The Economic Costs of Cardiovascular Disease Mortality in California, 1991: Implications for Public Health Policy

This study estimates costs of lost productivity in California due to cardio- vascular disease (CVD) mortality. Death records were used to calculate mortality losses including the number of deaths due to CVD, Years of Potential Life Lost (YPLL), and the value of productivity losses. In 1991 there was $5.3 billion in lost productivity due to mortality caused by diseases of the heart and over one billion dollars in lost productivity due to cerebrovascular disease mortality. Racial/ethnic differences in YPLL are pronounced, which likely reflect the long-standing inverse association between CVD mortality and socioeconomic status that has been documented in a variety of populations worldwide. While it is important to effectively retain or develop low risk behaviors in populations, it is equally important to reduce barriers engendered by social, economic, and political patterns that inhibit the compression of CVD morbidity and mortality.

[1]  J. Feldman,et al.  Health status and well-being of the elderly : National Health and Nutrition Examination Survey--I Epidemiologic Follow-up study , 1990 .

[2]  G. Kaplan Epidemiologic Observations on the Compression of Morbidity , 1991 .

[3]  A. Folsom,et al.  Community education for cardiovascular disease prevention: risk factor changes in the Minnesota Heart Health Program. , 1994, American journal of public health.

[4]  J. Mcnamara,et al.  Coronary artery disease in combat casualties in Vietnam. , 1971, JAMA.

[5]  James Fries THE COMPRESSION OF MORBIDITY: PROGRESS AND POTENTIAL , 1990 .

[6]  Gerald S. Berenson,et al.  Relation of serum lipoprotein levels and systolic blood pressure to early atherosclerosis: the Bogalusa heart study , 1986 .

[7]  T. Mackenzie,et al.  The human costs of tobacco use (1) , 1994, The New England journal of medicine.

[8]  J F Fries,et al.  The compression of morbidity: near or far? , 1989, The Milbank quarterly.

[9]  M. Terris Healthy Lifestyles: The Perspective of Epidemiology , 1992, Journal of public health policy.

[10]  M G Marmot,et al.  Employment grade and coronary heart disease in British civil servants. , 1978, Journal of epidemiology and community health.

[11]  Ted R. Miller,et al.  Which Estimates of Household Production are Best , 1990 .

[12]  J F Fries,et al.  Aging, natural death, and the compression of morbidity. , 1980, The New England journal of medicine.

[13]  Galen A. Ellis,et al.  Overcoming a Powerful Tobacco Lobby in Enacting Local Smoking Ordinances: The Contra Costa County Experience , 1996, Journal of public health policy.

[14]  R. D'Agostino,et al.  Risk for cardiovascular disease in the elderly and associated Medicare costs: the Framingham Study. , 1993, American journal of preventive medicine.

[15]  M. Alderman,et al.  The determinants of hypertension awareness, treatment, and control in an insured population. , 1994, American journal of public health.

[16]  L. Melton,et al.  The compression of morbidity hypothesis: promise and pitfalls of using record-linked data bases to assess secular trends in morbidity and mortality. , 1992, The Milbank quarterly.

[17]  C. Cassel,et al.  In search of Methuselah: estimating the upper limits to human longevity. , 1990, Science.

[18]  S. Glantz,et al.  Report of the Tobacco Policy Research Group on Marketing and Promotions Targeted at African Americans, Latinos, and Women , 1992, Tobacco Control.

[19]  Dorothy P. Rice,et al.  The economic costs of illness: A replication and update , 1985, Health care financing review.

[20]  R. Tuckson Race, sex, economics, and tobacco advertising. , 1989, Journal of the National Medical Association.

[21]  W. Grove Statistical Methods for Rates and Proportions, 2nd ed , 1981 .

[22]  J. Strong,et al.  The natural history of atherosclerosis: the early aortic lesions as seen in New Orleans in the middle of the of the 20th century. , 1958, The American journal of pathology.

[23]  H. Kraemer,et al.  A community-based heart disease intervention: predictors of change. , 1994, American Journal of Public Health.

[24]  W L Haskell,et al.  Effects of communitywide education on cardiovascular disease risk factors. The Stanford Five-City Project. , 1990, JAMA.

[25]  N. Roos,et al.  Living longer but doing worse: assessing health status in elderly persons at two points in time in Manitoba, Canada, 1971 and 1983. , 1993, Social science & medicine.

[26]  T. Hodgson,et al.  Health care expenditures for major diseases in 1980 , 1984, Health Care Financing Review.

[27]  L G Branch,et al.  Educational status and active life expectancy among older blacks and whites. , 1993, The New England journal of medicine.

[28]  S M Teutsch,et al.  The effect of known risk factors on the excess mortality of black adults in the United States. , 1990, JAMA.

[29]  M. Terris Determinants of Health: A Progressive Political Platform , 1994, Journal of public health policy.

[30]  Gower Street,et al.  Health inequalities among British civil servants: the Whitehall II study , 1991, The Lancet.

[31]  Rupert G. Miller Simultaneous Statistical Inference , 1966 .

[32]  P. Józan The epidemiological future. , 1991, Health policy.

[33]  J. Feldman,et al.  National trends in educational differentials in mortality. , 1989, American journal of epidemiology.