#dBlogWeek: The Cost of Chronic Illness

Today’s Diabetes Blog Week prompt:

Insulin and other diabetes medications and supplies can be costly.  Here in the US, insurance status and age (as in Medicare eligibility) can impact both the cost and coverage.  So today, let’s discuss how cost impacts our diabetes care.  Do you have advice to share?  For those outside the US, is cost a concern?  Are there other factors such as accessibility or education that cause barriers to your diabetes care?

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In 2012 the total cost of diabetes in the US was put at $245 billion. That’s the dollar figure the American Diabetes Association attached to the direct medical costs and reduced productivity combined.

$245 billion. Five years ago. Let that sink in for a minute. According to the 2012 CIA World Fact Book that was roughly equivalent to Chile’s total GDP.

These are costs we all, as a collective, bear.

We experience the effect of these costs as more and more of our tax dollars (and our own dollars) go to pay for health care to treat, but not cure, chronic illness.

We experience the effect of these costs in the a sluggish economy dragged down by a less productive, more disabled workforce.

We experience the effect of these cost in the sorrow of lives cut short.

How did half of all adults in the US come to live with one or more chronic illness?

There’s no one cause

It’s the result of an accumulation of decisions and actions and policies.

It’s the result of subsidizing corn and soy, but not lettuce and squash. It’s the result of eliminating physical education in school and replacing it with for-pay sport leagues. It’s the result of building suburbs for travel by car and not travel by foot or on bike.

It’s also the result of unsafe neighborhoods where people are afraid to walk the streets or let their kids go out and play. It’s the result of food deserts where it’s cheaper to buy a bag of chips than a piece of fresh fruit. It’s the result of the continual, low grade stress that accompanies stagnant wages and uncertain job prospects.

Where do we go from here?

Clearly changes need to be made.

The CDC identifies four health behaviors that can counter the risk for chronic illness. They are: regular physical activity or exercise; good nutrition; eliminate tobacco use; and limit alcohol consumption. Together these four behaviors can counter all chronic illness.

On the face of it it’s easy to assume that the individual should just adopt these healthy behaviors and everything will be good. No wonder people with diabetes, particularly people with type 2 diabetes, gets vilified.

But, it’s not that simple.

Environment plays a role in changing behavior. If the environment makes it easy to adopt healthy behaviors people are more likely to adopt and maintain those behaviors. What if we built those kinds of environments in our communities?

What if we identified, built, and maintained safe places in our communities for people to be physically active? In every neighborhood.

What if we built and maintained community gardens? In the city and the country.

What if we had community educational programs to teach health, nutrition, and job skills? And what if we offered these programs at low or no cost?

What if we had community-based campaigns to encourage people to use these places, gardens, and programs?

It won’t be cheap. But I doubt it will cost the GDP of Chile.

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