Emory Report
November 8, 2004
Volume 57, Number 11


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November 8, 2004
Study: Obesity hikes U.S. health care spending by 27%

BY Tia Webster

Rising obesity rates alone accounted for 27 percent of the growth in health spending from 1987–2001, according to a study by Emory health policy researchers. Published in the Oct. 20 issue of Health Affairs, the article attributes the increase mainly to treatment costs for the obesity-related conditions of diabetes, hyperlipidemia and heart disease.

A team of researchers led by Kenneth Thorpe, professor and chair of health policy and management in the Rollins School of Public Health, examined the contribution of obesity-related factors to growth in spending for three conditions clinically linked to obesity. Over the 14-year period—a time when the prevalence of obesity increased to nearly 24 percent of the population—the obesity trend accounted for more than 38 percent of diabetes spending growth, 22 percent of spending growth for hyperlipidemia and 41 percent for heart disease.

“The impact of weight on per capita spending is sizable,” Thorpe said. “Although we attributed the growth in health care spending to three of the major conditions, spending also is affected by the rising prevalence of gallstones, some forms of cancer, and other obesity-linked diseases.”

Data for the study were drawn from two surveys conducted by the Agency for Healthcare Research and Quality (AHRQ) that provide nationally representative estimates for health care spending for the U.S. population.

Using the 1987 National Medical Expenditure Survey (NMES), the researchers calculated the body mass index (BMI) of respondents according to their self-reported measures of height and weight and compared it to calculations of BMI reported by respondents of the 2001 Medical Expenditure Panel Survey, Household Component (MEPS-HC). Respondents to both surveys also self-reported medical conditions. Among adults, the sample sizes were 20,989 for the NMES and 21,460 for the MEPS.

“Growth in obesity and spending on obese people accounted for 27 percent of the growth in inflation-adjusted per capita health care spending between 1987 and 2001,” the researchers wrote. “To date, there is no evidence that the rise in the share of the U.S. population with [elevated] BMI … is abating. These results suggest that future cost-containment efforts need to attack the rising prevalence and costs of obesity head on.

This will require a focus on developing effective interventions to promote weight loss among obese people.”
The researchers found significant differences in mean per capita health care spending between the obese and normal weight categories in 1987 and 2001. Among the differences:
• the estimated per capita health care spending in 1987 (based on 2001 dollars) of $2,188 overall, with obese people speanding 15.2 percent more per capita than normal-weight people.
• the year 2001 brought larger differences in health care spending by weight category. Spending among the obese shot to 37 percent higher than among normal-weight people.

Other researchers involved in the study were Curtis Florence and David Howard assistant professors of health policy and management, and Peter Joski, a research associate.

The full text of their Health Affairs paper can be found at http://content.healthaffairs.org/cgi/content/abstract/hlthaff.w4.480.