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22 January 2007
Cardio-vascular disease is having a significant economic impact on South Africa's population. Vast amounts are being spent on heart disease by the members of at least one of South Africa's largest medical aid schemes. Discovery Health's Dr Craig Nossel, head of the company's Vitality Wellness programme, highlighted the cost of heart disease to medical aid schemes.
Nossel says heart disease and related conditions consume a significant portion of healthcare expenditure, a percentage that is increasing rather than abating.
If limited research is anything to go by, the burden on both private and government medical aid schemes is likely to get much worse.
While no such major studies exist in South Africa to date, by comparison, a study by the UK health care system in 1999 showed that the total direct health care costs of coronary heart disease amounted to £1.73 billion. The major costs were those used for hospital inpatient care (53%) and drug treatment (32%). Rehabilitation and community care, prevention and primary care, and outpatient care accounted for 7.4%, 3.6%, and 2.9% respectively, of the total costs. And that's just the direct cost.
Indirect costs of heart disease, while unlikely to be quantifiable in South Africa for some time, include absence from work and the associated loss of or decrease in productivity.
In the same 1999 study, UK health care reported £2.91 billion in adjusted productivity loss, with 24.1% of production losses attributable to mortality and 75.9% to morbidity (illness).
In terms of the substantial direct non-health service costs, the report found that while the patient's productivity is the obvious loss, the economy also suffers because a high percentage of the people who care for the patients would otherwise be in paid employment. The burden of productivity loss falls on employers as lost working days and on the government as incapacity benefits.
Overall, the total annual cost of all coronary heart disease-related burdens for this 1999 study amounted to £7.06 billion - the highest of all diseases in the UK for which comparable analyses have been done. Roughly 150 565 working years lost from deaths as a result of coronary heart disease in England and Wales; 71% of these lost working years were from deaths in men in the 45-64 year age range.
These UK figures make up part of what is known as a 'cost or burden of illness study', and are used to estimate the resources consumed in disease prevention, detection, and treatment. Such information provides a potentially useful decision-making aid for setting priorities in health care research. With the growing number of affluent South Africans - especially the rapidly growing black middle class - following an increasingly western diet of junk food and minimal or no exercise, such figures give an indication as to the direction in which South Africa is headed.
Coronary heart disease kills more than 17.5 million people around the world each year worldwide. According to the United States' Centre for Heart Disease, in 2006 alone the direct and indirect cost of heart disease is projected to have been more than $258 billion, including those indirect costs like health care services, medications and lost productivity.
With the 'sexy' death figures long having been the 'preserve' of HIV-AIDS, as malaria and TB jostling with the pandemic for space on the leader-board, it's a tall order for less dramatic and mostly preventable ailments like cardio-vascular disease to hit the headlines.
Despite the paucity of research into heart disease in South Africa, the Medical Research Council (MRC) has been making some headway into the subject in recent years. In cooperation with local and Australian hospitals and universities and the UN's Food and Agricultural Organisation (FAO), recent studies by the MRC's Chronic Diseases of Lifestyle and Burden of Disease Units show that such chronic diseases of lifestyle - heart, cancer and lung - are responsible for a staggering 50 to 60 % of deaths, of which cardiovascular disease accounts for a significant proportion. As suggested by the unit's name, these deaths are mostly preventable.
With rapid economic development in South Africa, afflictions previously associated with the fast-paced western world are evident - heart disease being of chief concern to South African health professionals. Understandably, long in the shadow of the HIV-AIDS pandemic, the subject of heart disease In South Africa has revealed some frightening trends.
Dr Nossel says heart disease is definitely on the rise; an increasing number of younger people are being affected (previously it was largely restricted to the older section of the population), more people are claiming for chronic diseases, such as high blood pressure, high cholesterol and diabetes, and more cases than ever before are being referred to hospital, which suggests increasing severity of cases.
Dr Nossel says our hyper-western lifestyle in South Africa is indeed killing us, and the odds are that a good proportion of the 'lifestyle related deaths' - which make up approximately 40% of deaths in this country - could theoretically have been prevented.
"Stop sitting, spend less time slouched in front of the TV, get active and take notice of what you eat and the odds are that the health of the average person - if it was questionable to start - will improve."
In his book 'A Race Against Time', a look at macro-economics of health in both developed and developing countries, Australian author Stephen Leeder found that India, Brazil and South Africa can expect a significant increase in deaths among their working populations. This is a grim prospect which supports previous warnings by experts that health systems already stretched by AIDS, malaria and poverty-related diseases, may snap under the additional burden of the modern South Africa lifestyle: heart disease, strokes and diabetes - all conditions linked to obesity.
We have cardiologists and experts in this field ready to be interviewed and give any information needed to get this message across to your readers, as well as ordinary South Africans who have suffered from heart disease and are happy to share their stories.
FOR MORE INFORMATION CONTACT:
Michelle Kearney,
Project Director: Communications & Public Relations,
The Heart and Stroke Foundation SA
+27-21-447 4222 -
email: michelle@heartfoundation.co.za
**This article was written by CNN Africa Journalist 2006 Angus Begg
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