232007 U.S. obesity epidemic: A Social Justice Issue

Tuesday, November 9, 2010 : 12:30 PM - 12:45 PM

Cheryl S. Hankin, PhD , Health Economics and Outcomes Research, BioMedEcon, Moss Beach, CA
Kenneth Thorpe, PhD , Health Policy and Management, Robert W Woodruff Professor and Chair, Emory University, Rollins School of Public Health, Atlanta, GA
Maria Lopes, MD, MS , Chief Medical Officer, AMC Health, Cresskill, NJ
Brent Pawlecki, MD, MMM , Corporate Medical Director, Pitney Bowes Inc, Stamford, CT
Diana DeGette, INVITED: Congresswoman, Colorado , United States Representative and Chief Deputy Whip, State of Colorado, Denver, CO
Despite the Surgeon General's call to prevent and decrease obesity, rates of obesity among U.S. adults have risen alarmingly in the past two decades, from 13.5% in 1987 to 33.8% in 2008. If these trends continue, experts predict that U.S. adult obesity prevalence will reach 41% within 5 years and exceed 51% by the year 2030. The health consequences of obesity are dire. Obesity is directly implicated in numerous highly prevalent and costly medical conditions, including heart disease, type 2 diabetes, and various cancers, and increases the risk of premature all-cause death by 50-100%. Experts assert that obesity's toll on health may be equivalent to that of poverty, smoking, or problem drinking, and they predict that within 15 years, adverse trends in obesity will completely overwhelm any benefits that have been attained by reductions in rates of smoking. A principal goal of Healthy People 2010 is to eliminate health disparities in obesity rates; however, many segments of the U.S. population are disproportionately afflicted. Obesity rates among African American/Non-Hispanic and Hispanic adults are 50.6% and 21.1% greater, respectively, than those among Caucasian/Non-Hispanic adults. By 2030, the rate of obesity among African American women is projected to reach nearly 100% (96.9%). Given the rising trend in overall U.S. prevalence, profound health consequences, and widening disparities in rates across population segments, obesity has become a significant U.S. social justice issue. This issue not only resides in the epidemiologic and biologic domains (our first two presentations), but must be considered in terms of public health policy. In our third presentation, we consider ways in which to evaluate the comparative effectiveness, safety, and costs of weight loss treatments across an array of current and emerging options. This is followed by an overview of current access, coverage, and reimbursement policies for weight loss treatments offered by U.S. public and private health care systems. Our final presentation summarizes these presentations and considers obesity as a social justice public health issue in need of specific recommended informed policies and practices.

The session will be comprised of 5 presentations: U.S. epidemiologic trends in obesity and the impact on public health and economic costs Mechanisms of obesity-related chronic illness as social injustice Comparative effectiveness research of weight loss treatments U.S. access, coverage, and reimbursement of weight loss treatments Obesity: A Social Justice Issue

Learning Areas:
Chronic disease management and prevention
Diversity and culture
Program planning
Public health or related public policy

Learning Objectives:
1. Describe the results of a health economic model estimating the lifetime medical savings associated with weight loss among newly-enrolled obese Medicare beneficiaries. 2. Describe the health and wellness initiatives of a Fortune 500 company designed to reduce the healthcare costs of obesity. 3. Discuss obesity as a social justice issue, characterized by gender, racial/ethnic, and socioeconomic status disparities in obesity rate and coverage and reimbursement for weight loss treatments. 4. Compare U.S. public and private health systems coverage and reimbursement policies currently available for surgical, pharmacologic, and behavioral weight loss treatments. 5. Evaluate comparative effectiveness research methods used to differentiate weight loss treatments.

Keywords: Obesity, Social Justice

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a health services researcher conducting research on chronic illness, health policy, comparative effectiveness, and health economics research.
Any relevant financial relationships? Yes

Name of Organization Clinical/Research Area Type of relationship
VIVUS Obesity Consultant
DexCom Diabetes Consultant
Mitsubishi Pharma America Chronic Kidney Disease Consultant
Medtronics Diabetes Consultant
Marine Polymer Inc ESRD Consultant

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.