The financial burden of overweight and obesity among elderly Americans: the dynamics of weight, longevity, and health care cost.
ABSTRACT To investigate the financial burdens attributed to overweight and obesity on the U.S. health care system among elderly Americans.
Longitudinal Cost and Use files of the Medicare Current Beneficiary Survey from 1992 to 2001.
We constructed a simultaneous equation system to model the dynamic relationship between changes in body weight, chronic diseases, functional status, longevity, and health care expenditures using maximum likelihood estimation. Based on the estimation, we conducted a simulation of one cohort with different baseline weights at age 65 and followed to death or up to age 100 of their health outcomes and lifetime health care expenditures.
The elderly men who were overweight or obese at age 65 had 6-13 percent more lifetime health care expenditures than the same age cohort within normal weight range at age 65. Elderly women who were overweight or obese at age 65 spent 11-17 percent more than those in a normal weight range. Both elderly men and women who were overweight or obese at age 65 had worse health outcomes than the normal weight cohorts. The average body mass index among survivors decreased by age.
Overweight and obesity could place significant financial burdens on the U.S. health care system.
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ABSTRACT: To examine in an older population all-cause and cause-specific mortality associated with underweight (body mass index (BMI)<18.5), normal weight (BMI 18.5-24.9), overweight (BMI 25.0-29.9), and obesity (BMI> or =30.0). Cohort study. The Health in Men Study and the Australian Longitudinal Study of Women's Health. Adults aged 70 to 75, 4,677 men and 4,563 women recruited in 1996 and followed for up to 10 years. Relative risk of all-cause mortality and cause-specific (cardiovascular disease, cancer, and chronic respiratory disease) mortality. Mortality risk was lowest for overweight participants. The risk of death for overweight participants was 13% less than for normal-weight participants (hazard ratio (HR)=0.87, 95% CI=0.78-0.94). The risk of death was similar for obese and normal-weight participants (HR=0.98, 95% CI=0.85-1.11). Being sedentary doubled the mortality risk for women across all levels of BMI (HR=2.08, 95% CI=1.79-2.41) but resulted in only a 28% greater risk for men (HR=1.28 (95% CI=1.14-1.44). These results lend further credence to claims that the BMI thresholds for overweight and obese are overly restrictive for older people. Overweight older people are not at greater mortality risk than those who are normal weight. Being sedentary was associated with a greater risk of mortality in women than in men.Journal of the American Geriatrics Society 02/2010; 58(2):234-41. · 3.74 Impact Factor
Article: Body Weight Outcomes and Food Expenditures Among Older Europeans: A simultaneous equation approach[show abstract] [hide abstract]
ABSTRACT: We analyze the inter-relationships between body weight outcomes and food expenditures among older Europeans using a simultaneous equation model. Several statistical tests were conducted to assess endogeneity of selected variables, the exogeneity, relevance, and validity of instruments used, and the identification of the model. Our results generally suggest, contrary to normative views, that food-away-from-home expenditure is negatively related to body mass index (BMI). BMI is negatively related to the percentage of food spent away from home.European Association of Agricultural Economists, 113th Seminar, September 3-6, 2009, Chania, Crete, Greece. 01/2009;