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Diabetes, a silent threat to US economy

Obesity is costly. It’s a fact rooted in research and historical data. Some of those costs are surprising ($2.5 billion wasted in gasoline). Others represent true injustice (obese black women earn 34 percent less than the rest of the workforce). And yet more of those costs are universal (over $8 billion from a less productive workforce).

But as significant as these diverse amounts are, they are almost incidental in comparison to the healthcare costs resulting from obesity. $316 billion in 2010. That figure alone – amounting to $3,500 per American – is powerful enough. $10,020 per second, $601,218 per minute, $36,073 per hour.

{mosads}But that amount – estimated by Professor John Crowley of Cornell – masks two powerful and even more concerning trends.First, the vast majority of those healthcare costs are associated with and driven by the type 2 diabetes epidemic, the sheer proportion of which is almost certainly greater than we can imagine. And second, those costs are rising faster than we think. Exponentially. Up by 48 percent in five years, with no sign of slowing.

And with the number of U.S. diabetes diagnoses expected to grow from 24 million to 44 million people by 2034, the compound effect of increased costs and prevalence of diabetes amounts not only to a pressing public health issue, but a national crisis. Diabetes costs our nation more than every single American conflict combined since World War II, according to the Congressional Research Service. That analogy is pertinent, because it represents the way we should be thinking about this problem: as a national (to say nothing of international) challenge that will touch every single person and threaten our very way of life.

Even if we set aside the parallels in terms of mass human suffering, the cost implications of the diabetes epidemic threaten our economic survival more than any international challenge to date. Certainly, in terms of scale and urgency, the oncoming crisis belongs only in the same league as the environmental challenges we will face in the coming decades – a similar story where we cover our eyes and ears and refuse to make short-term changes that could result in serious long-term gains.

The national conversation surrounding diabetes is inadequate in relation to the consequences of the epidemic. It is a complex dynamic that sits at the intersection of human psychology, political will (or lack thereof), and the seemingly illusive nature of solutions.

Awareness is a critical first step. The diaTribe Foundation, which I lead, is primarily devoted to informing and empowering all those potentially affected by diabetes and pre-diabetes. And let’s be clear – that is every single American.

But the potential solution to the massive cost implications may also lie in economics. Prevention, and primarily the promotion of healthier lifestyles, is best achieved when a financial incentive is a component – whether that’s through burgeoning workplace fitness incentive programs, taxes that dissuade people from unhealthy choices, or the desperate need to ensure that healthier foods are available at a competitive price. We do not live in an environment that motives people to make the right food and activity choices. As a solution, the healthy choice has to be the easy choice.

It may also be in the economic and innovation powerhouses of the new economy that solutions to diabetes are found. Beyond the tremendous (albeit costly) traditional advances in diabetes prevention and care, it is encouraging that ventures such as Google X or the recently introduced Apple ResearchKit see diabetes as a new frontier, ripe for technological investment that can produce significant societal gains. Omada and DPS Health are both working to democratize diabetes prevention, using healthy doses of technology that is possible to scale. Such innovations stand to help people lower their costs through more effective health management, and perhaps even provide doctors with the data necessary to intervene before it’s too late. It’s not a panacea, but it’s certainly a start, and what we need are smart, multi-faceted approaches for these large-scale social problems.

The costs of obesity might not be surprising, but dig a bit deeper and one realizes that the costs of diabetes that are truly shocking. They speak to the very need for a national conversation on solutions – a modern day New Deal to address a threat as real as any our country has ever faced. We have a proud history of successfully overcoming national challenges and there is every reason to believe we can tackle diabetes. But we must recognize it for the crisis it is, and start addressing it appropriately, now.


Close is the founder of The diaTribe Foundation.


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