It's Worth Repeating: Prevention Is Key

State Aims To Better Address, Stem Chronic Diseases

April 20, 2009|By Meredith Cohn | Meredith Cohn,

As a doctor, Richard H. Carmona was often dismayed that the first he'd see of a patient with a chronic disease such as diabetes and hypertension was after the often preventable malady had taken its toll.

"We have a sick care system, not a health care system," said Carmona, who was U.S. surgeon general from 2002 to 2006. "People only get care after they are sick. I realized when I was a trauma surgeon that most people I cared for had preventable problems, but we never talked about prevention."

Carmona was in Baltimore last week to spread the word about early intervention to stem the rising number of cases of chronic disease, which is the nation's leading causes of death and disability. He chairs the Partnership to Fight Chronic Disease, a coalition of health, business and government groups, and many in Maryland's health care community have just signed on.

Chronic diseases include heart disease, asthma, cancer, diabetes, hypertension, stroke, mental disorder and pulmonary conditions, and they cause seven in 10 deaths across the country, according to the group. About 133 million Americans have one of the diseases, which account for three-quarters of the approximately $2 trillion spent on health care.

In Maryland, 3.2 million people have at least one chronic disease. The state ranks just over the national average.

State officials expect to report by the end of the year on ways to tackle some of the most deadly and costly problems. The Chronic Disease Management Plan will outline ways to prevent and more effectively treat chronic diseases.

"We are the right people to partner with," said Del. Shawn Tarrant, a Baltimore Democrat who sponsored the first-in-the-nation legislation requiring the report.

Maryland has several programs under way to specifically address such problems as childhood obesity, diabetes and lack of quality foods in poor neighborhoods. Both the programs and problems will be assessed in the report, he noted.

But lack of information, poor dietary choices, culture and other factors make it difficult to change behaviors that can lead to disease, said Sharon Allison-Ottey, a local chair of the group and executive director of the COSHAR Foundation, a nonprofit group aimed at improving health care. Black Americans are disproportionally affected, so Baltimore city and Prince George's County have higher rates of chronic illness to tackle, she said.

"We need to meet people where they are," she said. That means going to churches, community groups and doctors' offices to spread the message about diet, exercise and health screenings.

About 40 local groups have signed on to support the effort, including many health care organizations, the Maryland State Conference of the National Association for the Advancement of Colored People branches, the Greater Baltimore Committee and the Maryland Chamber of Commerce.

Carmona said the problem isn't just about quality of care; it's financial strain, too. Maryland spends about $26 billion annually on treatment and lost productivity.

"The heartstrings argument won't work on everyone, so we're also making a business case," Carmona said during a news conference at the National Aquarium in Baltimore. "Healthier people aren't just happier, they are more productive, absent from work less. ... We're going at this from every angle. Over the years, we'll make incremental progress."

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