The obesity epidemic has caused a tenfold increase in the nation's private health insurance bill for conditions related to being overweight, according to a self-funded study by researchers with the Emory University Rollins School of Public Health published today in the online version of the journal Health Affairs. According to the study the cost of treating conditions linked to obesity increased from $3.6 billion to $36.5 billion between 1987 and 2002. The study concludes that the best way to lower healthcare spending is to target the rise in population risk factors -- especially obesity.
The team of Emory researchers led by Kenneth E. Thorpe, PhD, Woodruff Professor and chair of the Department of Health Policy and Management, Rollins School of Public Health, found that a rise in the number of cases treated, not a rise in the cost per treated case, is the primary factor responsible for the growth in private healthcare spending. Linked to the increased prevalence of treated cases is the substantial rise of privately insured obese adults. In 2002, 24 percent of privately insured adults were classified as obese, compared to 12.6 percent in 1987.
After examining the change in the number of the insured obese adults, the study team also found that the cost of obesity was compounded because the difference in healthcare spending between obese and normal weight individuals had also increased dramatically in the same time period. The difference in per person spending had increased from $272 more for obese adults in 1987 to $1,244 in 2002.
"Current approaches to controlling healthcare costs are not working because they ignore the true drivers of those costs," Dr. Thorpe says. "Increases in the number of people getting treatment for serious health problems like diabetes, heart disease, high cholesterol, and mental disorders are directly linked to population increases in obesity. If insurers and employers are serious about reigning in health care spending, then obesity prevention should be at the top of their agenda."
Dr. Thorpe and his colleagues analyzed 20 medical conditions that accounted for the largest portion of the rise in private healthcare spending between 1987 and 2002. The 20 conditions accounted for 67 percent of healthcare spending in 2002, up from 42 percent in 1987. For 16 of those conditions, the increase in the number of people receiving treatment -- rather than rising treatment costs per patient -- accounted for over half of the growth in health care spending. In 1987, 8.7 percent of obese adults were treated for six or more of the most costly medical conditions, compared to 15.5 percent of obese adults in 2002. Conditions clinically linked to obesity dramatically increased during the same time period. For example, the treated prevalence of diabetes rose 64 percent and hyperlipidemia increased five-fold.
Although the study points to obesity as the prominent population risk factor, the study also noted the impact of environmental factors such as air pollution, ozone levels, and exposure to aeroallergens that contribute to respiratory diseases.
The data for the study analysis was drawn from the 1987 National Medical Expenditure Survey (NMES) and the 2002 Medical Expenditure Panel Survey (MEPS). Among adults (18-64) identified as privately insured, the sample sizes were 13,974 for the NMES and 14,091 for the MEPS.
Other researchers involved in the study were Curtis Florence, PhD, and David Howard, PhD, assistant professors in the Department of Health Policy and Management, Rollins School of Public Health; and Peter Joski, research associate.