Politics & Current Events
Dear Community,
Our tech team has launched updates to The Nest today. As a result of these updates, members of the Nest Community will need to change their password in order to continue participating in the community. In addition, The Nest community member's avatars will be replaced with generic default avatars. If you wish to revert to your original avatar, you will need to re-upload it via The Nest.
If you have questions about this, please email help@theknot.com.
Thank you.
Note: This only affects The Nest's community members and will not affect members on The Bump or The Knot.
Our tech team has launched updates to The Nest today. As a result of these updates, members of the Nest Community will need to change their password in order to continue participating in the community. In addition, The Nest community member's avatars will be replaced with generic default avatars. If you wish to revert to your original avatar, you will need to re-upload it via The Nest.
If you have questions about this, please email help@theknot.com.
Thank you.
Note: This only affects The Nest's community members and will not affect members on The Bump or The Knot.
Obesity costs additional $190 billion a year
I know it's not Tuesday.
NEW YORK (Reuters) - U.S. hospitals are ripping out wall-mounted
toilets and replacing them with floor models to better support obese
patients. The Federal Transit Administration wants buses to be tested
for the impact of heavier riders on steering and braking. Cars are
burning nearly a billion gallons of gasoline more a year than if
passengers weighed what they did in 1960.
The nation's rising rate of obesity has been well-chronicled. But
businesses, governments and individuals are only now coming to grips
with the costs of those extra pounds, many of which are even greater
than believed only a few years ago: The additional medical spending due
to obesity is double previous estimates and exceeds even those of
smoking, a new study shows. |
Many of those costs have dollar signs in front of them, such as the
higher health insurance premiums everyone pays to cover those extra
medical costs. Other changes, often cost-neutral, are coming to the
built environment in the form of wider seats in public places from
sports stadiums to bus stops. |
The startling economic costs of obesity, often borne by the non-obese,
could become the epidemic's second-hand smoke. Only when scientists
discovered that nonsmokers were developing lung cancer and other
diseases from breathing smoke-filled air did policymakers get serious
about fighting the habit, in particular by establishing nonsmoking
zones. The costs that smoking added to Medicaid also spurred action.
Now, as economists put a price tag on sky-high body mass indexes (BMIs),
policymakers as well as the private sector are mobilizing to find
solutions to the obesity epidemic. |
"As committee chairmen, Cabinet secretaries, the head of Medicare and
health officials see these really high costs, they are more interested
in knowing, 'what policy knob can I turn to stop this hemorrhage?'" said
Michael O'Grady of the National Opinion Research Center, co-author of a
new report for the Campaign to End Obesity, which brings together
representatives from business, academia and the public health community
to work with policymakers on the issue. |
The U.S. health care reform law of 2010 allows employers to charge
obese workers 30 percent to 50 percent more for health insurance if they
decline to participate in a qualified wellness program. The law also
includes carrots and celery sticks, so to speak, to persuade Medicare
and Medicaid enrollees to see a primary care physician about losing
weight, and funds community demonstration programs for weight loss. |
Such measures do not sit well with all obese Americans. Advocacy groups
formed to "end size discrimination" argue that it is possible to be
healthy "at every size," taking issue with the findings that obesity
necessarily comes with added medical costs. |
The reason for denominating the costs of obesity in dollars is not to
stigmatize plus-size Americans even further. Rather, the goal is to
allow public health officials as well as employers to break out their
calculators and see whether programs to prevent or reverse obesity are
worth it. |
LOST PRODUCTIVITY |
The percentage of Americans who are obese (with a BMI of 30 or higher)
has tripled since 1960, to 34 percent, while the incidence of extreme or
"morbid" obesity (BMI above 40) has risen sixfold, to 6 percent. The
percentage of overweight Americans (BMI of 25 to 29.9) has held steady:
It was 34 percent in 2008 and 32 percent in 1961. What seems to have
happened is that for every healthy-weight person who "graduated" into
overweight, an overweight person graduated into obesity. |
Because obesity raises the risk of a host of medical conditions, from
heart disease to chronic pain, the obese are absent from work more often
than people of healthy weight. The most obese men take 5.9 more sick
days a year; the most obese women, 9.4 days more. Obesity-related
absenteeism costs employers as much as $6.4 billion a year, health
economists led by Eric Finkelstein of Duke University calculated. |
Even when poor health doesn't keep obese workers home, it can cut into
productivity, as they grapple with pain or shortness of breath or other
obstacles to working all-out. Such obesity-related "presenteeism," said
Finkelstein, is also expensive. The very obese lose one month of
productive work per year, costing employers an average of $3,792 per
very obese male worker and $3,037 per female. Total annual cost of
presenteeism due to obesity: $30 billion. |
Decreased productivity can reduce wages, as employers penalize less
productive workers. Obesity hits workers' pocketbooks indirectly, too:
Numerous studies have shown that the obese are less likely to be hired
and promoted than their svelte peers are. Women in particular bear the
brunt of that, earning about 11 percent less than women of healthy
weight, health economist John Cawley of Cornell University found. At the
average weekly U.S. wage of $669 in 2010, that's a $76 weekly obesity
tax. |
MORE DOCTORS, MORE PILLS |
The medical costs of obesity have long been the focus of health
economists. A just-published analysis finds that it raises those costs
more than thought. |
Obese men rack up an additional $1,152 a year in medical spending,
especially for hospitalizations and prescription drugs, Cawley and Chad
Meyerhoefer of Lehigh University reported in January in the Journal of
Health Economics. Obese women account for an extra $3,613 a year. Using
data from 9,852 men (average BMI: 28) and 13,837 women (average BMI: 27)
ages 20 to 64, among whom 28 percent were obese, the researchers found
even higher costs among the uninsured: annual medical spending for an
obese person was $3,271 compared with $512 for the non-obese. |
Nationally, that comes to $190 billion a year in additional medical
spending as a result of obesity, calculated Cawley, or 20.6 percent of
U.S. health care expenditures. |
That is double recent estimates, reflecting more precise methodology.
The new analysis corrected for people's tendency to low-ball their
weight, for instance, and compared obesity with non-obesity (healthy
weight and overweight) rather than just to healthy weight. Because the
merely overweight do not incur many additional medical costs, grouping
the overweight with the obese underestimates the costs of obesity. |
Contrary to the media's idealization of slimness, medical spending for
men is about the same for BMIs of 26 to 35. For women, the uptick starts
at a BMI of 25. In men more than women, high BMIs can reflect extra
muscle as well as fat, so it is possible to be healthy even with an
overweight BMI. "A man with a BMI of 28 might be very fit," said Cawley.
"Where healthcare costs really take off is in the morbidly obese." |
Those extra medical costs are partly born by the non-obese, in the form
of higher taxes to support Medicaid and higher health insurance
premiums. Obese women raise such "third party" expenditures $3,220 a
year each; obese men, $967 a year, Cawley and Meyerhoefer found. |
One recent surprise is the discovery that the costs of obesity exceed
those of smoking. In a paper published in March, scientists at the Mayo
Clinic toted up the exact medical costs of 30,529 Mayo employees, adult
dependents, and retirees over several years. |
"Smoking added about 20 percent a year to medical costs," said Mayo's
James Naessens. "Obesity was similar, but morbid obesity increased those
costs by 50 percent a year. There really is an economic justification
for employers to offer programs to help the very obese lose weight." |
LIVING LARGE, BUT NOT DYING YOUNG |
For years researchers suspected that the higher medical costs of
obesity might be offset by the possibility that the obese would die
young, and thus never rack up spending for nursing homes, Alzheimer's
care, and other pricey items. |
That's what happens to smokers. While they do incur higher medical
costs than nonsmokers in any given year, their lifetime drain on public
and private dollars is less because they die sooner. "Smokers die early
enough that they save Social Security, private pensions, and Medicare"
trillions of dollars, said Duke's Finkelstein. "But mortality isn't that
much higher among the obese." |
Beta blockers for heart disease, diabetes drugs, and other treatments
are keeping the obese alive longer, with the result that they incur
astronomically high medical expenses in old age just like their slimmer
peers. |
Some costs of obesity reflect basic physics. It requires twice as much
energy to move 250 pounds than 125 pounds. As a result, a vehicle burns
more gasoline carrying heavier passengers than lighter ones. |
"Growing obesity rates increase fuel consumption," said engineer
Sheldon Jacobson of the University of Illinois. How much? An additional
938 million gallons of gasoline each year due to overweight and obesity
in the United States, or 0.8 percent, he calculated. That's $4 billion
extra. |
Not all the changes spurred by the prevalence of obesity come with a
price tag. Train cars New Jersey Transit ordered from Bombardier have
seats 2.2 inches wider than current cars, at 19.75 inches, said
spokesman John Durso, giving everyone a more comfortable commute. (There
will also be more seats per car because the new ones are
double-deckers.) |
The built environment generally is changing to accommodate larger
Americans. New York's commuter trains are considering new cars with
seats able to hold 400 pounds. Blue Bird is widening the front doors on
its school buses so wider kids can fit. And at both the new Yankee
Stadium and Citi Field, home of the New York Mets, seats are wider than
their predecessors by 1 to 2 inches. |
The new performance testing proposed by transit officials for buses,
assuming an average passenger weight of 175 instead of 150 pounds, arise
from concerns that heavier passengers might pose a safety threat. If
too much weight is behind the rear axle, a bus can lose steering. And
every additional pound increases a moving vehicle's momentum, requiring
more force to stop and thereby putting greater demands on brakes.
Manufacturers have told the FTA the proposal will require them to
upgrade several components. |
Hospitals, too, are adapting to larger patients. The University of
Alabama at Birmingham's hospital, the nation's fourth largest, has
widened doors, replaced wall-mounted toilets with floor models able to
hold 250 pounds or more, and bought plus-size wheelchairs (twice the
price of regulars) as well as mini-cranes to hoist obese patients out of
bed. |
The additional spending due to obesity doesn't fall into a black hole,
of course. It contributes to overall economic activity and thus to gross
domestic product. But not all spending is created equal. |
"Yes, a heart attack will generate economic activity, since the surgeon
and hospital get paid, but not in a good way," said Murray Ross, vice
president of Kaiser Permanente's Institute for Health Policy. "If we
avoided that heart attack we could have put the money to better use,
such as in education or investments in clean energy." |
The books on obesity remain open. The latest entry: An obese man is 64
percent less likely to be arrested for a crime than a healthy man.
Researchers have yet to run the numbers on what that might save.
Re: Obesity costs additional $190 billion a year
I don't think I want to step in this hornet's nest today, other that to say that this is stupid:
Other changes, often cost-neutral, are coming to the built environment in the form of wider seats in public places from sports stadiums to bus stops.
If you put in larger seats, you are putting in fewer seats in the same amount of space, thus to achieve the same amount of revenue the cost will go up (for something like a sports arena where the charge is per seat). The bus stop thing strikes me as odd, since I've never seen a bus stop with anything other than a bench. If they are putting in bigger benches, that's still not cost neutral in supplies.
1. Just to tie this into another hot topic, how much fuel is wasted because obese people are not comfortable in compact cars and opt for larger, less efficient vehicles? Is there any effort at all to make fuel efficient cars that can accommodate people of size?
2. I dont doubt that there is some decreased physical activity for physically demanding jobs but for desk jobs, how much productivity is really lost? We already know that there is pay discrimination against heavier people but will this information be used to justify it? If statistics show that physically attractive people perform better in sales environments, does that justify paying less attractive people less? I think this ties in social stigma with productivity because how much can really be attributed to the person vs. how society treats them and this just adds to the feedback system.
3. The court system thing is really surprising. I just dont know what to make of that.
Please let this turn into a 10 page thread about how forcing fat people to sit in tiny seats will solve our obesity problem.
Seriously. I'm upset this hasn't gained steam. It might be too late :-(
From my experience, this seems to be an inaccurate statement. If anything, public seating is getting smaller. Ummm...hello, airplanes. Also, it isn't cost-neutral. It cost money to replace seating.
my read shelf:
ETA: Boo it doesnt look like its showing up but its Chris Farley fat guy in a little coat.
Some bus stops have little flip down seats like this:
They wouldn't have to make the benches any longer, they would just have fewer flip downs.