Jun 1, 2024
Combatting cardiodiabesity: Connecting the dots to address one of our most serious health challenges

The convergence of cardiovascular disease, obesity, and diabetes – known as cardiodiabesity – represents a serious health challenge in the United States. The impact of these conditions poses economic and psychological burdens on individuals, families, caregivers, and employers – particularly in underserved communities.

Addressing cardiodiabesity means continuing to focus on interventions and solutions while recognizing and addressing social determinants of health (SDOH) – the unique environmental conditions where people are born, live, learn, work, and play.

Read on to learn more about cardiodiabesity and how payers, employers, and other health care stakeholders – including Cigna Healthcare – are driving care solutions and taking action through personalized outreach in at-risk communities.

Connecting SDOH and cardiodiabesity

Obesity is the core condition of cardiodiabesity. Obesity continues to increase at an alarming rate within the U.S. population and is tied to the onset of heart disease and type 2 diabetes. Helping patients manage their weight can potentially prevent or reduce each of those conditions, but SDOH factors play a significant role in those outcomes.

One example of how SDOH directly impacts health, particularly obesity and diabetes, is a lack of access to nutritious food. Healthy, safe, and affordable food is essential for overall health but is often challenging to find in underserved communities. Nearly 13% of U.S. households – 17 million in total – experienced food insecurity in 2022.

In addition, treatment plans for obesity and other conditions sometimes fail because they often don’t consider SDOH barriers like lack of access to transportation, food insecurity, and time constraints, such as when people must work multiple jobs.

The far-reaching financial burden of cardiodiabesity

Separately or as comorbidities, cardiovascular disease, diabetes, and obesity also create a huge economic burden. The total annual cost of obesity in the U.S. is estimated at $173 billion, while the total annual cost of cardiovascular disease is estimated at $219 billion. And at an estimated $327 billion, the total annual cost of diabetes is even higher. This puts a significant financial strain on patients, families, health care providers, and the national economy. Research from the Evernorth Research Institute found that identifying cardiodiabesity when disease progression is preventable or can be managed in a primary care  setting is the key to bringing down costs.

Insurers, employers – and the entire health care system – bear this burden. In addition to the direct costs of caring for people with cardiodiabesity, employers incur other substantive costs, like loss of productivity and covering the high-priced diabetes and obesity medications such as GLP-1s now on the market.

According the aforementioned study by Evernorth Research Institute, care costs for patients with active cardiodiabesity increased when they had multiple cardiodiabesity conditions. Compared with patients diagnosed with one of those conditions, the average annual total cost of care per year was 53% higher for patients diagnosed with two conditions and 141% higher for patients diagnosed with all three.

What’s working: Personalizing community outreach

When zeroing in on the relationship between SDOH and cardiodiabesity, researchers have found that culturally competent community outreach and assistance can help lead to improvements in diet quality, among other factors. And these improvements are strengthened when employers become key players in health care.

Offering employees guided access to quality health care through personalized outreach is an essential strategy to address obesity and diabetes within at-risk populations. For example, community health workers can provide guidance and encouragement to support people’s improved health outcomes and help them make sustainable lifestyle changes.

Cigna Healthcare is piloting a community health worker diabetes management program, which offers personalized support in-person and virtually. Customers living with diabetes are paired with care advocates from their community who understand their cultural nuances, which nurtures productive, personalized conversations. These health workers also connect customers to benefits, services, support, and resources that help pave the way for better health outcomes. The in-person pilot is currently underway in Memphis, Tennessee, and Houston, Texas.

Initial results are promising. Many participants have seen reductions in their weight, A1C levels, and cholesterol levels. Equally important is that they appreciate the personalized support from people who understand their journeys, their cultures, and their communities.

Innovative solutions that are making a difference

One participant in the community health worker pilot hadn’t sought treatment previously because he felt his providers showed a lack of empathy. In contrast, he said the pilot program was "sent from heaven" and gave him "the angels he needed." He is grateful for having someone by his side – someone who cares about him – as he undergoes his personalized treatment journey.

Evernorth, the health services division of The Cigna Group, offers products and solutions to help patients with cardiodiabesity. A newly enhanced offering, EncircleRx, now protects employers with the first-ever GLP-1 financial guarantee. Patients can get support through digital lifestyle programs, especially those that provide relationship-based support, to promote healthy habits for long-term weight management.

Innovative, whole-person solutions that consider SDOH factors, like accessibility challenges to getting quality care or nutritious healthy food, along with the individual’s specific condition, can help improve health outcomes and reduce the economic burden on providers, employers, and the entire health care ecosystem.

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