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. 1980 Dec;70(12):1249–1260. doi: 10.2105/ajph.70.12.1249

The incidence and economic costs of cancer, motor vehicle injuries, coronary heart disease, and stroke: a comparative analysis.

N S Hartunian, C N Smart, M S Thompson
PMCID: PMC1619642  PMID: 7435742

Abstract

The economic impact of disease and injury has most often been calculated by examining the costs associated with the prevalence of the impairments in the reference year. An alternative accounting approach is to assign all disease costs to the year of incidence, an approach which entails present-valuing to the year of incidence both health care expenditures and lost productivity. The incidence approach is the more appropriate for gauging the economic gains achievable through prevention, immediate rehabilitation, and arresting progression. Incidence-based costs have been estimated for the United States in 1975 for cancer, coronary heart disease, motor vehicle injuries, and stroke. A noteworthy finding is the relative economic importance of motor vehicle injuries, which frequently have been overlooked in the ordering of public health expenditure priorities. After cancer, which generated approximately $23.1 billion in present-valued costs in 1975 (discounted at 6 per cent), motor vehicle injuries and coronary heart disease constitute the next most expensive conditions--having generated estimated annual costs of $14.4 billion and $13.7 billion, respectively. Stroke, at $6.5 billion, follows in economic importance.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Alter M., Christoferson L., Resch J., Myers G., Ford J. Cerebrovascular disease: frequency and population selectivity in an upper midwestern community. Stroke. 1970 Nov-Dec;1(6):454–465. doi: 10.1161/01.str.1.6.454. [DOI] [PubMed] [Google Scholar]
  2. Berk A., Paringer L., Mushkin S. J. The economic cost of illness: fiscal 1975. Med Care. 1978 Sep;16(9):785–790. doi: 10.1097/00005650-197809000-00009. [DOI] [PubMed] [Google Scholar]
  3. Carveth S. W., Olson D., Bechtel J. Proceedings: Emergency medical care system. Lincoln (Beb) mobile heart team. Arch Surg. 1974 Apr;108(4):528–530. doi: 10.1001/archsurg.1974.01350280130021. [DOI] [PubMed] [Google Scholar]
  4. Cooper B. S., Rice D. P. The economic cost of illness revisited. Soc Secur Bull. 1976 Feb;39(2):21–36. [PubMed] [Google Scholar]
  5. Cretin S. Cost/benefit analysis of treatment and prevention of myocardial infarction. Health Serv Res. 1977 Summer;12(2):174–189. [PMC free article] [PubMed] [Google Scholar]
  6. DAWBER T. R., MOORE F. E., MANN G. V. Coronary heart disease in the Framingham study. Am J Public Health Nations Health. 1957 Apr;47(4 Pt 2):4–24. doi: 10.2105/ajph.47.4_pt_2.4. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Donovan A. J., Turrill F., Berne C. J. Injuries of the pancreas from blunt trauma. Surg Clin North Am. 1972 Jun;52(3):649–665. doi: 10.1016/s0039-6109(16)39739-0. [DOI] [PubMed] [Google Scholar]
  8. Dresser A. C., Meirowsky A. M., Weiss G. H., McNeel M. L., Simon G. A., Caveness W. F. Gainful employment following head injury. Prognostic factors. Arch Neurol. 1973 Aug;29(2):111–116. doi: 10.1001/archneur.1973.00490260055011. [DOI] [PubMed] [Google Scholar]
  9. Dyken M. L., Conneally M., Haerer A. F., Gotshall R. A., Calanchini P. R., Poskanzer D. C., Price T. R., Swanson P. D. Cooperative study of hospital frequency and character of transient ischemic attacks. I. Background, organization, and clinical survey. JAMA. 1977 Feb 28;237(9):882–886. [PubMed] [Google Scholar]
  10. EISENBERG H., FELTNER W. R., PAYNE G. H., HADDAD C. A. The epidemiology of coronary heart disease in Middlesex County, Connecticut. I. A preliminary report on methodology and the incidence of primary myocardial infarction. J Chronic Dis. 1961 Aug;14:221–235. doi: 10.1016/0021-9681(61)90155-2. [DOI] [PubMed] [Google Scholar]
  11. EISENBERG H., MORRISON J. T., SULLIVAN P., FOOTE F. M. CEREBROVASCULAR ACCIDENTS. INCIDENCE AND SURVIVAL RATES IN A DEFINED POPULATION, MIDDLESEX COUNTY, CONNECTICUT. JAMA. 1964 Sep 21;189:883–888. [PubMed] [Google Scholar]
  12. Eckstrom P. T., Brand F. R., Edlavitch S. A., Parrish H. M. Epidemiology of stroke in a rural area. Public Health Rep. 1969 Oct;84(10):878–882. [PMC free article] [PubMed] [Google Scholar]
  13. Eraklis A. J., Kevy S. V., Diamond L. K., Gross R. E. Hazard of overwhelming infection after splenectomy in childhood. N Engl J Med. 1967 Jun 1;276(22):1225–1229. doi: 10.1056/NEJM196706012762203. [DOI] [PubMed] [Google Scholar]
  14. Geisler W. O., Jousse A. T., Wynne-Jones M. Survival in traumatic transverse myelitis. Paraplegia. 1977 Feb;14(4):262–275. doi: 10.1038/sc.1976.44. [DOI] [PubMed] [Google Scholar]
  15. Grant R. P., Jr, Gifford R. W., Jr, Pudvan W. R., Meaney T. F., Straffon R. A., McCormack L. J. Renal trauma and hypertension. Am J Cardiol. 1971 Feb;27(2):173–176. doi: 10.1016/0002-9149(71)90255-4. [DOI] [PubMed] [Google Scholar]
  16. Gresham G. E., Fitzpatrick T. E., Wolf P. A., McNamara P. M., Kannel W. B., Dawber T. R. Residual disability in survivors of stroke--the Framingham study. N Engl J Med. 1975 Nov 6;293(19):954–956. doi: 10.1056/NEJM197511062931903. [DOI] [PubMed] [Google Scholar]
  17. Haerer A. F., Smith R. R., Currier R. D. The Mississippi Regional Medical Program Stroke Unit. Critique and follow-up of the first 200 patients admitted. South Med J. 1971 Aug;64(8):951–955. doi: 10.1097/00007611-197108000-00011. [DOI] [PubMed] [Google Scholar]
  18. Hagstrom R. M., Federspiel C. F., Ho Y. C. Incidence of myocardial infarction and sudden death from coronary heart disease in Nashville, Tennessee. Circulation. 1971 Nov;44(5):884–890. doi: 10.1161/01.cir.44.5.884. [DOI] [PubMed] [Google Scholar]
  19. JOYCE J. W., FAIRBAIRN J. F., 2nd, KINCAID O. W., JUERGEN J. L. ANEURYSMS OF THE THORACIC AORTA. A CLINICAL STUDY WITH SPECIAL REFERENCE TO PROGNOSIS. Circulation. 1964 Feb;29:176–181. [PubMed] [Google Scholar]
  20. Kannel W. B. Role of blood pressure in cardiovascular morbidity and mortality. Prog Cardiovasc Dis. 1974 Jul-Aug;17(1):5–24. doi: 10.1016/0033-0620(74)90034-6. [DOI] [PubMed] [Google Scholar]
  21. Little J. A., Shanoff H. M., Csima A. Studies of male survivors of myocardial infarction. IX. Mortality experience and insurability. Can Med Assoc J. 1967 Apr 29;96(17):1204–1207. [PMC free article] [PubMed] [Google Scholar]
  22. Luce B. R., Schweitzer S. O. Smoking and alcohol abuse: a comparison of their economic consequences. N Engl J Med. 1978 Mar 9;298(10):569–571. doi: 10.1056/NEJM197803092981012. [DOI] [PubMed] [Google Scholar]
  23. MUSHKIN S. J., COLLINGS F. D. Economic costs of disease and injury. Public Health Rep. 1959 Sep;74:795–809. [PMC free article] [PubMed] [Google Scholar]
  24. Margolis J. R., Gillum R. F., Feinleib M., Brasch R., Fabsitz R. Community surveillance for coronary heart disease: the Framingham Cardiovascular Disease survey. Comparisons with the Framingham Heart Study and previous short-term studies. Am J Cardiol. 1976 Jan;37(1):61–67. doi: 10.1016/0002-9149(76)90500-2. [DOI] [PubMed] [Google Scholar]
  25. Matsumoto N., Whisnant J. P., Kurland L. T., Okazaki H. Natural history of stroke in Rochester, Minnesota, 1955 through 1969: an extension of a previous study, 1945 through 1954. Stroke. 1973 Jan-Feb;4(1):20–29. doi: 10.1161/01.str.4.1.20. [DOI] [PubMed] [Google Scholar]
  26. McNeer J. F., Wallace A. G., Wagner G. S., Starmer C. F., Rosati R. A. The course of acute myocardial infarction. Feasibility of early discharge of the uncomplicated patient. Circulation. 1975 Mar;51(3):410–413. doi: 10.1161/01.cir.51.3.410. [DOI] [PubMed] [Google Scholar]
  27. Mills E., Thompson M. The economic costs of stroke in Massachusets. N Engl J Med. 1978 Aug 24;299(8):415–418. doi: 10.1056/NEJM197808242990810. [DOI] [PubMed] [Google Scholar]
  28. Mundth E. D., Austen W. G. Surgical measures for coronary heart disease (third of three parts). N Engl J Med. 1975 Jul 17;293(3):124–130. doi: 10.1056/NEJM197507172930306. [DOI] [PubMed] [Google Scholar]
  29. Oh S. J. Cerebro-vascular diseases in Negroes. J Natl Med Assoc. 1971 Mar;63(2):93–98. [PMC free article] [PubMed] [Google Scholar]
  30. PELL S., D ALONZO C. A. IMMEDIATE MORTALITY AND FIVE-YEAR SURVIVAL OF EMPLOYED MEN WITH A FIRST MYOCARDIAL INFARCTION. N Engl J Med. 1964 Apr 30;270:915–922. doi: 10.1056/NEJM196404302701801. [DOI] [PubMed] [Google Scholar]
  31. QUATTLEBAUM J. K. Massive resection of the liver. Ann Surg. 1953 Jun;137(6):787–796. doi: 10.1097/00000658-195306000-00002. [DOI] [PMC free article] [PubMed] [Google Scholar]
  32. Swanson P. D., Calanchini P. R., Dyken M. L., Gotshall R. A., Haerer A. F., Poskanzer D. C., Price T. R., Conneally M. A cooperative study of hospital frequency and character of transient ischemic attacks. II. Performance of angiography among six centers. JAMA. 1977 May 16;237(20):2202–2206. [PubMed] [Google Scholar]
  33. Walker A. E., Leuchs H. K., Lechtape-Grüter H., Caveness W. F., Kretschman C. Life expectancy of head injured men with and without epilepsy. Arch Neurol. 1971 Feb;24(2):95–100. doi: 10.1001/archneur.1971.00480320023001. [DOI] [PubMed] [Google Scholar]
  34. Weinblatt E., Shapiro S., Frank C. W., Sager R. V. Return to work and work status following first myocardial infarction. Am J Public Health Nations Health. 1966 Feb;56(2):169–185. doi: 10.2105/ajph.56.2.169. [DOI] [PMC free article] [PubMed] [Google Scholar]
  35. Whisnant J. P. Epidemiology of stroke: emphasis on transient cerebral ischemia attacks and hypertension. Stroke. 1974 Jan-Feb;5(1):68–70. doi: 10.1161/01.str.5.1.68. [DOI] [PubMed] [Google Scholar]

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