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Obesity, Prevention, and Health Care Costs

Obesity, Prevention, and Health Care Costs

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For Campaign 2012, Ross Hammond prepared a response to Alice Rivlin's policy brief proposing ideas for the next president on America’s health care system. Hammond argues that the next president must address the nation’s obesity epidemic by renewing prevention efforts, increasing investment in public health research and better coordinating America’s public health policy.
For Campaign 2012, Ross Hammond prepared a response to Alice Rivlin's policy brief proposing ideas for the next president on America’s health care system. Hammond argues that the next president must address the nation’s obesity epidemic by renewing prevention efforts, increasing investment in public health research and better coordinating America’s public health policy.

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categoriesTypes, Research
Published by: Brookings Institution on May 21, 2012
Copyright:Attribution Non-commercial

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Obesity, Prevention, andHealth Care Costs
Alice Rivlin highlights the twin health care challengesfacing America and the next president: covering the uninsuredwhile curbing unsustainable increases in health care costs andtheir impact on the debt. She provides a compelling argumentfor how to address these challenges through health carelegislation. I would like to focus here on the role that investmentin
public health 
and
prevention 
can play as a complementarystrategy for controlling health care spending.Perhaps the most pressing public health challenge for theUnited States today is the epidemic of overweight and obesity,which is linked to an array of costly and debilitating healthconsequences. According to data from the National Center forHealth Statistics, two in three American adults are nowoverweight, including one in three who are obese. A recentstudy also found that almost one-third of children andadolescents are overweight or obese. These rates are evenhigher among ethnic minorities, rural populations, and thosewith low income or education. The health risks associated withobesity reported by the Institute of Medicine include a muchhigher incidence of cardiovascular disease, diabetes, several
AUTHOR
Ross A. Hammond
Senior Fellow,Economic StudiesDirector,Center on Social Dynamicsand Policy
 
 
2
cancers, hypertension, high cholesterol, asthma, osteoarthritis, and liver disease.Not surprisingly, then, the obesity epidemic is a major driver of health care costs inthe United States, and the costs may continue to increase significantly in the future if it isnot controlled. The increased health risks for major disease that come with obesity carrynot only a high social price tag but also a high economic one
relative medical costs forthe obese are estimated to be 36 to 100 percent higher than for Americans of healthyweight. A 2009 study found that childhood obesity alone is responsible for $14.1 billion indirect medical costs annually. By some estimates,
nearly 21 percent of 
 
all current medical spending 
in the United States is now obesity related. A significant proportion of thesemedical costs is paid by Medicaid and Medicare, and one recent analysis concluded thattotal Medicaid spending would be almost 12 percent lower in the absence of obesity.Beyond direct medical spending, additional costs from obesity are driven by increasedrates of disability and by reduced productivity.The impact of obesity on health care spending is likely to increase in the comingyears unless further preventative steps are taken. Although recent data suggest thatobesity rates may now be leveling off after a period of very rapid growth, the epidemic inchildren is especially worrisome because most obese children become obese adults.Childhood obesity means more chronic disease will begin earlier in life for more people
driving up lifetime costs considerably. For example, type 2 diabetes (for which obesity is aparticularly strong risk factor) occurred primarily in adults until recently, but the Centers forDisease Control report that it is now beginning in childhood for more Americans. A recentreport in the
Journal of the American Medical Association 
estimates that one-third of allchildren born in the United States today (and one-half of all Latino and African Americanchildren) will develop type 2 diabetes in their lifetime. Even if the epidemic does notworsen, these costs are likely to prove an unsustainable burden on the health systemgiven the long-term growth of the federal debt.Keeping the costs of obesity from overwhelming the health care system will requirea renewed focus by the next president on
obesity prevention 
. This has the potential tocontain costs much more effectively than the mere treatment of obesity-related chronichealth conditions. Early childhood can be an especially important period
once obesitydevelops, a powerful set of physiological processes and behavior patterns make itchallenging to reverse. From the perspective of health care costs, early prevention canproduce substantial savings. According to an analysis in the
American Journal of Public 

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