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 hear more podcasts, subscribe to us on Apple podcast, Spotify, Stitcher, and Google Podcasts, and make sure you leave a rating or review to let others know about the work we're doing. For more from the congressional watchdog, the U.S. Government Accountability Office, visit us at GAO dot gov.