January 21, 2004

Researchers Estimate States Spend Billions in Medical Costs of Obesity

Media Contacts

Research Triangle Park, NC -- Researchers from RTI International and the Centers for Disease Control and Prevention (CDC) estimate that states spend as much as $75 billion a year in medical expenditures related to obesity. In a report published in this month's edition of Obesity Research, the economists provide the first state-by-state estimates of obesity-attributable medical expenditures. The report also provides rough estimates of the share of obesity expenditures in each state that are funded by taxpayers through Medicare and Medicaid.

Total state-level estimates in 2003 dollars range from $87 million (Wyoming) to $7.7 billion (California). Obesity-attributable Medicaid expenditures range from $23 million (Wyoming) to $3.5 billion (New York), and Medicare expenditures range from $15 million (Wyoming) to $1.7 billion (California).

"This report further drives home the point that we must stem the tide of the obesity epidemic in this country," said Department of Health and Human Services Secretary, Tommy G. Thompson. "These findings are a dramatic illustration of the devastating economic impact obesity has on health care delivery systems across the nation," Thompson said.

The percentage of annual medical expenditures in each state attributable to obesity ranges from 4 percent (Arizona) to 6.7 percent (Alaska). For Medicare expenditures, the percentage ranges from 3.9 percent (Arizona) to 9.8 percent (Delaware). For Medicaid recipients, the percentages are much higher, ranging from 7.7 percent (Rhode Island) to 15.7 percent (Indiana). The higher percentage of Medicaid expenditures attributed to obesity results from the higher prevalence of obesity among Medicaid recipients.

"These estimates of obesity-attributable medical expenditures present the best available information concerning the economic impact of obesity at the state level," said Eric A. Finkelstein, RTI economist and lead author of the paper. "Policy makers should consider these estimates, along with other factors, in determining how best to allocate scarce public health resources," Finkelstein said.

The figures confirm earlier findings that obesity accounts for a significant, and preventable, portion of the nation's medical bill, and highlight the role of the states in financing these costs. Finkelstein and his colleagues caution that the estimates should not be used to make cost comparisons across states or between payers because the state-level estimates are associated with large standard errors influenced by many variables within each state.

In another paper published in the journal Health Affairs last May, the same authors estimated national costs attributable to both overweight and obesity to be $93 billion (2002 dollars). The state-by-state analysis focuses solely on obesity. (http://content.healthaffairs.org/cgi/content/full/hlthaff.w3.219v1/DC1)

"These reports are particularly alarming given that obesity has been shown to promote many chronic diseases, including type 2 diabetes, cardiovascular disease, several types of cancer (endometrial, postmenopausal breast, kidney, and colon cancer), musculoskeletal disorders, sleep apnea, and gallbladder disease," said Dr. Julie Gerberding, director of CDC. "The long-term effects of obesity on our nation's health and on our economy cannot be underestimated," Gerberding said.

According to CDC's 1999-2000 National Health and Nutrition Examination Survey, which is based on measured heights and weights, an estimated 64 percent of U.S. adults are either overweight (33 percent) or obese (31 percent). Another CDC survey, the Behavioral Risk Factor Surveillance System (BRFSS) revealed data that self-reported obesity prevalence by state ranges from 15 percent in Colorado to 25 percent in West Virginia. Among Medicare recipients, obesity prevalence ranges from 12 percent (Hawaii) to 30 percent (Washington, DC). Obesity prevalence among Medicaid recipients is much higher, ranging from 21 percent (Rhode Island) to 44 percent (Indiana).

State-Level Estimates of Annual Medical Expenditures Attributable to Obesity, by Eric A. Finkelstein and Ian C. Fiebelkorn, RTI International, and Guijing Wang, Centers for Disease Control and Prevention, appears in the January 2004 edition of the journal Obesity Research, published by the North American Association for the Study of Obesity. Copies of the paper are available from the journal's web site (http://www.obesityresearch.org/) beginning January 23, 2004.

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