Health & Social Policy

Trimming Waistlines … and Expenses

The United States of America: The nation that produced Coca-Cola, McDonald’s, and Southern fried chicken … and an extraordinarily high prevalence of obesity.

According to the Centers for Disease Control, in 2009 the state with the lowest percentage of obese adults was Colorado – and Colorado still had 18.6 percent prevalence of obesity, defined as a body mass index of 30 or more. Beyond Colorado, 33 states had a prevalence of obese adults of 25 percent or more. Nine states reach even scarier heights, with 30 percent or more of adults in those states falling into the category of obese.

As absurd as those percentages look, the racial makeup of obesity in the United States is even more appalling. Looking at data from 2006 to 2008, the CDC discovered that prevalence of obesity among blacks was on average 51 percent higher than among whites, and among Hispanics obesity was on average 21 percent more prevalent than among whites.

Obesity is linked to higher risk for a grocery list of conditions, including heart disease, diabetes, certain types of cancers, high blood pressure, cholesterol problems, strokes, liver disease, respiratory disease, osteoarthritis and even gynecological problems. Consider this information in light of health insurance statistics. In 2009, 12 percent of non-Hispanic whites were uninsured, according to a study done by the U.S. Census Bureau. In the same year, 21 percent of blacks and 32.4 percent of Hispanics were uninsured.

Percentages of people with health insurance will change in the coming years, given the emphasis of the new health care plan on universal health insurance. However, during the debates leading up to the passage of the bill, it was estimated that the accepted bill would still result in 18 million people without insurance. The price tag associated with high rates of obesity in minorities in the United States is enormous, especially when compounded with high rates of uninsured families.

What does this price tag look like? The CDC did a study to estimate the cost of obesity from 1996 to 1998, at which time all states’ obesity prevalence fell into the 10 to 19 percent range, far below current rates.  At the national level, it was estimated that between $26.8 million to 47.5 million was being spent on medical bills attributable to obesity. Between $13.5 million and $24.5 million of this spending came from Medicaid or Medicare.

State level costs were examined from 1998 to 2000 – still a time period with lower obesity prevalence than today. All states’ costs combined, obesity cost $75 billion, $39 billion of which was Medicare or Medicaid spending.

Whipping our health spending into shape is essential, especially as the new health care plan is rolled out piece by piece. States and the federal government alike need to think of creative policies to decrease obesity, especially among minorities. I believe that the emphasis on free preventive care in our new health care system can help, but changing the lifestyles of children will be most effective way to combat the growing waistlines in the United States.

Obesity in low-income children is already being addressed through policies regulating school nutrition. Another policy option would be to increase the amount of exercise in public school curricula. This could be difficult, as it would require teachers and equipment to institute, but could be extremely productive in training children for a healthy lifestyle.

Nutrition education for mothers could be very effective in changing obesity trends among children, and possibly even among adults. Nutrition education is already in place through a variety of services and nonprofits, but needs to be reformulated. These classes on nutrition education should focus not only on how to eat healthy and what children should avoid eating, but also teach them how to eat healthy on a limited budget and with limited time.

Mothers who are working may not believe they have the time to cook a healthy meal for their children, leading them to resort to unhealthy meals from fast food restaurants or frozen dishes with a high amount of fat and cholesterol. Low-income families may also not be aware of how to eat healthy without spending too much money, and eat diets that are high in carbohydrates and fat but cheap to purchase and assemble. Clear instruction and guidance on how healthy eating can fit in with any allotment of time and money could increase nutritional standards and health not only for children, but also for their families.

We cannot continue to ask our health care system and taxpayers to absorb the costs associated with rising obesity rates, and we must institute creative policies to turn the tide and decrease obesity in future generations.

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