Daniel Weintraub: Obesity is a costly challenge – and a big health opportunity

Toni Colley-Perry shows off a box of whole grain pasta as she teaches a free cooking class in Oak Park last month to promote healthy eating.
Toni Colley-Perry shows off a box of whole grain pasta as she teaches a free cooking class in Oak Park last month to promote healthy eating.

The latest numbers on obesity in California provide vivid new evidence that reducing health care costs will depend far more on keeping people healthy than on tinkering with the way doctors, hospitals and insurance companies deliver care and pay for it.

The good news is that Californians have among the lowest obesity rates in the country, thanks to our relatively healthy eating habits and high levels of physical activity.

The bad news? The state still has more than 3 million people considered “severely obese,” and those people cost California’s public and private insurance carriers more than $8 billion in added health care costs each year.

The numbers come from two independent reports, one from the website Wallethub and the other from the journal Health Affairs.

In a report titled “Fattest states in America,” Wallethub analyzed data from the U.S. Centers for Disease Control and Prevention, along with other studies to rank the states on obesity levels and the behaviors known to contribute to weight gain or losses.

Mississippi had the highest percentage of residents considered overweight or obese – at just more than half the state’s population. Hawaii’s rate was the lowest, at 36 percent. California ranked 12th best, with about 40 percent of its residents overweight or obese.

Not surprisingly, Wallethub’s related look at “unhealthy habits and consequences” tracked closely with the weight numbers. California ranked 13th-best overall in this review of such factors as diet and exercise. The state was tops in the nation on eating habits, with the lowest percentage of adults who reported eating less than one serving of fruit or vegetables per day.

Unfortunately, as the study in Health Affairs showed, California still has a high number of overweight and even severely obese residents. Severe obesity was defined as having a body mass index of 35 or higher – the equivalent of about 230 pounds for a 5-foot, 8-inch male.

That study, by George Washington University professor Michael Long, found that a person with severe obesity incurs about $2,000 more per year in health care bills than a person whose weight is normal. That comes from treating not just obesity but the many problems it causes, including diabetes, high blood pressure and cancer.

Nationwide, that means we’re spending about $69 billion more on health care for people with severe obesity. In California alone, the number is a staggering $8 billion, with about $1.3 billion of that coming through the taxpayer-funded Medi-Cal program for low-income people. The rest comes from private insurance and the federal Medicare program for the elderly and disabled.

Given these numbers, it’s not an exaggeration to call obesity one of the state’s most important – and costly – public health problems. It’s a problem that calls out for an urgent response from individuals, the community and government.

Even in California, people need to eat better and exercise more, and we need to design our communities and our workplaces in ways that encourage healthy, active living. Access to healthy foods, streets that are safe for walking and biking, parks where kids (and adults) can exercise, and reduced stress at work would be the best places to start. And given the link between income and obesity rates, the best way to reduce obesity over the long-term would be to boost economic growth and reduce poverty.

Daniel Weintraub is editor of the California Health Report.