The burden of neurological disease in the United States: A summary report and call to action

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As the expense of health care in the United States rises toward unsustainable levels, we have entered a new age of cost justification in which the prevalence, morbidity, and disability of the diseases we treat are becoming critical to the continued allocation of fiscal resources toward neurological care and research. The return on the considerable investments in cardiovascular disease and cancer research over the past few decades has yielded remarkable therapeutic benefits for those diseases, dramatically increasing overall health and survival. However, less investment has been made in overcoming neurological disorders, and therefore therapeutic gains have been correspondingly limited. Ironically, the burgeoning number of elderly citizens resulting from decreases in the mortality of cardiovascular disease and cancer is producing unprecedented numbers of people affected by neurological disease, because neurological disease is so much more prevalent in the elderly.1 As of 2011, nearly 100 million Americans were afflicted by at least one of the >1,000 neurological diseases.2 Although mortality is often the primary outcome measure in many research studies, the cost and societal impact of diseases are largely determined by the disability they cause; consequently, nearly 50% of the total health burden in the United States is due to morbidity and disability. This is particularly true of neurological disorders, and the years lost to disability from neurological and musculoskeletal disorders is greater than that of all other categories of disease.5
In this editorial, we provide a summary overview of the substantial current and future economic impact of neurological disease, and provide an action plan for reducing this burden through neurological research and enhanced clinical management of neurological disorders in the United States.
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