Top 10 Conditions With the Most Impact on Health

The top conditions on the Blue Cross Blue Shield Health Index — hypertension, major depression, high cholesterol, coronary artery disease and Type 2 diabetes — have become more entrenched because of rising prevalence.

The five medical conditions with the most impact on overall health among commercially insured people in the United States are growing even more widespread, according to a new analysis of member data by the Blue Cross and Blue Shield Association.

The Association’s Blue Cross Blue Shield Health IndexSM — an annual look at the health of people in nearly every U.S. county — reflects an analysis of 200 health conditions using anonymous claims data from more than 41 million commercially insured members of Blue Cross and Blue Shield companies.

The impact of each condition is based on the risk of premature death and the disabling effects of illness. The top five conditions — hypertension, major depression, high cholesterol, coronary artery disease, Type 2 diabetes — have become more entrenched at the top of the index because of rising prevalence, the Association found.

Hypertension again leads the top 10. That’s because high blood pressure increases the risk of other chronic conditions. People with high blood pressure are five times more likely to have heart failure or a stroke, according to the analysis. They also are at greater risk for coronary artery disease, Type 2 diabetes and high cholesterol.

Hypertension grows more prevalent with age, with 51 percent of members ages 55 to 64 diagnosed with the condition. However, the percentage of millennials with hypertension increased 19 percent from 2014 to 2016.

Early detection, regular treatment and lifestyle choices such as a healthy diet and regular exercise may help avoid or reduce hypertension. Costs to treat the condition are flat or declining, due to the use of lower-cost generic drugs, according to the Health Index report.

Substance use disorder — a category that includes any drug other than alcohol and tobacco — moved up on the ranking to No. 6 from No. 7. That’s largely because of the opioid crisis, the Association said.

Nationally, more than 42,000 people died from opioid drug overdoses in 2016, and about 40 percent were tied to prescription opioids, according to data published in March by the Centers for Disease Control and Prevention. More than 1,000 people are treated in emergency rooms each day for misusing prescription opioids, the CDC said.

Blue Plans are working with physicians, pharmacists and other stakeholders on the proper use and disposal of prescription opioids. Blue Cross and Blue Shield Plans in Illinois, Oklahoma, Montana, New Mexico, Oklahoma and Texas, for example, are using claims data to identify and educate doctors whose opioid prescribing patterns are out of step with CDC recommendations. The Plans are also using claims data to identify and seek help for members who appear to be misusing opioids.

[Related: Read more about efforts to tackle the opioid crisis]

The Health Index was created in 2015 to support local and national discussions on improving American health policy and practice, and to help various stakeholders address the social determinants of health. An interactive website allows users to compare the health of communities across the country.

States with the top Health Index scores include California, Colorado, Montana and Utah. Those with the lowest health index scores include Alabama, Rhode Island, Florida and Maryland.

Maureen Sullivan, chief strategy and innovation officer for BCBSA, says the data may help “researchers, local health officials and policymakers better measure the health of local communities and benchmark them against nearby or similar communities across the country.”

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