Strokes to cost $2.2 trillion by 2050
if prevention, treatment don't improve
By Kara Gavin
U-M Health System Public Relations
Unless Americans do more to lower their risk of stroke and improve care, the nation will pay $2.2 trillion over the next 45 years to care for people who suffer the most common form of stroke, a new U-M study predicts.
And a disproportionate share of the bill will be for African-American and Latino stroke patients because of their tendency to suffer strokes at younger ages and get poorer-quality preventive care. In fact, stroke-related costs among people under age 65 account for about half of the predicted total.
The study, published Aug. 16 in the online version of the journal Neurology and funded by the National Institutes of Health, highlights the importance of efforts to prevent strokes in all ethnic groups, particularly young and middle-aged African-Americans and Latinos, says lead author Dr. Devin Brown, assistant professor in the Department of Neurology and a member of the U-M Stroke Program, which is part of the Cardiovascular Center
"Doing the right thing now ultimately could be cost-saving in the future, but we have a long way to go before all Americans receive adequate stroke prevention and emergency stroke care," Brown says. "If our society is not going to do it for the right reasons, perhaps we can do it because it's going to be obscenely expensive."
Brown and her colleagues say their $2.2-trillion estimate is extremely conservative because it is based on current rates of the conditions that put people at higher risk of stroke, such as diabetes, cardiovascular disease and obesityconditions that are projected to become even more common in the future.
The estimate includes everything from ambulances and hospital stays to medications, nursing home care, at-home care and doctor's visits. It also includes lost earnings for stroke survivors under age 65, based on current median salaries for each ethnic group. Earnings of those over 65 weren't included.
In specific the study finds that the total direct and indirect costs of stroke in the next 45 years will be $1.52 trillion for non-Hispanic whites, $313 billion for Latinos, and $379 billion for African-Americans. On a per-capita basis across the whole population a white stroke victim's cost will average just under $16,000, a Latino's will be just over $17,000 and an African-American stroke patient's cost will total nearly $26,000.
"We need to examine stroke in African Americans and Latinos further, and strengthen efforts to improve stroke prevention and acute stroke treatment for all patients, but especially these two groups," says senior author Dr. Lewis Morgenstern, professor of neurology, neurosurgery and emergency medicine and director of the Stroke Program.
Individuals can cut the risk of stroke by quitting smoking, losing weight, eating healthy, exercising, and keeping their blood pressure, cholesterol levels and any heart-rhythm problems under control, Brown says. And doctors and hospitals can do a better job of providing preventive care and screening to patients with high blood pressure, clogged arteries and heart-rhythm problems.
In addition to Brown and Morgenstern, study authors include researchers from the U-M and the VA Ann Arbor Healthcare System, including Dr. Ken Langa, Lynda Lisabeth, Malika Fair and Melinda Smith. Columbia University Medical Center researchers B. Boden-Albala and Dr. R.L. Sacco also contributed to the study.