Post on 28-Dec-2015
transcript
Cardiovascular Disease in Tennessee
Audrey M Bauer, DVM, MPH
Surveillance, Epidemiology and Evaluation Tennessee Department of Health
Practical Strategies in Medication Adherence for Cardiac and Stroke Patients – June 8, 2012
Overview
• Tennessee vs. the United States
• CVD risk factors
• CVD hospitalizations
• CVD mortality
Tennessee vs. The United States
• In 2009, Tennessee had the…– 8th highest heart disease mortality rate– 5th highest stroke mortality rate
Data source: Xu JQ, Kochanek KD, Murphy SL, Tejada-Vera B. Deaths: Final Data for 2007. National Vital Statistics Reports; vol. 58 no. 19. Hyattsville, MD: National Center for Health Statistics, 2010.
TN: 211/100,000US: 180/100,000
Data source: Xu JQ, Kochanek KD, Murphy SL, Tejada-Vera B. Deaths: Final Data for 2007. National Vital Statistics Reports; vol. 58 no. 19. Hyattsville, MD: National Center for Health Statistics, 2010.
TN: 47/100,000US: 39/100,000
Data source: Xu JQ, Kochanek KD, Murphy SL, Tejada-Vera B. Deaths: Final Data for 2007. National Vital Statistics Reports; vol. 58 no. 19. Hyattsville, MD: National Center for Health Statistics, 2010.
Tennessee vs. The United States
• In 2010, Tennessee had the…– 14th highest smoking prevalence– 7th highest obesity prevalence– 4th highest diabetes prevalence
Data source: Centers for Disease Control and Prevention. Behavioral Risk Factor Surveillance System Prevalence and Trends Data. Accessed November 2010 at http://apps.nccd.cdc.gov/brfss/.
Cardiovascular DiseaseRisk Factors
Risk Factor Prevalence (%) Change from 2000-2009
Diabetes 10.3 43%
Smoking 22.0 14%
High Blood Pressure 32.6 22%
High Cholesterol 32.9 20%
Physical Inactivity 64.0 no change
Overweight & Obesity 69.0 16%
CVD Risk Factor PrevalenceTennessee, 2009
Data source: Tennessee Department of Health; Office of Health Statistics; Behavioral Risk Factor Surveillance System (BRFSS). Data are for adults 18+ years of age.
36.5 35.4 36.8 35.4 37.034.9 36.5 36.7 36.8 36.1
22.9 23.4 24.5 25.027.2 27.4 28.8
30.7 31.232.9
0
10
20
30
40
50
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
Per
cen
t
Year
Overweight and Obesity PrevalenceTennessee, 2000-2009 (BRFSS)
Overweight Obese
Data source: Tennessee Department of Health; Office of Health Statistics; Behavioral Risk Factor Surveillance System (BRFSS). Data are for adults 18+ years of age.
44% increase in obesity
None8.2%
One23.4%
Two32.0% Three to Six
36.4%
Number of CVD Risk Factors among AdultsTennessee, 2009 (BRFSS)
Data source: Tennessee Department of Health; Office of Health Statistics; Behavioral Risk Factor Surveillance System (BRFSS). Data are for adults 18+ years of age.
1.0 1.52.0 1.4
8.3
5.0
20.9
12.0
0
5
10
15
20
25
Heart Attack Stroke
Per
cen
tCVD Prevalence by Number of Risk Factors
Tennessee, 2009 (BRFSS)
0 1-2 3-4 5-6
Data source: Tennessee Department of Health; Office of Health Statistics; Behavioral Risk Factor Surveillance System (BRFSS). Data are for adults 18+ years of age.
Cardiovascular DiseaseHospitalizations
CVD Hospitalizations
• CVD are the leading cause of inpatient hospitalizations and the 3rd leading cause of emergency room visits in Tennessee
• In 2009, combined inpatient and outpatient hospital discharges for CVD totaled approximately 208,000
• Combined inpatient and outpatient hospital charges for CVD totaled over $5 billion in 2009 – a 79% increase since 2000
Data source: Tennessee Department of Health; Office of Health Statistics; Hospital Discharge Data System (HDDS).
Heart Disease Hospitalizations
• Heart disease is the most common cause of CVD hospital stays– 72% of inpatient hospitalizations– 62% of outpatient visits
Data source: Tennessee Department of Health; Office of Health Statistics; Hospital Discharge Data System (HDDS).
1,528 1,545 1,545 1,549 1,5051,456 1,436
1,357 1,3231,242
798 804 840 840 860 830 800 775 800 839
0
200
400
600
800
1,000
1,200
1,400
1,600
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
Ag
e-a
dju
ste
d R
ate
pe
r 1
00
,00
0
Year
Heart Disease In- and Outpatient HospitalizationsTennessee, 2000-2009
Inpatient Outpatient
Data source: Tennessee Department of Health; Office of Health Statistics; Hospital Discharge Data System (HDDS).
2,3002,460
2,900
3,2903,510
3,6603,780 3,720
3,8504,040
0
500
1,000
1,500
2,000
2,500
3,000
3,500
4,000
4,500
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
Tota
l Ch
arg
es (
$M)
Year
Total Hospital Charges for Heart DiseaseTennessee, 2000-2009 (HDDS)
Outpatient
Inpatient
Data source: Tennessee Department of Health; Office of Health Statistics; Hospital Discharge Data System (HDDS). Charges are inflation adjusted to 2009 dollars.
23
,20
0
25
,90
0 33
,40
0
29
,70
0 37
,20
0
36
,00
0
39
,30
0
40
,50
0
44
,10
0
43
,70
0
4,4
00
5,1
00
6,3
00
7,6
00
8,8
00
8,9
00
8,8
00
9,6
00
10
,00
0
11,7
00
0
10,000
20,000
30,000
40,000
50,000
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
Ch
arg
es
Pe
r V
isit
($
)
Year
Per Visit Hospital Charges for Heart DiseaseTennessee, 2000-2009 (HDDS)
Inpatient
Outpatient
Data source: Tennessee Department of Health; Office of Health Statistics; Hospital Discharge Data System (HDDS). Charges are inflation adjusted to 2009 dollars.
1,410 1,405 1,429 1,465 1,414 1,375 1,3461,204 1,152
1,080
1,597 1,637
1,8271,930
1,7171,795 1,810
1,7071,612
1,530
0
200
400
600
800
1,000
1,200
1,400
1,600
1,800
2,000
2,200
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
Ag
e-a
dju
ste
d R
ate
pe
r 1
00
,00
0
Year
Heart Disease Inpatient Hospitalizations by RaceTennessee, 2000-2009
White Black
Data source: Tennessee Department of Health; Office of Health Statistics; Hospital Discharge Data System (HDDS).
861
1,395 1,352
1,705
0
200
400
600
800
1,000
1,200
1,400
1,600
1,800
2,000
White Female Black Female White Male Black Male
Ag
e-a
dju
ste
d R
ate
pe
r 1
00
,00
0Heart Disease Inpatient Hospitalizations by Gender & Race
Tennessee, 2009
Data source: Tennessee Department of Health; Office of Health Statistics; Hospital Discharge Data System (HDDS).
Cardiovascular DiseaseMortality
0
100
200
300
400
500
600
700
800
900
1900 1920 1940 1960 1980 2000
Dea
ths
per
100
,000
Year
Age-Adjusted Mortality Rate for CVDUnited States, 1900-2007
Data source: CDC. Achievements in Public Health, 1900-1999: Decline in Deaths from Heart Disease and Stroke. MMWR 1999; 48(30):1141-1147.
449433
419431 433 427 418 418
405 396 395377 379
365339
328308
296 295278
0
100
200
300
400
500
600
Ag
e-a
dju
ste
d R
ate
pe
r 1
00
,00
0
Year
Cardiovascular Disease DeathsTennessee, 1990-2009
Data source: Tennessee Department of Health; Office of Health Statistics; Death Statistical System (DDS). Mortality rates prior to 1999 were compatibility adjusted to account for ICD revisions.
CVD Mortality
• In 2009, there were approximately 18,400 deaths due to CVD – about one death every 30 minutes
• Almost one-third of deaths in Tennessee are due to CVD– Heart disease is the 1st leading cause of death– Stroke is the 5th leading cause of death
Data source: Tennessee Department of Health; Office of Health Statistics; Death Statistical System (DDS).
Heart Disease24.4% (1)
Cancer23.2% (2)
CLRD6.0% (3)
Accidents5.4% (4)
Stroke5.4% (5)
Alzheimer’s3.8% (6)
Diabetes3.0% (7)
Flu and Pneumonia2.3% (8)
Kidney Disease1.6% (9)
Suicide1.6% (10)
All Other Causes23.1%
Leading Causes of DeathTennessee, 2009
Data source: Tennessee Department of Health; Office of Health Statistics; Death Statistical System (DDS).
392
344362 368
325 312 303284 277
257281 271 274 262
244 236 225 216 219 209
0
50
100
150
200
250
300
350
400
450
500
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
Ag
e-a
dju
ste
d R
ate
pe
r 1
00
,00
0
Year
Heart Disease Deaths by RaceTennessee, 2000-2009
Black
White
Data source: Tennessee Department of Health; Office of Health Statistics; Death Statistical System (DDS).
161
206
276
338
0
50
100
150
200
250
300
350
400
White Female Black Female White Male Black Male
Age
-adj
uste
d Ra
te p
er 1
00,0
00Heart Disease Deaths by Gender and Race
Tennessee, 2009
Data source: Tennessee Department of Health; Office of Health Statistics; Death Statistical System (DDS).
Questions?
Audrey Baueraudrey.bauer@tn.gov
Health Information Tennessee (HIT) – http://hit.state.tn.us/