Earlier this month, the Milken Institute released a report on the economic burden of chronic disease in America. The report considers the health care and financial effects of cancer, diabetes, high blood pressure, stroke, heart disease, pulmonary conditions, and mental disorders. The report adds to the growing base of information describing the impact of chronic disease on health care costs and provides detailed analysis about its influence on the labor supply and the economy through decreased worker productivity.

What is most striking and troubling is that Massachusetts ranks in the lowest quartile of states—at 40th overall. According to the Milken report, Massachusetts’ chronic disease ranking is attributable to high cancer rates and the high incidence of alcohol abuse and other mental disorders.

The ranking is surprising because Massachusetts is generally viewed as one of the healthiest states in the nation. We rank first among states in terms of the overall rates of obesity — 19% of all Massachusetts residents are obese, compared to 30% of residents of Mississippi, which ranks last. But, at the same time, we rank 27th in the percent of children who are obese. Read more…

Massachusetts is one of the healthiest states in the country, but—like the rest of the nation—we face unacceptable racial and ethnic disparities in health and health care.

The Department of Public Health (DPH) recently released health status indicators and data that confirm alarming disparities across the state. They exist in access to care; incidence of chronic diseases, such as asthma, diabetes, and high blood pressure; and in hospitalizations and mortality for conditions like cancer and HIV/AIDS. Throughout the United States and in all regions of Massachusetts, racial and ethnic minorities—particularly African-Americans and Latinos—have worse health outcomes than other groups.

The numbers say it all. The infant mortality rate among African-Americans is more than double that of whites, and heart disease death rates are more than 40% higher. Hispanics are almost twice as likely to die from diabetes as non-Hispanic whites. Cervical cancer risk is particularly high among Latinas, with incidence rates that are double those of white women, who are also less likely to die from the disease. And Korean-American men, for example, experience a rate of stomach cancer that is five times the rate of white men.

Although critically important, access to insurance is not the most significant contributor to these differences, so while health care reform will benefit those who were not previously insured, we must take other action steps to address disparities. Read more…

Some 20 years ago, the New England Journal of Medicine published an article called “Is the Genie Out of the Bottle?” The genie was coronary artery bypass graft surgery for people with coronary artery disease or blocked arteries. The problem was that the surgery had already become standard treatment before studies had clarified the circumstances in which it was appropriate.

Cutting-edge medical research and technological advancements are at the heart of evolving efforts to prevent and treat disease. Only through innovation have we been able to decrease deaths due to cancer and heart disease, manage diabetes and prevent devastating complications such as blindness from diabetes, and tailor treatment for individuals based on genetics.

But there remains widespread use of procedures, medications and other therapies before their benefits and risks are fully understood. As providers, payers and policymakers, we all contribute to this phenomenon. But, ultimately, everyday people bear the consequences: higher costs and lower quality in health and health care.

Take estrogen replacement therapy. Read more…