THE ASSOCIATION BETWEEN BODY-MASS AND HEALTH-CARE EXPENDITURES

With several studies estimating the health care costs attributable to obesity-related medical conditions, the economic consequences of being overweight are beginning to come into focus. The present study comple ments this growing body of literature by directly estimating health ca re costs across a broad range of body mass index values. Data were obt ained from the 1987 National Medical Expenditure Survey (NMES) public use data tapes and retrospective analyses conducted on NMES Household Survey data only. The analyses included a total of 16,217 individuals between the ages of 18 and 65. Four classes of health care utilization and expenditures were derived using the NMES data: (1) use of any hea lth care service and total health care expenditures, (2) use of inpati ent services and inpatient expenditures, (3) use of outpatient service s and outpatient expenditures, and (4) use of prescription medication and medication expenditures. Estimates based on our findings suggested strong relationships between body mass and the likelihood of using he alth care services and between body mass and average annual health car e expenditures for both men and women. Increased body mass was associa ted with in creased expenditures. However, this association was greate r among males than among females and did not hold for individuals in t he lowest body mass category. Ideal body mass was associated with 6.3% to 36.1% lower annual health care expenditures among females and 3.6% to 18.2% lower health care expenditures among males. The results of t his set of analyses suggest that health care expenditures increase as weight deviates from the ideal-that is, health care expenditures among both underweight and overweight individuals in the United States were increased in relation to ideal weight. Separate analyses including we ight-related diseases such its diabetes and hypertension indicated tha t body mass increased health care expenditures largely by increasing t he risk for these costly chronic medical conditions.