Economics of adult obesity and diabetes in Appalachia

Janaranjana Herath, Cheryl Brown, David Hill

Division of Resource Management, Davis College, West Virginia University, Morgantown, USA.
Tillman School of Business, Mount Olive College, Mount Olive, USA.
Tillman School of Business, Mount Olive College, Mount Olive, USA;.

DOI: 10.4236/health.2013.512290                

Abstract

Obesity and diabetes are major health problems in the United States. The primary aim of this study is to examine the association between obesity and diabetes and to estimate the cost of diabetes linked to obesity in the Appalachian region. A system of simultaneous equations approach, and a logit estimation are employed for the analyses. Behavioral Risk Factor Surveillance System (BRFSS) surveys for 2001 and 2009 are the main sources of data. Both county-level and individual-level data are used for the analyses. The simultaneous approach at county-level based on the changes of income, employment, obesity, and diabetes reveals that obesity increases diabetes, but diabetes does not have an effect on obesity. The counties with high initial levels of obesity had less obesity growth but more diabetes growth. Increasing income impacts negatively on diabetes growth. Logit analysis indicates that obesity significantly increases the risk of diabetes of adults’ in Appalachia. Besides, being employed, higher income, as well as engaging in exercise reduce the prevalence of diabetes, while age increases diabetes. The economic cost of obesity-related diabetes is $1.9 billion, and can be reduced through mitigating obesity.

 

Keywords

Appalachia; Diabetes; Logit Analysis; Obesity

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Sabate, J. and Wien, M. (2010) Vegetarian diets and childhood obesity prevention. American Journal of Clinical Nutrition, 9, 1525s-1529s. http://dx.doi.org/10.3945/ajcn.2010.28701F
[2]	Finkelstein, E., Trogdon, J., Cohen, J.W. and Dietz, W. (2009) Annual medical spending attributable to obesity: Payer and service-specific estimates. Health Affairs, 28, 822-831. http://dx.doi.org/10.1377/hlthaff.28.5.w822
[3]	Dor, A., Ferguson, C., Langwith, C. and Tan, E. (2010) A heavy burden: The individual costs of being overweight and obese in the United States. Research Report. Department of Health Policy, School of Public Health and Health Services, The George Washington University.
[4]	Sturm, R., Ringel, J.S. and Andreyeve, T. (2004) Increasing obesity rates and disability trends. Health Affairs, 23, 199-205. http://dx.doi.org/10.1377/hlthaff.23.2.199
[5]	Malnick, S.D.H. and Knobler, H. (2006) The medical complications of obesity. QJM: An International Journal of Medicine, 99, 565-579. http://dx.doi.org/10.1093/qjmed/hcl085
[6]	Miljkovic, D. and Nganje, W. (2008) Regional obesity determinants in the United States: A model of myopic addictive behavior in food consumption. Agricultural Economics, 38, 375-384. http://dx.doi.org/10.1111/j.1574-0862.2008.00307.x
[7]	World Health Organization. Risk Factor Projects (2005) Overweight and obesity. http://www.who.int/mediacentre/news/releases/2005/pr44/en/index.html
[8]	Cawley, J., Meyerhoefer, C. and Newhouse, D. (2005) The impacts of state physical education requirements on youth physical activity and overweight. NBER Working Paper 11411.
[9]	Sacerdote, B. (2007) How large are the effects from changes in family environment? A study of Korean American adoptees. Quarterly Journal of Economics, 122, 119-158. http://dx.doi.org/10.1162/qjec.122.1.119
[10]	Inagmi, S., Cohen, D.A., Finch, B.K. and Asch, S.M. (2006) You are where you shop: Grocery store locations, weight and neighborhoods. American Journal of Preventive Medicine, 31, 10-17. http://dx.doi.org/10.1016/j.amepre.2006.03.019
[11]	Wang, M.C., Kim, S., Gonzalez, A.A., Macleod, K.E. and Winkleby, M.A. (2007) Socioeconomic and food related physical characteristics of the neighborhood environment are associated with body mass index. Journal of Epidemiology Community Health, 6, 491-498. http://dx.doi.org/10.1136/jech.2006.051680
[12]	Hagist, C. and Kotlikoff, L.J. (2009) Who’s going broke? Comparing growth in public healthcare expenditures in ten OECD Countries. Hacienda Pública Espanola, IEF, 188, 55-72.
[13]	Hammond, R.A. and Levine, R. (2010) The economic impacts of obesity in the United States: Diabetes, metabolic syndrome and obesity. Targets and Therapy, 3, 285-295.
[14]	US Department of Health and Human Services (2010) The surgeon general call to action to prevent and decrease overweight and obesity. US Department of Health and Human Services, Office of Surgeon General, Rockville.
[15]	Gregg, E.W., Cheng, Y.J., Cadwell, B.L., Imperatore, G., Williams, D.E., Flegal, K.M. and Williamson, D.F. (2005) Secular trends in cardiovascular disease risk factors according to body mass index in US adults. Journal of American Medical Association, 293, 1868-1874. http://dx.doi.org/10.1001/jama.293.15.1868
[16]	Colditz, G.A. (1992) Economic costs of obesity. American Journal of Clinical Nutrition, 55, 503s-507s.
[17]	Kumanyika, S.K., Obarzanek, E., Stettler, N., Bell, R., Field, A.E., Formann, S.P., Franklin, B.A., Gillman, M.W., Lewis, C.E., Poston II, W.C., Stevens, J. and Hong, Y. (2008) Population based prevention of obesity: The need for comprehensive promotion of healthful eating, physical activity, and energy balance. Circulation, 118, 428-464. http://dx.doi.org/10.1161/CIRCULATIONAHA.108.189702
[18]	Appalachian Regional Commission [ARC] (2011) Economic overview of Appalachia 2011. http://www.arc.gov/images/appregion/Sept2011/EconomicOverviewSept2011.pdf
[19]	Appalachian Regional Commission [ARC] (2010) Economic assessment of Appalachia. An Appalachian development initiative report. http://www.arc.gov/images/programs/ardi/EconomicAssessmentofAppalachiaJune2010.pdf
[20]	Wewers, M.R., Katz, M., Paskett, E.D. and Fickle, D. (2006) Risky behaviors among Ohio Appalachian adults. Preventive Chronic Disease, 3, A127.
[21]	Centers for Disease Control and Prevention [CDC] (2009) Behavioral risk factor surveillance system survey data. US Department of Health and Human Services, Atlanta, Georgia.
[22]	Centers for Disease Control and Prevention [CDC] (2009) Estimated county-level prevalence of diabetes and obesity-United States, 2007. Morbidity and Mortality Weekly Report, 58. http://www.cdc.gov/mmwr/PDF/wk/mm5845.pdf
[23]	Deller, S.C., Tsung-Hsiu, T., Marcouiller, D.W. and English, D.B.K. (2001) The role of amenities and quality of life in rural economic growth. American Journal of Agricultural Economics, 83, 352-365. http://dx.doi.org/10.1111/0002-9092.00161
[24]	Rosenberger, R.S., Sneh, Y. and Gurvitch, R. (2005) A spatial analysis of linkages between healthcare expenditures, physical inactivity, obesity and recreational supply. Journal of Leisure Research, 2005.
[25]	Quah, E. and Boon, T. L. (2002) The economic cost of particulate air pollution on health in Singapore. Journal of Asian Economics, 14, 73-90. http://dx.doi.org/10.1016/S1049-0078(02)00240-3
[26]	Lvovsky, K. (1998) Economic cost of air pollution with Special Reference to India, South Asia Environment Unit, World Bank, Washington DC.
[27]	Ostro, B. (1995) Fine particulate air pollution and mortality in two southern California counties. Environmental Research, 70, 98-104. http://dx.doi.org/10.1006/enrs.1995.1053
[28]	Centers for Disease Control and Prevention (CDC) Behavioral risk factor surveillance system survey data. US Department of Health and Human Services, Atlanta.
[29]	Centers for Disease Control and Prevention [CDC] (2009) Behavioral risk factor surveillance system survey data. US Department of Health and Human Services, Atlanta.
[30]	Bureau of Economic Analysis [BEA] (2009) Regional economic accounts. http://www.bea.gov/regional/gdpmap/GDPMap.aspx
[31]	US Census Bureau (2000) Summary File 1 (SF 1) 100-percent data. http://www.census.gov/census2000/sumfile1.html
[32]	US Census Bureau (2010) State and county quick facts. http://quickfacts.census.gov/qfd/states/54000.html
[33]	(1995) STATA 9.0. Statistical/Data Analysis. StataCorp, College Station. http://www.stata.com
[34]	Mayo Clinic (2011) Type two diabetes, risk factors. http://www.mayoclinic.com/health/type-2-diabetes/DS00585/DSECTION=risk-factors
[35]	Eliasson, B. (2003) Cigarette smoking and diabetes. Progress in Cardiovascular Diseases, 45, 405-413.
[36]	Carlsson, S., Hammar, N. and Grill, V. (2005) Alcohol consumption and type 2 diabetes. Meta-analysis of epidemiological studies indicates a U-shaped relationship. Diabetologia, 48, 1051-1054. http://dx.doi.org/10.1007/s00125-005-1768-5
[37]	Milken Institute (2007) An unhealthy America: Economic burden of chronic disease. http://www.chronicdiseaseimpact.com/ebcd.taf?cat=disease