Health risks, obesity interact to raise medical costs
02/06/04
By Aaron Levin, Science Writer
Health Behavior News Service
The survey covered a dozen potential health risks, ranging from physical activity, stress and blood pressure to cholesterol, smoking, seat-belt use and others.
“Medical costs and the prevalence of diabetes were each lower when the numbers of additional health risks were lower, regardless of [weight] category,” says lead researcher Shirley Musich, Ph.D., of the University of Michigan. “Reducing health risks within any weight category could provide an alternative strategy to achieve medical cost savings and a lower prevalence of diabetes.”
The study team included others from the university as well as representatives from General Motors and the United Auto Workers. The findings appear in the January/February issue of the American Journal of Health Promotion.
The researchers first ranked the participants by body mass index, a measure relating height and weight: below normal (BMI under 18.5); normal (BMI 18.5 to 24.9); overweight (BMI 25 to 29.9); and two levels of obesity (BMI 30 to 34.9 and BMI 35 and over). Then they counted the number of health risks for each participant in each weight class and compared that information with average annual medical charges from 1996 to 2000. They also analyzed how many people in each BMI category reported having diabetes.
They next compared numbers of health risks to medical charges incurred by the participants. The charges included both medical services and prescription drugs recorded under the company’s health plan. Less than 1 percent of the workers had no charges at all during the study period.
Within each BMI category, medical costs increased with additional health risks, says Musich. “Overall, medical charges increased significantly across risk levels from $3,094 for those with zero risks to $7,289 for those with four or more risks.”
Costs rose not only with the number of health risks, but also with weight, as reflected in BMI. In the “normal” group, the healthiest BMI category, a person with no health risks incurred annual charges of $2,655, but someone in the same weight range with four or more risks accrued an average of $6,555 per year.
On the other hand, a very obese person (BMI 35 or more) with zero risks used $4,151 in medical charges, but $8,075 with four or more risks.
Type 2 diabetes also increased significantly within each BMI category as health risks increased. Among the entire study population, the diabetes rate was 4.3 percent. However, only 2.6 percent of those with zero risk reported diabetes, compared to 7.3 percent of those with four or more risks. (The national diabetes rate is 6.3 percent among all ages.)
With one exception, both medical charges and diabetes rates rose with weight and with the number of risks. The exception was the “below normal” weight class, where medical costs and diabetes rates were higher than those in the normal weight category, Musich says.
“Improving risk levels at any weight would benefit the individual by reducing medical services, which are really a reflection of pain and suffering,” Musich says. “Since weight loss programs have low rates of long-term success, a strategy focused on these ‘other’ health behaviors could provide an alternative approach to improving overall health risk levels, regardless of weight levels.”
Funding for this project came from corporate consortium funds at the University of Michigan.
Health Behavior News Service: (202) 387-2829 or www.hbns.org.
Interviews: Contact Shirley Musich at (734) 763 2462 or smusich@umich.edu.
American Journal of Health Promotion: Call (248) 682-0707 or visit www.healthpromotionjournal.com.
Center for the Advancement of Health
Contact: Ira R. Allen
Director of Public Affairs
202.387.2829
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