epidemiology of kidney disease in the United States. (Vol. 2, Chapt. 1). Ann Arbor, Michigan: USRDS Coordinating Center. Click here for free full text https://www.usrds.org/adr.aspx  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

 

CANCER: 5-year survival rate improves in recent decades

Survival improved substantially over this time period for both whites and blacks overall (all sites) and for almost all cancer types…”

The overall five-year survival rate for cancer patients has improved in the past 40 years, according to national data in this fact-packed, scholarly article.

Looking at the more treatable cancers, here are the top five with the highest survival rates, based on recent data:

  • Prostate (99.3 percent five-year survival rate)
  • Thyroid (98.3 percent)
  • Skin (93.2 percent)
  • Breast (90.8 percent)
  • Uterine (83.4 percent)

Source: Jemal, A., and others. (2017). Annual report to the nation on the status of cancer, 1975-2014, featuring survival. Journal of the National Cancer Institute, 109(9).  Click here for free full text: https://academic.oup.com/jnci/article-lookup/doi/10.1093/jnci/djx030  Posted by AHA Resource Center (312) 422-2050 rc@aha.org

POPULATION HEALTH: How many diabetics in 2030?

The team finds that in spite of medical advances and prevention efforts, diabetes presents a major health crisis in terms of prevalence, morbidity, and costs, and that this crisis will worsen significantly over the next 15 years.

An estimated 54.9 million people will have diabetes in the U.S. in the year 2030, compared to 35.6 million in 2015, according this study from the Institute for Alternative Futures.  This represents a 54 percent increase.  The prevalence of diabetes will represent a cost to the nation of over $622 billion in 2030 (calculated in 2015 dollars), up from roughly $408 billion in 2015.  Maps included in the article show some clustering projected for 2030 – states with higher proportions of diabetics are in the southeast, southwest, and Rust Belt regions.

Source: Rowley, W.R., and others. (2017, February). Diabetes 2030: Insights from yesterday, today, and future trends. Population Health, 20(1), 6-12.  Click here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5278808/pdf/pop.2015.0181.pdf.  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

POPULATION HEALTH: Trends in heart disease and cancer death rates by county shows geographic clusters in U.S.

Thirty years ago researchers first noted an ‘enigma of the Southeast’ with high mortality rates in that region, often due to stroke, and a range of possible causes including environmental exposures related to coal and metal mining, housing and population density, and access to health care.”

Death rates from different types of cardiovascular disease and 29 types of cancer were studied at the county level for the entire U.S. in these related articles out of the University of Washington’s Institute for Health Metrics and Evaluation.  Extensive variation was found in death rates between counties and some degree of clustering was found.  For example, there is a cluster of counties with high death rates from ischemic heart disease on a line between central Oklahoma and eastern Kentucky and also along the Mississippi River valley – although there were also counties with high mortality in other parts of the country.  Death rates from stroke and hypertension were found to be concentrated in the South.  Counties with higher rates of breast cancer death were found to be along the Mississippi River and in the South.  High death rates from lung and related cancers were found to be clustered in Kentucky and West Virginia.  Again, in each of these categories, there are also counties with high mortality rates in other parts of the country.

NOTE: There is also information in these articles about areas of the country where the mortality rates were found to be unusually low.

Sources:

Roth, G.A., and others. (2017, May 16). Trends and patterns of geographic variation in cardiovascular mortality among US counties, 1980-2014. JAMA, 317(19), 1976-1992. Click here: http://jamanetwork.com/journals/jama/fullarticle/2626571?resultClick=3

Mokdad, A.H., and others. (2017, January 24). Trends and patterns of disparities in cancer mortality among US counties, 1980-2014. JAMA, 317(4), 388-406.  Click here: http://jamanetwork.com/journals/jama/fullarticle/2598772  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

POPULATION HEALTH: Are these battles winnable?

An estimated 400,000 people quit smoking between 2012 and 2016 – one of the successful initiatives of the “Winnable Battles” campaign begun by the Centers for Disease Control and Prevention in 2010.  The outcomes of this program five years later are reviewed in this report and summarized in the JAMA article.  The idea was to target a carefully-chosen set of public health issues and then devote federal, state and local resources to improving them.

Here is a summary of what happened five years on:

  1. Clear success in decreasing adult and teen smoking
  2. Likewise, exceeded the target in decreasing teen pregnancies
  3. Making good progress on most measures of reducing healthcare-associated infections – except catheter-associated urinary tract infections
  4. Slow progress on measures related to nutrition, exercise, obesity
  5. Slow progress on reducing foodborne illness
  6. Slow progress on reducing motor vehicle deaths
  7. Mixed results on measures related to HIV

Sources:

Winnable battles: Final report. (2016, November). Atlanta: U.S. Centers for Disease Control and Prevention. Click here: https://www.cdc.gov/winnablebattles/report/docs/winnable-battles-final-report.pdf; and, Frieden, T.R., Ethier, K., ad Schuchat, A. (2017, February 2). Improving the health of the United States with a “winnable battles’ initiative. JAMA. Click here: http://jamanetwork.com/journals/jama/fullarticle/2601246  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

PREVALENCE: 1.7 percent of US population paralyzed

These statistics are estimates based on the Paralysis Prevalence & Health Disparities Survey, which was conducted by the Centers for Disease Control & Prevention in 2013.  Note that these are prevalence estimates, which means that the statistics represent the entire population living with paralysis, not just those who have become paralyzed in a particular year.  It is also worth noting that the survey data have been analyzed to result in estimates that represent the nation as a whole.

  • Just under 6 million people – or 1.7 percent of the U.S. population – are paralyzed
  • Nearly three-quarters of people who are paralyzed are under age 65
  • Stroke is the leading cause of paralysis – accounting for one-third of the cases
  • Spinal cord injury is the second leading cause – accounting for just over one-quarter of cases

Source: Armour, B.S., and others. (2016, October). Prevalence and causes of paralysis – United States, 2013. AJPH. American Journal of Public Health, 106(10), 1855-1857. Click here for publisher’s website: http://ajph.aphapublications.org/doi/pdf/10.2105/AJPH.2016.303270   Posted by AHA Resource Center (312) 422-2050, rc@aha.org

 

CANCER: Childhood and adolescent death rate declining

The cancer death rate among children and adolescents declined between 1999 and 2014, according to this data release from the U.S. National Center for Health Statistics.  The mortality rate for cancer patients (aged between 1 and 19 years) was 2.28 deaths per 100,000 persons in 2014, which was 20 percent lower than in 1999.

What types of cancer are the major causes of death for this age group?

  1. Brain (30 percent)
  2. Leukemia (25 percent)
  3. Bone and related (10 percent)

Source: Curtin, S.C., Minino, A.M., and Anderson, R.N. (2016, Sept.). Declines in cancer death rates among children and adolescents in the United States, 1999-2014. NCHS data brief, 257. Click here for free full text: https://www.cdc.gov/nchs/data/databriefs/db257.pdf  Posted by AHA Resource Center (312) 422-2050, rc@aha.org