U.S. Stroke Bill Could Top $2.2 Trillion by 2050

Lost earnings from younger victims a major factor, study finds

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By Ed Edelson
HealthDay Reporter

WEDNESDAY, Aug. 16, 2006 (HealthDay News) -- Stroke will cost the United States $2.2 trillion over the next 50 years, with lost income from younger stroke victims playing a major role and the burden falling heaviest on minorities, a new study finds.

"The risk of stroke is highest in minority groups such as blacks and non-white Hispanics," said Dr. Devin Brown, an assistant professor of neurology at the University of Michigan stroke program, and lead author of a report in the Aug. 16 online issue of Neurology.

Brown and her colleagues used data from two local studies, one in New York City and one in Texas, both with large numbers of minorities, to arrive at their estimate. They included cost of ambulance services, hospitalization, nursing home care, rehabilitation, drugs and potential lost earnings.

That last item was of major importance, the report said.

"Interestingly, the younger age group, consisting of the 45- to 64-year-olds, accounts for approximately half the costs in this model, whereas the oldest age group, those 85 and older, accounts for approximately 10 percent of the costs," the researchers wrote.

While the incidence of stroke increases with age, "costs for the youngest age group include lost earnings, whereas this is not a contributor to the costs in the oldest age group," the report said. "Interventions to reduce the cost of stroke must therefore not solely be targeted to the elderly."

Those interventions should be aimed at the known risk factors for stroke, such as high blood pressure, high cholesterol levels, smoking and diabetes, Brown said.

"We are hopeful that these high numbers will help drive health policy decisions," she said.

The American Academy of Neurology, which publishes the journal, issued a statement calling for a 5 percent increase, or $1.4 billion, in funding for the National Institutes of Health (NIH). The study was supported by the National Institute of Neurological Disorders and Stroke, which is part of the NIH.

The time is ripe for a major initiative to reduce the incidence of stroke, said Dr. Matthew Fink, chief of the division of stroke and critical care neurology at Weill Cornell Medical College, in New York City.

"A huge number of baby boomers will start turning 60 this year, entering the period when lots of strokes occur," Fink said. "This is a huge public health problem that people do not understand yet."

And the audience is there for prevention, he said. "My patients say, 'Doctor, I'd rather be dead than have a stroke,' so the motivation for preventing a stroke is even stronger than for preventing a heart attack," Fink said.

While "our health-care system is not designed to focus on prevention," an effort is being made by the NIH and others, he said. "We need more public education on this," Fink added.

Another study reported by the National Stroke Association said that many stroke survivors do not get the rehabilitation they need to improve their quality of life. The study of more than 500 stroke survivors found that more than 40 percent of them reported limited success in meeting goals such as the ability to walk better and to regain speech.

More information

Stroke risk factors and treatment are described by the National Institute of Neurological Disorders and Stroke.

SOURCES: Devin Brown, M.D., assistant professor, neurology, University of Michigan, Ann Arbor; Matthew Fink, M.D., chief, division of stroke and critical care neurology, Weill Cornell Medical College, New York City; Aug. 16, 2006, Neurology online

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