The Economic Impact of Obesity in the South: Assessing Medical Spending Attributable to Obesity
Research Center: Southern Rural Development Center, Mississippi State University
Investigator: Kolbo, Jerome R., Amal Khoury, and Wendy Bounds
Institution: University of Southern
College of Health and Human Sciences
University of Southern Mississippi
Hattiesburg, MS 39406
The study objectives were to:
Two nationally representative data sets were used to develop cost estimates:
the Medical Panel Survey (MEPS) and the National Health Interview
Surveys (NHIS). MEPS is conducted by the Agency for Healthcare
Research and Quality (AHRQ). It is a nationally representative survey of
civilian non-institutionalized population that collects data about people's
healthcare utilization and annual medical spending, including the percentage
of spending by out-of-pocket and third-party payers. MEPS contains information
about insurance status, region (Northeast, Midwest, South, and
West), and sociodemographic variables.
- Determine the prevalence of overweight and obesity among adults
in the Southern Region of the United States
- Estimate the increase in adult per capita medical spending attributable
to overweight and obesity
- Assess overweight and obesity related healthcare expenses (both
in dollars and as a percentage of total spending)
- Analyze costs by payer group and sociodemographic groups.
Assessing medical expenditures related to overweight and obesity in the
Southern Region can inform policy for food and nutrition assistance
programs and strategies to address weight loss and prevent weight gain. In
addition, state health departments may use the information to develop new
prevention programs appropriate for their populations.
The sampling frame was derived from linking the 1996-2000 MEPS public
use file to the records of the same persons in the appropriate years of the
NHIS. Height and weight data, necessary to calculate Body Mass Index
(BMI), were available for a subset of adult NHIS participants and were
merged with the MEPS data. The final sample included adults nineteen
years of age and older residing in the Southern Region with weighting variables
that allowed generation of regionally representative estimates.
Excluded from the analysis were those in the MEPS/NHIS population
missing height and weight data, which included all individuals under 18 at
the time of the NHIS interview and pregnant women.
A four-equation regression approach was used to predict annual overweightand
obesity-attributable medical spending. Variables representing the four
BMI categories (underweight, normal, overweight, and obese) were included
in the regressions to predict their impact on annual medical spending. All
regressions controlled for age, sex, race/ethnicity, income, education, and
marital status. Insurance status (i.e., private, Medicaid, Medicare, uninsured)
was included to estimate the increase in annual medical spending attributable
to overweight and obesity for each insurance category. Prevalence rates were
combined with per capita spending estimates, and the percentages of aggregated
expenditures attributable to overweight and obesity were computed.
Based on the data analysis, overweight and obesity are pervasive in the
Southern Region; prevalence rates are increasing; associated medical costs
are significant; expenditures vary by age, gender, race, and payer group;
rates are highest among those receiving public assistance; and the greatest
increases in expenditures are among private and out-of-pocket payers.
This research provides the first estimates of obesity-related medical costs in
the Southern Region. The results can be used to estimate cost savings associated
with incremental reductions in the prevalence of obesity in the south.
Trends in obesity-related medical spending over time could be determined by
comparing future estimates of spending with baseline data from this study.
Findings may be used to develop obesity-related programs by public agencies,
private health plans, and employers. Findings may guide policymakers
who determine the distribution of limited resources to address obesity
prevention or develop policies for food and nutrition assistance programs.
Since some of these programs are a source of nutrition education for lowincome
families, they may play a role in the prevention of obesity.