I work in the realm of patient engagement healthcare technologies, and I fancy myself a bit of a patient advocate in general. I’m so passionate about health education, in fact, that I became a peer health educator from the ages of 14 on through graduation from high school. Nutrition, wellness, and family planning were some of my favorite topics to speak about, and these health education efforts were aimed exclusively at the individuals with a lower income that were patients of the health center that I interned at. It did not take me long to realize how oppressive some health conditions are to those that are already struggling financially. The good news is that many of these costs are within our power to control.
I earlier reported in “Getting in Great Shape using 4 Apps and $3” that, according to the Centers for Disease Control, losing just 10% of your body weight can reduce your lifetime medical expenses by up to $5,300. However, I wish to take this discussion to another level. I want to explore the yearly medical expenses related to certain preventable medical conditions (where that data is available) that can then be directly managed simply through managing your wellness. I’ll also put on my health educator hat and provide wellness tips as we go along.
Type 2 Diabetes
In discussions with healthcare providers across the country, Type 2 Diabetes tops the list of “chronic conditions” that drive up the cost of care considerably. The total estimated cost of diagnosed diabetes in the United States is $245 billion per year, which includes $176 billion in direct medical costs and $69 billion in reduced productivity. While quite overwhelming, these population wide figures do little to help you understand the potential impact that Type 2 Diabetes would have on your wallet. So, let’s look at the median annual direct medical costs associated with diet-controlled Type 2 Diabetes. These are the out-of-pocket costs that are not covered by insurance, which total $1,700 per year for men and a much higher $2,100 per year for women. What does this money pay for? Approximately 60-90% of these costs are associated with insulin treatment, dialysis and treatments for diabetes complications (more specifically angina and myocardial infarction) that were directly caused by the Type 2 Diabetes.
What you can do to prevent Type 2 Diabetes: Your first line of defense against Type 2 Diabetes comes down to weight which is ultimately controlled by calories in versus calories out as controlled by diet and exercise. You should also speak to your healthcare providers as there have been several studies that show that various types of diabetes drugs, along with a healthy lifestyle, can cut your chances of developing Type 2 Diabetes if you are at high-risk for the condition. Let me just be clear in stating that while these drugs can reduce the risk, there is nothing that can reduce the risk more than stopping yourself from being at high-risk in the first place. Type 2 Diabetes is a 100% preventable condition, and managing that now could save you $2,000 per year down the line.
Hypertension (High Blood Pressure)
Go ahead and check your pulse. Each time you feel your heart beat that indicates that blood is being pumped throughout your entire body by way of your arteries. With hypertension, also commonly called high blood pressure, the force of blood pushes up against the artery walls, and the more pressure that is applied to the artery walls the harder your heart has to work to pump the blood that nourishes all of your major organs. Over time your organs start to become damaged due to lack of nourishment. If that happens to your kidneys, then you get renal failure. If that happens to your heart, then you get aneurysms, heart failure, stroke, and heart attacks. Want to guess what happens to your brain? Researchers out of UC Davis reported that high blood pressure during middle age raises your risk of cognitive decline later in life.
Due to how connected your circulatory system is to your entire body, being able to put a price tag on the direct costs of hypertension becomes a staggering exercise. You will see two examples below that are specific to heart attack and stroke.
What you can do to prevent hypertension: Fortunately, there are lots of things you can do to prevent hypertension. At the Connected Health Symposium last October it was reported that 75% of all doctor visits are stress related. The awesome thing is that you can now use “biofeedback” tools like HeartMath to self manage your stress response. You see, there is actually a cluster of neurons in the heart that are referred to as a “little brain”. You can train that little brain (and your big brain while you are at it), to help prevent hypertension. Of course, like most items in this post, hypertension can also be prevented through diet and exercise, but the nutrition story is quite interesting here. We have likely all heard that reducing your salt and alcohol consumption can help prevent high blood pressure. However, you can also prevent high blood pressure by ensuring that you are getting your recommended daily intake of potassium, calcium, and magnesium.
Like hypertension, the cost of high cholesterol is hard to quantify because it impacts the circulatory system, which, given its name, impacts every other part of your body. However, the mechanics involved in high cholesterol are quite different. Cholesterol is a waxy substance found in the fats in your blood, and cholesterol is needed to help your body build healthy cells. In addition to the cholesterol you get from the foods your eat, your body has its very own cholesterol factory that produces cholesterol even in a diet completely devoid of cholesterol. The problem occurs when your body has more cholesterol than it can handle. High levels of cholesterol cause fatty deposits to build within your blood vessels, which, like hypertension, makes it difficult to get enough blood to flow through the arteries.
What you can do to prevent high cholesterol: Ultimately the body gets cholesterol from two sources. The first source is the body’s very own cholesterol factory. Some individuals, like myself, have naturally fatty blood while others can have cholesterol factories that are pretty slow. The other source of cholesterol is, of course through food. The latter is much easier to solve than the former. In fact, by going vegan you will not consume any cholesterol at all and your body will only contain the cholesterol it makes itself. In cases where you inherit high cholesterol, your doctor may prescribe medication to keep your circulatory system healthy. It should be noted, though, that unhealthy lifestyle choices are most often to blame for high cholesterol. Even folks like me that are at high risk have the power to prevent heart problems through wellness practices.
We have largely accounted for the causes of heart disease (also cardiovascular disease) by way of our discussions on hypertension and high cholesterol, but what is heart disease exactly? It’s a bit of a misnomer. Heart disease is actually a way of classifying a variety of disorders and conditions. The two most common are coronary artery disease and heart attack. For those of you saving up for retirement, you will need to save considerably more if you have a condition (or conditions) linked to heart disease. Your out-of-pocket expenses related to the disorders are estimated to be a whopping $37,996 in costs not covered by insurance during your last five years of life.
What you can do to prevent heart disease: In order to prevent heart disease, you must control the contributors to heart disease, which are hypertension and high cholesterol. Also, I cannot stress enough how much being able to control your stress will save you over a lifetime.
While we don’t hear about stroke as often as we hear about heart attacks, stroke is actually the 4th leading cause of death in the United States. In fact, a person dies of stroke every four minutes. A stroke occurs when blood flow through the brain is hindered in some way. This can occur if the blood flow is blocked (think heart attack in the brain) or when a blood vessel in the brain ruptures (think aneurysm in the brain). The average out-of-pocket costs associated with the first 12 months after a stroke are $1,110. The most common costs relate to prescriptions. However, costs relates to modifications that need to be made at home were also significant. These costs include the price of aids and equipment that make a home more livable after a stroke.
What you can do to prevent stroke: Preventing stroke all comes down to understanding the risk factors associated with stroke. These include:
- Lifestyle risk factors: This includes eating well, exercising, as well as not smoking or drinking.
- Medical risk factors: This includes high blood pressure, atrial fibrillation (Afib), high cholesterol, diabetes and circulation issues.
There are some risk factors associated with stroke that can’t be controlled. These include things like age, gender, and ethnicity, which could increase your chances of being a stroke victim. However, like high cholesterol, your wellness is a primary indicator of risk. Further, if you are genetically predisposed to stroke, then maintaining your wellness is even more critical.
Let’s be clear. Babies are not, in and of themselves, health problems. Being unprepared from a financial standpoint is. This one hits close to home for me. I’m a product of generational poverty, and one factor that you typically see in generational poverty is a cycle of young women giving birth girls that become young women that give birth to girls that become young women that give birth to girls that become young women. I can track this pattern back five generations in my family. One of the ways that I was lucky is that I had the opportunity to be a peer health educator in high school, which gave me access to sex education resources by default. I can testify that having access to this information did not make me more eager to pursue sexual liaisons. In fact, it made me less eager to be quite frank. I know that my life would be so very much different without those early lessons since being a young mom would have hindered many of my plans. While I was in high school my family of four was living off of $7,800 per year. The average child costs $245,000 to raise.
What you can do to prevent unplanned pregnancy: Ultimately, good decision making and family planning prevent unplanned pregnancies. We must empower our girls with education on both.
Sexually Transmitted Diseases & Infections
Unfortunately, when a disease or infection is passed from one person to another through, gasp, sex, it quickly becomes stigmatized and shamed. Being sexually transmitted does nothing, in and of itself, to make a sexually transmitted disease or infection worse for your health than a disease or infection acquired without sex. However, there can be increased complications related to our own willingness to access care for sexually transmitted diseases and infections due to societal stigmas. Unfortunately, this shame only exacerbates these health problems.
What you can do to prevent STDs and STIs: Many sexually transmitted infections and diseases are largely preventable through protected sex. This includes HIV. However, there are a few viruses, such as HPV and herpes simplex, that are transmitted via skin to skin contact. In the case of viruses like HPV, as mentioned above, there are vaccines available. In other instances it all comes down to empowering individuals with proper sex education. The out-of-pocket costs associated with STDs and STIs vary considerably depending on the illness in question. Many of these infections can be controlled with a low cost dose of penicillin. However, STDs and STIs can become more expensive in the form of:
- Pharmaceutical costs related to herpes simplex
- Costs associated with the management of cervical cancer caused by Human Papillomavirus (HPV)
- Costs associated with the treatment of HIV, which can lead to AIDs. HIV/AIDS is no longer a death sentence if treated early.
Vaccine Preventable Diseases
There are many, once deadly, conditions and disorders that science has helped all but eliminate through the power of vaccines. These disorders include, but are not limited to, the following:
- Measles: This is the most deadly childhood rash, and the disease is very easily spread from person to person through simple skin contact.
- HPV: The Human Papillomavirus (HPV) is also spread via skin to skin contact, but, unfortunately, it is stigmatized because it is a sexually transmitted disease. Stigmatizing a condition does not make it go away. In fact, it only helps it spread. All told, approximately 80% of the population are carriers for the HPV virus, and condoms do not prevent the spread from person to person. Neither does the limitation of sex education. Vaccinations do.
- Pertussis: Also known as “whooping cough”, Pertussis is a highly contagious respiratory tract infection. You have not heard human suffering quite like what is heard when a baby gasps for breath.
I was fortunate to spend time at the Jonas Sulk Institute in high school, and I learned quite a bit about vaccines. In Cliff Notes version, vaccines work. Right now there is much heated debate on the topic, but I implore you to thoroughly research the issue. The truth of the matter is that vaccines work.
What you can do to prevent vaccine preventable diseases: Please, please, get your children vaccinated.
The Bottom Line
So much of our health is in our own hands. The good news is that while bad health certainly costs a lot, good health actually costs very little. It’s a myth that nutritious foods and an active lifestyle are expensive. Both cost far less in both time and money than you could imagine. Under the premise that a penny saved is a penny earned, you can earn a great deal of money by investing in your wellness.