Costs of Obesity in Older Adults with Disabilities

A body of research has worked to document the effects of obesity on medical expenditures and utilization  (e.g., Finkelstein, et al.; Sturm et al.) This study extends that work to focus on older adults with disabilities--a population associated with a higher risk of obesity, and one for whom Medicaid and Medicare are major sources of insurance.  We use prior observations in our own work and in others to identify potentially interesting sources of heterogeneity in this population, particularly age and race/ethnicity.

We use data from the Medical Expenditure Panel Survey-Household Component (MEPS-HC), a nationally representative survey of the civilian, non-institutionalized population of the United States. We pool MEPS panels for years 2001 to 20011 and focus on middle-age and older adults.  We include measures of socioeconomic status and geographic characteristics in most models, and include or stratify by age group, sex, and race/ethnicity in others.  Given the skewed nature of expenditure data, we estimate two-part models for most expenditures and count data models for utilization measures such as office visits. 

Our early models show a consistent pattern of negative and but usually non-significant effects on expenditures of being overweight across age and race/ethnicity groups, while being obese has a generally positive but not always statistically significant effect.  Subsequent analysis will explore these patterns in greater detail.  We will then explore the implications of our findings for the Medicare and Medicaid programs.