From the U.S. Government Accountability Office, www.gao.gov

Transcript for: The Costs of Diet-Related Chronic Health Conditions in
the U.S. And The Federal Response
Description: Chronic health conditions' such as diabetes, cardiovascular
disease, and obesity-are often caused by diet related factors, and
they're having a significant impact on our lives, the economy, as well
as the nation's well-being. We find out more about the impacts of these
health conditions and the federal response to them from GAO's Sharon
Silas and Steve Morris.

Related GAO Work: GAO-21-593, Chronic Health Conditions: Federal
Strategy Needed to Coordinate Diet-Related Efforts

Released: September 2021

[Intro Music]

[Sharon Silas:] Chronic health conditions are costly and deadly. But
these conditions are largely preventable with healthy diet and healthy
behaviors.

[Music:]

[Holly Hobbs:] Hi, and welcome to GAO's Watchdog Report, your source for
news and information from the U.S. Government Accountability
Office-celebrating 100 years of fact based nonpartisan government
oversight. I'm Holly Hobbs. COVID-19 has claimed hundreds of thousands
of lives in the U.S. But in 2020, it wasn't the leading cause of death.
Heart disease and cancer were. Chronic health conditions like these, as
well as diabetes, cardiovascular disease, and obesity are often caused
by diet related factors, and they're having a significant impact on our
lives, the economy, as well as the nation's well-being. 
Today, we'll find out more from GAO directors Sharon Silas' a health care
expert-and Steve Morris-an expert in federal agriculture programs. They
led work on our new report about the costs of chronic health conditions
in the U.S. and the government's response. Thanks for joining us. 

[Sharon Silas:] Thanks for having me, Holly. 

[Steve Morris:] Thanks for having me on, Holly. 

[Holly Hobbs:] Sharon, can you give us some examples or numbers that
might help explain how big of an issue this is?

[Sharon Silas:] Sure. So in our report, we discuss select diet-related
chronic health conditions. And as part of that, we reviewed federal data
on prevalence, mortality and costs of these conditions. And what we
found was that, for example, 42 percent of adults had obesity and 12
percent had diabetes. We also found that diet-related chronic health
conditions were associated with high mortality rates. The prevalence of
diet-related chronic health conditions was higher in 2018 than in 2009.
For example, the percentage of U.S. adults who had obesity increased 19
percent, and the percentage of adults with severe obesity increased 46
percent.  

[Holly Hobbs:] And there's a lot on the news about how underlying health
conditions can increase your risks if you get COVID. But what do we know
about health care outcomes? 

[Sharon Silas:] First, people who contracted COVID-19, who reported
underlying health conditions, were six times more likely to be
hospitalized and 12 times more likely to die compared with those who
were reported not having these conditions. 

[Holly Hobbs:] And outside of health risk to Americans, what are some of
the other costs? 

[Sharon Silas:]  In 2018, spending to treat cardiovascular diseases,
cancer and diabetes accounted for 26 percent of the approximately $1.5
trillion in total health care spending for U.S. adults. And amongst
government payers-so, this would include Medicare and Medicaid-those
payers accounted for more than half of 2018 spending for treatment of
those diseases. The trends and costs are also increasing. Specifically
spending for cardiovascular diseases, cancer and diabetes was 18 percent
higher.

[Holly Hobbs:] Steve, our report also looked at the federal government's
efforts to reduce chronic health conditions. What did we find? 

[Steve Morris:] Well, Holly, the government has a number of efforts
aimed at improving American science and reducing their risk of chronic
health conditions.  In our work, we identified 200 efforts spread across
21 federal agencies. And most of these were managed by the USDA and the
Department of Health and Human Services. The efforts themselves focused
on 4 key areas. They include things like funding and conducting research
on things like improving the nutritional quality of crops. Also
educating people on healthy food choices through counseling and
community outreach. Providing folks with food directly or money to buy
food, and also to help them access healthy foods through, for example,
farmer's markets. And lastly, to regulate the food industry, and that
would include grocery stores and restaurants to ensure safe and
wholesome food supply. 

[Holly Hobbs:] So, there are 200 federal efforts to improve diet. What
kind of coordination is there for these efforts at the federal level? 

[Steve Morris:] There really is no overarching federal strategy to guide
the government's efforts to improve American's diet. And we found that
the 21 agencies we looked at that have a role in diet and health, they
often work independently without a common purpose or goal. And also
because the 200 efforts we identified are spread out, or what we would
say are fragmented across the government-they can overlap in some cases,
which could result in some wasted resources. Or they may fail to focus
on the areas that really warrant attention. So let me give you an
example, Holly. So we found an instance where there were gaps in
scientific research, which, if addressed, really could provide a better
understanding of the relationship between diet and health, especially
for infants and young children. 

[Music break:]

[Holly Hobbs:] So, Sharon and Steve just told us that chronic health
conditions have had had significant impacts on Americans' health, the
economy, and national spending; and that while the federal government
has taken actions to address diet-related issues, the effort lacks a
central strategy and coordination.
So, Steve, given the significance of this issue, what actions could
policymakers take to improve the federal government's efforts? 

[Steve Morris:] Well Holly, you know, based on our work, we think more
can definitely be done to both unify and focus the government's efforts
and also to leverage resources to address some of the most pressing
needs, like I mentioned. So we're calling on Congress to essentially
implement a federal strategy that would coordinate many of these
ongoing, diet-related efforts across the government. And ultimately, we
think this type of approach to go a long way in helping to reduce
America's risk of chronic health conditions.

[Holly Hobbs:] And last question, what's the bottom line of this report?
Sharon, let's start with you?

[Sharon Silas:] So chronic health conditions are costly and deadly. But
these conditions are largely preventable with healthy diet and healthy
behaviors. The federal government has hundreds of efforts to address
diet-related chronic health conditions. And we believe that a federal
strategy, along with federal leadership, can facilitate agencies working
more closely together and ultimately help to improve outcomes for these
efforts. 

[Holly Hobbs:] And Steve?

[Steve Morris:] The government has taken this issue seriously. But we
found that, these efforts are often spread out across the government and
they're not as efficient and effective as they could be. So we believe
that a federal strategy could provide better direction and focus more
attention to these efforts and, again, ultimately asking us to do
similar things with the chronic health conditions.

[Holly Hobbs:] That was GAO's Sharon Silas and Steve Morris talking
about their new report on diet-related chronic health conditions. Thanks
for your time! 

[Sharon Silas:] Thanks, Holly. 

[Steve Morris:] Thank you Holly. 

[Holly Hobbs:] And thank you for listening to the watchdog report. To
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