MORTALITY, MORBIDITY, AND COST OF DISEASES CANCER Statistics of the annual number of deaths and total current number of disabilities caused by the major diseases dealt with in the National Cancer Institute. I. Cancer deaths in 1964 (unpublished data supplied by the National Center for Health Statistics, Division of Vital Statistics) II. Cancer disability in 1964 (estimated on the basis of data supplied by the National Cancer Institute and the National Center for Health Statistics) (a) Estimated cases under treatment_ (b) Estimated person-days of disability (these estimates have a 891, 000 52, 200, 000 29, 800, 000 III. Cancer's cost to the Nation in 1962 (source: Report of the President's Commission on Heart Disease, Cancer, and Stroke) (a) A total of 221,000 man-years of productivity, amounting to $1 billion, were lost in 1962 as a result of illness and disability for members of the labor force, housewives, and others who were unable to attend to their usual activities. (b) Among the 274,000 cancer deaths in 1962, more than 100,000 man-years valued at almost $420 million were lost to gainful employment. (c) The sum of the direct costs plus losses of output by members of the labor force amounted to $8 billion, or 1.4 percent of gross national product in 1962. MENTAL ILLNESS Statistics on the total current number of mentally ill persons receiving psychiatric care by type of facility and estimated cost. I. Estimated number of patients under care Over 2.6 million persons received care for mental illness or mental deficiency in psychiatric facilities during 1964. This understates the numbers who received special care, not only are the figures for psychiatric facilities underreported but some mentally ill persons are served at nonpsychiatric medical or custodial facilities or by private psychiatrists. In addition a large number of persons who are mentally ill or mentally deficient do not receive any type of treatment. Therefore, this is a minimum estimate of the numbers of patients who were mentally ill in the United States for 1964. 1The number of patients receiving care are based on the sum of resident patients at beginning of year plus all admissions (excluding transfers). Estimated. *Includes VA clinics. II. Estimated cost of care To Federal, State, and local governments for care of patients, fiscal year 1965,' $2,162,366,000. CARDIOVASCULAR DISEASES Statistics of the annual number of deaths and total current number of disabilities caused by each of the major diseases dealt with in the National Heart Institute, and the estimated annual cost to the Nation. 1. Deaths from cardiovascular diseases during 1964 (Division of Vital Statistics, National Center for Health Statistics) Category: Arteriosclerotic heart disease (includes coronary disease or "heart attacks"). Number 545, 499 1 Based on data received from Federal and State agencies. Data from private agencies and individuals are not available. II. Disabilities from cardiovascular diseases (unpublished figures from Division of Health Interview Statistics, National Center for Health Statistics, based on data collected during the period July 1964 to June 1965) III. Estimated annual cost to the Nation A. Estimated economic impact (Second National Conference on Cardiovascular Diseases vol. II Community Services and Education). The total impact of cardiovascular (including cerebrovascular) diseases on the Nation was estimated at $31.9 billion for the year 1962. This figure includes: Direct costs (hospital and medical services). From illness and death during 1962_ Billion $3.1 4.3 24. 5 B. Veterans compensation and pension payments (unpublished data from Veterans' Administration). Payments to veterans disabled by diseases of the circulatory system are estimated to total $607 million for the fiscal year 1966. DENTAL DISEASES Statistics of the annual number of deaths and total current number of disabilities caused by each of the major diseases dealt with in the Dental Institute and the estimated annual cost to the Nation. 1. Deaths related to dental disease. No information available. 2. Disabilities caused by dental diseases The proper functioning and state of health of the oral cavity contribute importantly to the individual's physical, mental, and social well-being.. They not only are indispensable to nutrition and communication but they also influence the general health of the body. Since early manifestations of systemic illnesses frequently appear first in the mouth periodic oral examinations serve a broader purpose in the preservation of total health. Since the enamel is usually incapable of healing itself preservation of the teeth calls for a lifelong commitment to proper oral hygiene and the periodic seeking of professional care. Avoidance of the loss of teeth from periodontal disease, still wrongly considered by many an inevitable consequence of aging, calls for a similar regimen. A major factor in the neglect of dental disorders is ignorance both of their importance and the value of preventive services. Although over 98 percent of Americans have seen a physician some time during their lives, one out of every six has never been examined or treated by a dentist, according to findings of the U.S. national health survey. Nearly half of all children under 15 have never seen a dentist, and less than 40 percent of the population sees the dentist even once a year. National health survey findings indicate the intensity with which dental diseases strike in the American population. At least one in four adults has no natural teeth remaining in either one or both jaws, according to the study, and there is an average of 20.4 decayed, missing, and filled teeth per person. Moreover, about three out of every four persons with natural teeth remaining show some effects of gingivitis or destructive periodontal disease. The cost of dental neglect is dramatically demonstrated in the dental needs presented by inductees into the military service. On the average, every 100 inductees require 505 fillings, 80 extractions, 25 bridges, and 20 dentures. Meeting these needs is considered by the Armed Forces to be vital to the effectiveness of our military personnel. Magnitude of oral health problems.-Virtually every man, woman, and child in the United States either have or will develop some degree of dental decay during their lifespan. It has been estimated that probably no less than half of all tooth extractions today are due to periodontal diseases. Perfectly sound teeth may have to be removed because of disorders of the supporting structures. By the age of 50 half of our population has lost several teeth for this reason; practically everyone by the age of 65. This year, 6,000 babies in the United States will be born with a cleft lip or cleft palate. Today, over a quarter of a million persons in the United States have some form of oral cleft. More than half the population suffers at some time from canker sores, fever blisters, or other painful mouth irritations. 2 Estimated annual cost to the Nation More than 10 percent of health care costs are for dental purposes. The annual expenditure for professional dental care is estimated at $2.4 billion. Since 1935 he amount of dental care received per person as measured by 1957-59 dollars has increased over 140 percent. Man-hours lost from productive work come to over 151 million a year (even if only 2 hours are lost per worker per year). As the dentist-population ratio continues to widen, it is becoming increasingly evident that research holds the only realistic hope for meeting the Nation's mounting oral health problems. Research can provide a key to causes, develop improved methods of treatment, and ultimately provide measures of prevention for oral diseases. However, less than 2 percent of the Nation's health research budget is spent for dental research. ARTHRITIS AND METABOLIC DISEASES Statistics concerning the annual number of deaths and total current number of Esabilities caused by some of the major diseases under study in the National Institute of Arthritis and Metabolic Diseases and the estimated annual cost to the Nation Category : I. Deaths during 1964 Diabetes mellitus. 32, 279 Gastrointestinal diseases (ulcer of stomach and duodenum, cirrhosis of the liver, gastritis and duodenitis, gastroenteritis and colitis, chronic enteritis and ulcerative colitis__. 42, 311 Rheumatic diseases (arthritis, rheumatism, gout). $2, 000, 000, 000 ALLERGY AND INFECTIOUS DISEASES Statistics covering the annual number of deaths and reported illnesses caused by selected diseases dealt with in the National Institute of Allergy and Infectious Diseases are presented in table I. Only those deaths and new cases reported by professional health personnel are included. Table II reports annual disability and estimated cost to the Nation's populace of infections, parasitic, and respiratory diseases. Sources: Morbidity statistics taken from Morbidity and Mortality Weekly Report. Annual Supple ment 1964; vol. 13, No. 54, Sept. 30, 1965; Communicable Disease Center, Atlanta, Ga., p. 4, table 2. Mortality statistics taken from Final Mortality Statistics, Advance Report 1964, through personal com munications from the Mortality Division of the National Center for Health Statistics, DHEW, Dec. 14 1965. 501 307 166, 655 14 3, 587 1,03 $ 37,740 74 (1) (1) 1,69 458, 083 42 4 212, 932 $ 6,939 2 122 13 • 448, 796 5 |