Processed food, obesity, health care, and societal costs

I suppose food is on my mind today (although I don't really know why, since I've eaten enough)... However, this graphic from Next Generation Food got me thinking about something else in the health care debate - something that isn't discussed: the health cost of the food we eat.

A 2005 (I believe) publication from the American Heart Association showed that 30.4% of adults in the United States were considered "obese," based on BMI. (Now, while I do have an issue with the use of BMI as a metric for individuals, at a population level, its trend does seem to work better.) What I want to draw attention to, though, is the link that the AHA makes between obesity and health and financial consequences:

The publication lists correlations with life expectancy and obesity, and has a nice table (on page 14) of increased likelihoods of diseases, too. For example, for people with a BMI greater than 35, there is a:

• 6.16 times greater possibility of developing type-II diabetes,
• 5.48 times greater possibility of gallstones,
• 3.77 times greater possibility of having hypertension,
• 2.39 times greater possibility of arthritis,
• 1.75 times greater possibility of stroke, and
• 1.67 times greater possibility of heart attack..

With regard to financial costs, the publication cites a 1999 paper ("The costs of body mass index levels in an employed population") that showed that as BMI increased, so did the number of sick days, medical claims and insurance costs. Furthermore, they cite a 2002 paper ("The Effects Of Obesity, Smoking, And Drinking On Medical Problems And Costs") that showed:

Obesity is associated with a 36 percent increase in inpatient and outpatient spending and a 77 percent increase in medications, compared with a 21 percent increase in inpatient and outpatient spending and a 28 percent increase in medications for current smokers and smaller effects for problem drinkers.

How does work in with the health care debate currently going on in the United States? I can see it working itself into the conversation in two ways: current denials to those who are BMI-obese and future population-level costs if it isn't effectively addressed in the future. In the first case, the husband of a friend of mine was declined health insurance because his BMI was too high. This is why I use the term "BMI-obese," since I am categorized as "obese" by the BMI table. (My previous entry on BMI talks a lot about the problems with BMI as a modern-day scale as well as the logical problem of using it as an individual measure.) Since he cannot get medical insurance, he is one more of the 40 million Americans on the uninsured lists due to a "pre-existing condition". It is likely, too that many people who are BMI-obese may have their insurance dropped if this fact is found out, or may have it drastically increased.

In the second case, let's assume that pre-existing conditions cannot be a cause for dropping (or not enrolling) a person to health insurance. Under these circumstances, the costs of the truly obese (as opposed to BMI-obese) will be borne by all of the payers. However, if rates of obesity continue to increase, then that cost burden will also become greater and greater. If there is not mechanism to award people who are healthy (as opposed to only penalizing people who are not healthy), then the financial problems of obesity will not go away.

What does this all have to do with processed food? Well, in addition to what the numbers and charts show in the graphic above, food purveyors want their customers to purchase their product. What manufactured food does is prey upon the human evolutionary desires of sugars and fats, and thus give us sugary drinks and fatty foods, which we (in turn) consume with all the evolutionarily pressured gusto we can manage before going back for more (and more and more). This cycle tends to lead to obesity in a population and (if left unchecked) obesity of a population, which (in turn) leads to increased health care costs as well as increased macro-economic costs.

That's enough navel-gazing for right now on this topic. However, it's likely to not go away from my mind any time soon...