Walking Summit 2011

George C. HalvorsonChairman and Chief Executive OfficerKaiser PermanenteSeptember 20, 2011

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U.S. Health Care generated $2.8 trillion in costs last year.

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By itself, the American Health Care Expenditure Level is larger than the total

economies of all but five countries -- including the United States:

Only China, Japan, India, and Germany have total economies larger than

U.S. health care all by itself.

Source : CIA Source book, 2009 est. https://www.cia.gov/library/publications/the-world-factbook/rankorder/2001rank.html

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Health Care in the United States

-- Chronic health conditions

account for 75% of

$2.8 trillion spent annually

for care in the U.S.

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Chronic Care

Acute Care

25%

75%

Care Cost Drivers

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U.S. Health Care Cancer = $263.8 Billion

Annual Costs of Cancer

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Non-communicable diseases, including

diabetes, account for 60% of all deaths worldwide.

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-- In 1985 there were an estimated 30 million diabetics.

-- Today diabetes affects more than 285 million people (almost 6% of the world's adult population).

-- Each year another 6 million people develop diabetes.

-- By 2030, there will be approximately 438 million diabetics (7.8% of the adult population).

The Worldwide Growth of Diabetes

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Chronic Conditions are Diseases of Urbanization.

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Top World Cities 1950

Rank Country Population 1 New York, United States 12,463,000 2 London, United Kingdom 8,860,000 3 Tokyo, Japan 7,000,000

4 Paris, France 5,900,000 5 Shanghai, China 5,406,000 6 Moscow, Russia 5,100,000 7 Buenos Aires, Argentina 5,000,000 8 Chicago, United States 4,906,000 9 Ruhr, Germany 4,900,000

10 Kolkata, India 4,800,000

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Top World Cities 2010

Rank Country Population 1 Tokyo, Japan 36,669,000

2 Delhi, India 22,157,000 3 São Paulo, Brazil 20,262,000 4 Mumbai, India 20,041,000 5 Mexico City, Mexico 19,460,000 6 New York, United States 19,425,000 7 Shanghai, China 16,575,000 8 Kolkata, India 15,552,000 9 Dhaka, Bangladesh 14,648,000

10 Karachi, Pakistan 13,125,000

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Old World

Old World-- walking, local foods

(fish, fowl and lean meats).

Constant physical activity.

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New World

New World-- massive slums and poor neighborhoods, motorized transportation, unsafe walking, mass market foods (white wheat, white rice, white sugar, and fat rich mass produced meat products).

Constant inactivity

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Diabetes, like heart diseaseand stroke, are all diseases of urbanization.

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Is there anything we can do to slow, mitigate, prevent, and alleviate the burden and impact of chronic, non

communicable diseases?

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Yes.

Two things.

Healthy Eating and Active Living

(HEAL).

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Health Care in the United States

-- Most chronic conditions can be

prevented, delayed, and even

treated by regular exercise and

physical activity.

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Health Care in the United States

-- The most accessible and achievable physical

activity is walking.

-- We don’t need to run, lift weights or swim.

Those are all good things to do -- but we get

huge benefits just by walking -- and walking is,

by far, the easiest physical activity for most

people to do.

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Health Care in the United States

-- We need to start a national

agenda to take advantage of the

health benefits of walking.

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U.S. Obesity TrendsPercent of Obese (BMI > 30) in U.S. Adults

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U.S. Obesity TrendsPercent of Obese (BMI > 30) in U.S. Adults

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The Global Obesity Forecast

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According to the World Health Organization,

there are 1.6 billion overweight adults in the

world.

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-- That number is projected to grow by 40% over the next 10 years.

-- Healthy eating needs to be part of our total agenda for health -- creating access to the right foods and avoiding the wrong foods. 

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Active living is the highest potential chronic condition

mitigation pathway-- and the best mechanism for achieving active living in large scale is to

get people to walk.

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Walking is our best hopeand our best strategy for improving health.

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Benefits of Walking Daily -- Huge Value 

-- Prevents and manages diabetes

-- Prevents heart disease and strokes

-- Prevents and treats depression and anxiety

-- Helps manage asthma

-- Lowers the rate of some cancers 

A Moderate Amount Of Walking Has A Huge Impact

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Walking 30 minutes a day, five days a week can cut new

cases of diabetes in half. (Losing ten pounds as well can cut the rate of new diabetics by nearly two thirds.)

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We don’t need to walk a lot -- 30 minutes a day makes

the body work better.

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The human body is made to walk.

Our bodies function better when we walk.

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The body resists diseases better when we walk, and the body heals faster when we

walk.

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-- Walking generates positive neurochemicals.

-- Walking strengthens the heart.

-- Walking strengthens bones.

-- Walking improves the circulatory system.

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Walking 30 minutes a day:

-- Reduces hypertension-- Cuts rate of diabetes by more than half -- Cuts risk of stroke by almost half-- Cuts risk of people over 60 becoming diabetic

by almost 70%-- Cuts risk of heart disease by more than 40%-- Cuts risk of cancers

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Men who walk thirty minutes a day have a significantly lower level of

prostate cancer.

Men who do not walk regularly have a 60% higher risk of colon cancer.

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For men with prostate cancer, studies have shown that walkers have a 46% lower mortality rate.

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Walking improves our biological health, our physiological health, our psychological

health, and walking helps with our emotional health.

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Walking reduces the risk of both cognitive

impairment and dementia.

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Walking also helps prevent depression, and people who walk

regularly are more likely to see improvements in their depression.

Walking to Treat Depression

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In one study, women who were depressed who walked and took medication scored twice as well on the depression level evaluation in 30 days as the women who only took the medication.

Another study showed that depressed people who walked regularly had a significantly higher level of not being depressed in a year compared to depressed people who did not walk.

Walking to Treat Depression

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Walking to Treat Depression

• University of Wisconsin study: Exercise appears to be as effective as psychotherapy at relieving moderate depression.

• After a year, over 90% of those people who were assigned to the exercise program were no longer depressed.

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Walking to Treat Depression

• Ohio State University study: Depressed stay-at-home-moms.

• One group walked 45 minutes a day, five days a week – the other did

not walk.

• Walking group's depression index scores improved from 14.81,

indicating mild depression, to 3.27, indicating minimal depression.

• Results indicate that an exercise program may be an alternative to

medication for treating mild to moderate depression in women who

stay at home.

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Walking speeds up metabolismand burns calories.

Walkers often find that eating habits change and weight loss results from

those eating changes.

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Fit Beats Fat

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Walking half an hour a day has health benefits that can exceed the benefits of losing

twenty pounds.

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A single 30-minute walk can reduce blood pressure

by 5 points for over 20 hours.

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Walking improves the health of our blood.

Walking is a good booster for high density cholesterol -- and people with

high levels of HDL are less likely to have heart attacks and stroke.

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Walking reduces the risk of blood clots in our legs.

People who walk regularly have much lower risk of deep vein thrombosis.

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People who walk are less likely to catch colds, and when

people do get colds, walkers have a 46% shorter symptom

time from their colds.

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The need for gallstone surgery is 20% to 31%

lower for walkers.

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Women who walk have a 20% lower likelihood of getting

breast cancer and a 31% lower risk of getting colon cancer.

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Women with breast cancer who walk regularly can reduce their

recurrence rate and their mortality rate for breast cancer

by over 50%.

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0%

10%

20%

30%

40%

50%

60%

Breast Cancer Colon Cancer Reoccurrence &Breast CancerMortality Rate

20% Lower Risk

31% Lower Risk

50% Lower Risk

Women Who Walk Have Lower Risk

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Walking can literally add years -- entire years -- to your life.

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The Reason For Walking

-- There are very few things that we can do that have a more positive impact on our health and our lives than walking.

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Thirty minutes a day is enough to have a huge impact on our

health.

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The best news …

The thirty minutes doesn’t have

to be done in one lump of time.

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Two 15 minute walks achieve the same goals.

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It’s often a lot easier to find 15 minutes than it is to find a

full half hour -- and 15 minutes is enough when

we do it twice a day.

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Three 10 minute walks achieve most of those goals.

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Getting Patients to Walk

-- KP physicians literally prescribe

walking as front line medicine.

-- Walking brings remarkable results to

patients.

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Prescribe Walking

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Make the Right ThingEasy to Do

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We need a national agenda to create a

culture of health and a culture where people

walk.

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We need to encourage walking, support walking, empower walking,

enable walking and celebrate walking

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We need walking in our schools, our communities, our work places, and our

family settings.

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Our goal to start a national conversation about the remarkable

health benefits of walking and create a culture of health.

www.EveryBodyWalk.org

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-- Inspirational videos

-- Interactive maps

-- Important information

-- Irrefutable medical science

www.EveryBodyWalk.org

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Our Goal for Population Health:

Make the Right Thing Easy to Do

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It’s good to walk.

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www.everybodywalk.org

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Be Well