An Unhealthy America: The Economic Burden of ... - Milken Institute

An Unhealthy AmericaMilken InstituteImportance of Behavioral and Environmental Risk Factors: Spotlight on Obesityand SmokingWe find that the single most important way to reduce the burden of disease and reduce costs to society is toreduce obesity, closely followed by continuing to achieve reductions in smoking prevalence. Obesity is a key riskfactor for many diseases and a key contributor to disability. For example, a RAND study finds that if obesity trendscontinue unchecked, disability rates will climb across all age groups, offsetting past reductions in disability. 23 RANDestimates that if current trends continue, one-fifth of health-care expenditures would be devoted to treating theconsequences of obesity by 2020.Based on our analysis, if the country could reverse the growth rate of obesity and return to 1998 levels in 2023, theimpact would be close to 15 million fewer reported cases compared to baseline (a reduction of 14 percent) of theseven diseases studied. This would translate to a reduction in health-care spending of $60 billion and an increasein productivity of $254 billion, and account for a large proportion of the overall economic impact.Lower obesity rates have the largest effect in reducing the total number of cases for hypertension (5.7 million, or12 percent). They could reduce reported cases for heart disease by 4.4 million (20.4 percent) and for diabetes by2.8 million (13.3 percent). Reducing obesity would result in the largest percent decline in the total number ofprostate cancer cases (up to 22 percent).Figure 14 displays the differences in total treatment costs and lost economic output between the two scenariosattributable to obesity versus other factors. (Note that the total avoidable costs reflected in figure 14 are lowerthan those described elsewhere in this report because they exclude avoidable-cost growth related to assumptionsabout differences in the growth of health-care costs.) We are showing the avoidable costs that are attributable tofewer cases of these chronic diseases so that they can be linked back to their underlying causes.The lowered obesity assumption in the optimistic scenario reduces treatment expenditures and improvesproductivity for hypertension by a combined $100.1 billion ($8.9 billion and $91.2 billion, respectively), the largestabsolute impact. This is followed by cancer, at $84.6 billion (treatment expenditures of $12.4 and higher productivityof $72.2); heart disease at $73.2 billion ($27.6 billion for treatment expenditures and $45.6 billion for productivity);diabetes at $52.4 billion ($9.6 billion for treatment expenditures and $42.8 billion for productivity); and stroke at$3.3 billion ($1.2 billion for treatment expenditure and $2.1 billion for productivity).[ 22 ]