More and more communities are seeing the wisdom of investing in their citizens' health education to help them choose better lifestyles. National averages for health risks are reported below. But your community is unique. This analysis will help you use your resources efficiently by breaking down the cost of lifestyle-related illnesses into the risk factors which contribute to the development of those diseases. For example, it may be of little benefit to conduct community-wide blood pressure screenings if in fact you are spending a significantly larger share of your health care dollars on smoking- or stress-related illness. CHA helps you target not only the right health risks, but also the right groups. By making an effort to recruit into your program individuals who meet the demographic profile identified as generating high costs for each health risk, you can better reach those who most need help.

• only 22% exercise even moderately
  
• 30% are obese
  
• fat accounts for 36% of the average diet (30% or less is recommended)
  
• the average diet includes only half the fiber recommended
  
• 27% have cholesterol levels over 240 mg/dl (considered high)
  
• 29% smoke
  
• 7% have some level of dependence on alcohol
  
• 30% of adults have high blood pressure; most do not have it under control
  
• 58% do not wear seat belts
  
• 5% are diabetic
  
• more than half do not obtain regular dental care
  
• 41% have current or recent severe stress in their lives
  
• 5% suffer from depression
  
• 1 of four Americans is injured every year
  YOUTH
  
• 21% are obese
  
• half of eighth­graders and two­thirds of tenth­graders have tried cigarettes
  
• 44% of high school seniors reported trying marijuana; 10% used cocaine
  
• 60% of seniors reported drinking alcohol; 33% reported drinking heavily
  
• accidents account for half of all deaths among those aged 15 to 24

CHART 4

By examining the hospital discharge data, CHA found that Evansville lifestyle related costs and potential savings for Indiana patients are concentrated among Medicare and Private Insurers' patients. In charts 5 through 14, CHA further analyzes the community's health care costs to provide meaningful data that can be used to establish programming targets by age, sex and health risk factor.

CHART 5 - Lifestyle Related Claims for All Patients by Health Risk

Chart 5 illustrates the lifestyle/behavior health risk categories used for analysis by the CHA. Evansville's Indiana patients' claims costs with a link to lifestyle and behavior are broken down by risk and presented below. The portions of this cost which could potentially be saved are referred to as the Potential Savings $. The most prominent risk categories for all patients are: lack of exercise, followed by accidents, obesity and smoking. Exercise­related claims represent the most potential savings (24%).

Risk Category L/B Related $ % L/B Potential Savings $ % Savings

CHART 6 - Potential Savings for All Patients by Age and Sex

Chart 6 and the table below provide an age/sex distribution of the potential savings for all Evansville Indiana patients. All age/sex groups 18 and over filed significant avoidable claims costs. Males age 45 to 64 and 18 to 44 incurred the largest portions of the community's potential savings, followed by females 75 and over and 45 to 64, and males 65 to 74.

CHART 7 - Medicare Patients' Lifestyle Costs by Health Risk

Evansville's Medicare patients residing in Indiana filed lifestyle/behavior related claims totaling $92,556,602 during the period audited. This represents 52% of all Indiana patients' lifestyle/behavior related claims. Of this claims cost, $34,544,388 (47%) was determined to be potentially avoidable. The predominant health risk categories for Medicare patients areobesity, smoking, lack of exercise and accidents. Obesity­related claims represent the most potential savings (23%) for Medicare patients.

CHART 8 - Medicare Potential Savings by Age and Sex

The majority of potential savings related to obesity was filed by females age 65 to 74, followed by those 75 to 84 and males of the same ages. Smoking related savings was found among males 65 to 74, followed by older males. Females 65 to 74 filed the greatest volume of avoidable costs related to exercise, followed by males of the same age group. Accident-related costs were incurred primarily by females 75 and older.

Since obesity, smoking and lack of exercise cause damage over long periods of time, the community would benefit from prevention programs for these risk factors targeting Medicare patients of all ages. Accident-related programs for Medicare patients should target primarily females 75 to 84.

CHART 9 - Medicaid Patients' Lifestyle Costs by Health Risk

Lifestyle/behavior related claims filed by Evansville's Indiana Medicaid patients during the period audited total $11,353,295. This represents 6% of the total lifestyle claims costs. Of those costs, 52% ($5,851,301) is potentially avoidable. The most prominent risk categories for Medicaid filers are: obesity and accidents, followed by lack of exercise and stress. Obesity­related claims represent the most potential savings (18%).

Risk Category L/B Related $ % L/B Potential Savings $ % Savings

CHART 10 - Medicaid Patients' Potential Savings by Age and Sex

Females age 18 to 44, followed by females 45 to 64 incurred most of the potentially avoidable costs for Medicaid patients. Accident-related savings were found in the under 45 age bands for both males and females. Obesity-and exercise-related costs were found among females 18 to 64. CHA found the greatest potential savings for stress/mental health in the 17 and under group for both males and females.

Accident prevention programs for Medicaid patients should attempt to reach people under age 45; obesity and exercise programs should target females age 18 to 64; patients 17 and under would benefit from programs focusing on stress/mental health.

CHART 11 - Self-Paying Patients' Lifestyle Costs by Risk

Evansville's Self-Paying patients living in Indiana filed lifestyle/behavior related claims totaling $6,617,599 or 4% of the total lifestyle/behavior related claims of the community. $3,158,038, or 48% of this could potentially be avoided through lifestyle changes. The most prominent risk categories for Self-Paying patients are: accidents and lack of exercise, followed by obesity. Accident­related claims represent the most potential savings (42%).

CHART 12 - Self-Paying Patients' Potential Savings by Age and Sex

Males filed 60% of Self-Paying patients' potentially avoidable costs. Accident related costs were filed by primarily males age 18 to 44, followed by females of the same age and people 17 and under.

Self-Paying patients, especially males under age 45, would benefit from health promotion programs focusing on accident prevention. Exercise and obesity programs should target males and females 18 to 64.

CHART 13 - Private Insurers' Patients' Lifestyle Costs by Risk

Evansville Private Insurers' patients living in Indiana filed lifestyle related claims totaling $68,389,232 or 38% of the total lifestyle/behavior related claims of the community. $29,948,464, or 44% of this could potentially be avoided through lifestyle changes. The most prominent risk categories for Private Insurers' patients are: lack of exercise, accidents and obesity. Exercise­related claims offer the most potential savings (31%).

CHART 14 - Private Insurers' Potential Savings by Age and Sex

Males age 45 to 64 and 18 to 44, followed by females of the same age groups generated the majority of the potentially avoidable exercise-related costs for Private Insurers' patients. Accident related costs were filed by males and females age 18 to 44, followed by males 45 to 64 and under 18. Avoidable costs related to obesity were found primarily among females 45 to 64, followed by males of the same ages and females 18 to 44.

Private Insurers' patients 18 to 64 would benefit from health promotion programs focusing on obesity and exercise. Those under 45 would benefit from accident prevention programs. The fact that these are some of the same health risks which appear as major cost factors among Medicare patients reveals that these individuals are following the same lifestyle patterns as their elders. Programs designed to alter this trend can achieve much for the Evansville Community, in terms of dollars saved, and lives enhanced.

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