David Barker, MD, PhD
Why do some people, given the same apparent set of risk factors, develop certain diseases and others do not? British scientist David Baker, MD, PhD, is examining this question from a unique perspective.
Barker, a professor of clinical epidemiology at the University of Southampton in the United Kingdom, is a pioneer in a field known as fetal programming. Fetal programming is the process in which environmental influences during prenatal development alter the bodyâ€™s structuresâ€”for life.
He and other experts spoke on the fundamentals of the subject recently at the first Predicting Lifespan Health Conference at Emory University. â€œWhat weâ€™re really looking for is just a few core mechanisms, which are linked to early human development and lead to a plethora of disorders,â€ says Barker.
Emerging evidence suggests that chronic diseases of adult life, including cardiovascular disease, type 2 diabetes and certain cancers, have their origin through fetal programming, explains Michelle Lampl, associate director of the Emory/Georgia Tech Predictive Health Institute. â€œThese diseases and others are initiated by adverse influences before birth,â€ says Lampl.
Speakers addressed fetal programming and the placenta, long-term cardiovascular disease and kidney function in low birth-weight babies, epigenetics and immunity, as well as postnatal influences from infant diet and growth patterns.
Posted on March 2, 2011
A new study by Emory University public health researchers finds that outpatient treatment for chronic diseases such as diabetes, hypertension and kidney disease are to blame for the recent rise in Medicare spending. Kenneth Thorpe, PhD, chair, Health Policy and Management, Rollins School of Public Health, presented study findings today at a briefing of the National Press Club in Washington, DC.
The report, â€œChronic Conditions Account for Rise in Medicare Spending from 1987 to 2006,â€ was published Feb. 18 by the journal Health Affairs.
Kenneth E. Thorpe, PhD
Thorpe and colleagues analyzed data about disease prevalence and about level of and change in spending on the 10 most expensive conditions in the Medicare population from 1987, 1997 and 2006.
Among key study findings:
- Heart disease ranked first in terms of share of growth from 1987 to 1997.Â However, from 1997 to 2006, heart disease fell to 10th, while other medical conditions â€“ diabetes the most prevalent â€“ accounted for a significant portion of the rise.
- Increased spending on diabetes and some other conditions results from rising incidence of these diseases, not increased screening and diagnoses.
Posted on February 23, 2010
Todayâ€™s news points to a study on projected obesity costs released by Kenneth E. Thorpe, PhD, Robert W. Woodruff professor and chair of health policy at Rollins School of Public Health, and colleagues from Emory. The unique study departs from looking at historical costs of obesity and uses an econometric model developed by Thorpe and team to estimate the growth of health care costs over time that are linked to changes in obesity rates.
Obesity costs rising
Using nationally representative data on adults, the study estimates the effect of the increasing prevalence of obesity on total direct health care costs in the next decade. The report is titled “The Future Costs of Obesity: National and State Estimates of the Impact of Obesity on Direct Health Care Expenses.”
The report was commissioned by three groups – the UnitedHealth Foundation, the Partnership for Prevention and the American Public Health Association – in conjunction with their annual America’s Health Rankings report.
Major findings from the report include:
- Obesity is growing faster than any previous public health issue our nation has faced. If current trends continue, 103 million American adults will be considered obese by 2018.
- The United States is expected to spend $344 billion on health care costs attributable to obesity in 2018 if rates continue to increase at their current levels. Obesityâ€related direct expenditures are expected to account for more than 21 percent of the nationâ€™s direct health care spending in 2018.
- If obesity levels were held at their current rates, the United States could save an estimated $820 per adult in health care costs by 2018 â€ a savings of almost $200 billion dollars.
Thorpe says, â€œAt a time when Congress is looking for savings in health care, this data confirms what we already knew: obesity is where the money is. Because obesity is related to the onset of so many other illnesses, stopping the growth of obesity in the U.S. is vital not only to our health, but also to the solvency of our health care system.”
The Partnership to Fight Chronic Disease, co-directed by Thorpe, says that a top priority must be addressing the obesity epidemic through meaningful, evidence-based approaches, including:
- Removing barriers and empowering Americans to take control of their health.
- Educating Americans to see being obese as a serious medical condition that significantly heightens their risk for other health problems
- Ensuring that fear about the stigma of obesity does not eclipse the need to combat it
- Redesigning our health care system to treat obesity like a preventable medical condition
- Engaging employers and communities to get them invested in promoting wellness
Follow Thorpe on his Health Reform Blog.
Posted on November 17, 2009