THE HEALTH CARE SYSTEM ON OBESITYKatrina ReevesNorfolk State UniversityHIM 310 Current Trends in Health CareMs. Bernice Sawyer-Watson, Instructor

Obesity is now a epidemic

• Being overweight or obese and their associated health problems have a significant economic impact on the U.S. health care system.

• The medical costs involve both direct and indirect costs.• Direct medical costs may include preventive, diagnostic,

and treatment services related to obesity.• Indirect costs relate to morbidity and mortality costs.

What is Obesity?

• Obesity is an excess proportion of total body fat. A person is considered obese when his or her weight is 20% or more above normal weight. The most common measure of obesity is the body mass index or BMI.

• A person is considered overweight if his or her BMI is between 25 and 29.9; a person is considered obese if his or her BMI is over 30.

• "Morbid obesity" means that a person is either 50%-100% over normal weight, more than 100 pounds over normal weight, has a BMI of 40 or higher, or is sufficiently overweight to severely interfere with health or normal function.

If you are overweight or obese you are more susceptible to develop these problems

• Type 2 Diabetes• Coronary Heart Disease and

Stroke• Metabolic Syndrome• Cancer• Sleep Apnea• Osteoarthritis• Gallbladder Disease• Fatty Liver Disease• Pregnancy Complications

Source: http://www.rochescolumn.com/archivefatamerica.htm

Insurance Category Overweight and Obesity Obesity

MEPS (1998) NHA (1998) MEPS (1998) NHA (1998) Out-of-pocket $7.1 $12.8 $3.8 $6.9

Private $19.8 $28.1 $9.5 $16.1

Medicaid $3.7 $14.1 $2.7 $10.7

Medicare $20.9 $23.5 $10.8 $13.8

Total $51.5 $78.5 $26.8 $47.5

Aggregate Medical Spending, in Billions of Dollars, Attributable to Overweight and Obesity, by Insurance Status and Data Source, 1996–2000

Approximately half of these costs were paid by Medicaid

and Medicare.

• According to a study of national costs attributed to overweight individuals (BMI 25–29.9) and obese individuals (BMI greater than 30), medical expenses accounted for 9.1 percent of total U.S. medical expenditures in 1998 and may have reached as high as $78.5 billion and $92.6 billion in 2002.

State-Level Estimated Costs of Obesity

• A more recent study focused on state-level estimates of total, Medicare and Medicaid obesity attributable medical expenditures Researchers used the 1998 MEPS linked to the 1996 and 1997 NHIS, and three years of data (1998–2000) from the Behavioral Risk Factor Surveillance System (BRFSS) to predict annual state-level estimates of medical expenditures attributable to obesity (BMI greater than 30).

• State-level estimates range from $87 million (Wyoming) to $7.7 billion (California).

• Obesity-attributable Medicare estimates range from $15 million (Wyoming) to $1.7 billion (California), and obesity-attributable Medicaid expenditures range from $23 million (Wyoming) to $3.5 billion (New York).

Being overweight or obese is not only a personal issue that affects one's health but is also a public health issue that impacts other people in society.

Obesity is the second leading cause of preventable death in the U.S. Think about this for a moment, you can die because you are excessively fat which makes you too unhealthy to continue living. What a way to go, isn't it?

The extra demands made of the healthcare system by overweight and obese elderly amounts to Medicare's spending on average an extra $15,000 on overweight elderly individuals and an extra $26,000 on obese individuals.

Most of American’s are overweight and there's no end in sight; to begin with there's a great deal of money in it.

The average percent of individuals reporting being either obese or overweight = 25.0

Determining your health status

• You can use a measurement called a body mass index, or BMI, to decide whether your weight is dangerous to your health. The BMI is a combination of your height and weight.

• If you have a BMI of 30 or higher, your extra weight is putting your health in danger.

• If you are Asian, your health may be at risk with a BMI of 27.5 or higher.

Can you imagine having to purchase and extra-large MRI machine?

• Hospitals have renovated facilities and purchased specialized medical products to care for their increasingly obese patients.

Many different kinds of specialized medical equipment are necessary to handle obese patients:

Bariatric blood pressure cuffs, Bariatric beds and mattresses, Stretchers, Compression stockings, tables, non-clinical furniture, surgical instruments, ID bands, needles, and O.R. tables

The White House Stance

• •USDA, Treasury, and HHS will work with Congress to bring grocery stores and other healthy food retailers to underserved areas by supporting more than $400 million in investments in a Healthy Food Financing Initiative;

• •DOT and EPA will promote walking and biking to school, with a new best practices guide from the DOT-funded National Center for Safe Routes to School and new proposed voluntary “school siting” guidelines from EPA.

• •Federal agencies will also make funds available to local communities, including $25 million from HHS to support obesity prevention and screening services for children, and $35 million in physical education program grants to schools from the Department of Education, which will also be working with Congress to create a Successful, Safe, and Healthy Students initiative as part of a reauthorized Elementary and Secondary Education Act.

Federal agencies will be moving quickly to implement the recommendations in the report that require federal action. In the coming year alone:

•HHS will release new guidance for standards for physical activity and nutrition in child care settings, and help consumers make informed choices at restaurants and grocery stores, by getting calorie counts onto menus and by working with the food and beverage industry to develop a clear, standard “front of pack” food label;

•USDA will update the Dietary Guidelines and Food Pyramid to provide parents and caregivers with helpful information about nutrition, and work with Congress to pass a child nutrition reauthorization bill that improves food in schools;•FTC will continue monitoring how food is marketed to children, with a follow-up study to its 2008 report on industry practices;

REFERENCESCalorie Lab. (2010, June). Health News. Retrieved November 1, 2010, from Calorie Lab: Http://calorielab.com/news/2010/06/28/fattest-states-2010/Centers for Disease Control. (2009, June). Overweight and Obesity. Retrieved November 1, 2010, from CDC.gov http://www.cdc.gov/obesity/causes/economics.html

Everyday Health. (2010, May). Obesity. What is it? Retrieved November 1, 2010, from Everyday Health: http://www.everydayhealth.com/health-center/obesity.aspx

Hobson, K. (2010, June 10). Survey: 28% of Hospitals Renovated Last Year to Accommodate the Obese. Retrieved November 1, 2010, from The Wall Street Journal: http://blogs.wsj.com/health/2010/06/10/survey-28-of-hospitals-renovated-last-year-to-accommodate-the-obese/

The White House. (2010, February 9). White House Task Force on Childhood Obesity Report to the President. Retrieved November 1, 2010, from White House.gov: http://www.letsmove.gov/obesitytaskforce.php

Control Information Network. (2009, April). The National Instiute of Diabetes and Digestive and Kidneys. Retrieved November 1, 2010, from WIN: http://www.win.niddk.nih.gov/index.htm