title: Health care expenses in relation to obesity and smoking among U.S. adults by gender, race/ethnicity, and age group: 1998-2011.
abstract: OBJECTIVE
  Obesity and smoking are two leading health risk factors and consume substantial health care resources. This study estimates and tracks annual per-capita health care expenses associated with obesity and smoking among U.S. adults aged 18 years and older from 1998 to 2011.
  
  
  METHODS
  Retrospective data analysis.
  
  
  METHODS
  Individual-level data came from the National Health Interview Survey 1996-2010 waves and the Medical Expenditure Panel Survey 1998-2011 waves. Annual per-capita health care expenses associated with obesity and smoking were estimated in two-part models, accounting for individual characteristics and sampling design.
  
  
  RESULTS
  Obesity and smoking were associated with an increase in annual per-capita total health care expenses (2011 US$) by $1360 (95% confidence interval: $1134-$1587) and $1046 ($846-$1247), out-of-pocket expenses by $143 ($110-$176) and $70 ($37-$104), hospital inpatient expenses by $406 ($283-$529) and $405 ($291-$519), hospital outpatient expenses by $164 ($119-$210) and $95 ($52-$138), office-based medical provider service expenses by $219 ($157-$280) and $117 ($62-$172), emergency room service expenses by $45 ($28-$63) and $57 ($44-$71), and prescription expenses by $439 ($382-$496) and $251 ($199-$302), respectively. From 1998 to 2011, the estimated per-capita expenses associated with obesity and smoking increased by 25% and 30% for total health care, 41% and 48% for office-based medical provider services, 59% and 66% for emergency room services, and 62% and 70% for prescriptions but decreased by 16% and 15% for out-of-pocket health care expenses, 3% and 0.3% for inpatient care, and 6% and 2% for outpatient care, respectively. Health care expenses associated with obesity and smoking were considerably larger among women, Non-Hispanic whites, and older adults compared with their male, racial/ethnic minority, and younger counterparts.
  
  
  CONCLUSIONS
  Health care costs associated with obesity and smoking are substantial and increased noticeably during 1998-2011. They also vary significantly across gender, race/ethnicity and age.
authors.affiliation: Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, 1206 South 4th Street, Champaign, IL 61820, USA. Electronic address: ran5@illinois.edu.
authors.forename: R
authors.initials: R
authors.lastname: An
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D000367:Age Factors; D000368:Aged; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000191:economics* / Q000208:ethnology; D044469:Racial Groups / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012737:Sex Factors; D012907:Smoking / Q000191:economics* / Q000208:ethnology; D014481:United States; D044465:White People / Q000706:statistics & numerical data; D055815:Young Adult
keywords: Cost; Expense; Health care; Obesity; Smoking