Diabetes 2030: Insights from Yesterday, Today, and Future Trends.

To forecast future trends in diabetes prevalence, morbidity, and costs in the United States, the Institute for Alternative Futures has updated its diabetes forecasting model and extended its projections to 2030 for the nation, all states, and several metropolitan areas. This paper describes the methodology and data sources for these diabetes forecasts and discusses key implications. In short, diabetes will remain a major health crisis in America, in spite of medical advances and prevention efforts. The prevalence of diabetes (type 2 diabetes and type 1 diabetes) will increase by 54% to more than 54.9 million Americans between 2015 and 2030; annual deaths attributed to diabetes will climb by 38% to 385,800; and total annual medical and societal costs related to diabetes will increase 53% to more than $622 billion by 2030. Improvements in management reducing the annual incidence of morbidities and premature deaths related to diabetes over this time period will result in diabetes patients living longer, but requiring many years of comprehensive management of multiple chronic diseases, resulting in dramatically increased costs. Aggressive population health measures, including increased availability of diabetes prevention programs, could help millions of adults prevent or delay the progression to type 2 diabetes, thereby helping turn around these dire projections.

Creating public awareness: state 2025 diabetes forecasts.

The incidence and prevalence of diabetes (primarily type 2 diabetes) has risen sharply since 1990. It is projected to increase another 64% between 2010 and 2025, affecting 53.1 million people and resulting in medical and societal costs of a half trillion dollars a year. We know how to prevent many cases of diabetes and how to treat it effectively. Early appropriate treatment makes a significant difference in preventing major complications and reducing premature death, but it does not cure the disease. Early detection of prediabetes, in conjunction with lifestyle changes, can reduce the number of people with diabetes. A dramatic reduction in diabetes prevalence over time will require significant lifestyle changes on the part of society as a whole. The purpose of this study is to increase public awareness of the severity of regional diabetes trends by providing detailed forecasts for all states and several metropolitan areas for 2010, 2015, and 2025. A model was created to utilize the latest national diabetes and population data and projections, and to transform these into state and metropolitan area forecasts for the whole population and major subgroups. These forecasts were then summarized in easy-to-understand briefing papers for each state and selected metro areas, which are provided online for easy public access. This research is important because little data exist that project the future prevalence and potential costs of diabetes at the state and metro area level. With this data, key stakeholders can make informed decisions concerning diabetes, its impact on their communities, and resource allocation.

Disparities, cancer surveillance, and next steps.

BACKGROUND: Effective cancer surveillance is critical for understanding disparities in current cancer incidence and treatment. The years ahead will see significant changes in how surveillance can be done. METHODS: Scenarios developed for the Cancer Surveillance Futures Project identify 4 paths for the next decade (Growth--Advances in science and technology for health care and cancer control; Stagnation--Hard times, slow and unequal progress on many fronts; Choice--Creating a healthy marketplace for health care; and Transformation--Accelerating cancer control for all). RESULTS AND CONCLUSIONS: In terms of getting to near-term and longer term success with cancer surveillance, the Intercultural Cancer Council and C-Change have made several recommendations including consistent collection of socioeconomic status, risk factors, and treatment information as well as community involvement in collecting cancer information and developing cancer control approaches, developing data standards, and broadening cancer surveillance to include treatment quality, risk factor data, and preneoplastic events.

The future of patient-centered care: scenarios, visions, and audacious goals.

The U.S. health care system is transforming. It must. Patient-centered care (PCC) is a core quality that the system should include. This article presents the highlights of a project on the future of PCC created for the Picker Institute. As an example of futures work, this project developed four images or stories of what might happen, as well as a vision and audacious goals for what should happen to PCC. The first and most likely scenario is an increase in patient-centeredness as a function of current trends. However, in the second scenario, health care could become even more stressed and leave PCC behind as it seeks to lower cost without focusing on quality. The third scenario envisions more excellent systems that integrate PCC seamlessly into their work. The fourth scenario sees collaboration and shared responsibility, in association with advanced information tools, thereby enabling PCC to contribute to preventing illness and lowering health care costs. The scenarios indicate that the patient-centeredness of health care could improve slightly, stall, or advance significantly. The PCC Vision calls for each of us to be in charge of our health, and to get the care we need (not less and not more) in timely, effective, and personal ways consistent with our values. The audacious goals set an agenda with priorities from the PCC community. These include shared decision making by consumers, ensuring health care professionals are trained in supporting active patients, anticipating health and long-term care needs for individuals, adopting the Institute of Medicine's (IOM) simple rules for health care, and making the patient perspective a priority in policy and planning. Each of us and our organizations are confronted with the challenge of this vision and audacious goals. Health care professionals and provider systems, whether conventional or alternative in nature, face these issues. While complementary and alternative medicine (CAM) providers often get higher marks from consumers for their attention, many CAM modalities are largely provider-determined. Patient-centered care will require more empowerment and activation of patients and consumers.

Atención a la salud en América Latina y el Caribe en el siglo XXI. Perspectivas para lograr salud para todos / 21st Century health care in Latin America and the Carribean. Prospects for achieving Health for All

Explora las posibilidades de lograr cambios favorables en los sistemas de atención a la salud de América Latina y el Caribe y de alcanzar una Salud para Todos en el siglo XXI. Contenido: Futuros de la salud : herramientas para una mejor toma de decisiones; Desarrollo económico y social y Salud para Todos; La revolución informativa y la atención a la salud en Chile; El futuro de terapéutica; Tendencias futuras de la vacunología; La genómica: promesas y las precauciones a tomar en la aceleración de la calidad de la prevención; el diagnóstico, el tratamiento y la curación; El futuro de los fármacos y de su regulación en América Latina; Los sistemas de salud latinoamericanos en transición: una visión para el futuro; El futuro de la atención gerenciada en América Latina; Salud para Todos en las Américas: el escenario preferido; ¿Qué significa todo esto? El sector privado, el sector público y Salud para Todos