title: Economic Burden of Disease-Associated Malnutrition at the State Level.
abstract: BACKGROUND
  Disease-associated malnutrition has been identified as a prevalent condition, particularly for the elderly, which has often been overlooked in the U.S. healthcare system. The state-level burden of community-based disease-associated malnutrition is unknown and there have been limited efforts by state policy makers to identify, quantify, and address malnutrition. The objective of this study was to examine and quantify the state-level economic burden of disease-associated malnutrition.
  
  
  METHODS
  Direct medical costs of disease-associated malnutrition were calculated for 8 diseases: Stroke, Chronic Obstructive Pulmonary Disease, Coronary Heart Failure, Breast Cancer, Dementia, Musculoskeletal Disorders, Depression, and Colorectal Cancer. National disease and malnutrition prevalence rates were estimated for subgroups defined by age, race, and sex using the National Health and Nutrition Examination Survey and the National Health Interview Survey. State prevalence of disease-associated malnutrition was estimated by combining national prevalence estimates with states' demographic data from the U.S. Census. Direct medical cost for each state was estimated as the increased expenditures incurred as a result of malnutrition.
  
  
  RESULTS
  Direct medical costs attributable to disease-associated malnutrition vary among states from an annual cost of $36 per capita in Utah to $65 per capita in Washington, D.C. Nationally the annual cost of disease-associated malnutrition is over $15.5 billion. The elderly bear a disproportionate share of this cost on both the state and national level.
  
  
  CONCLUSIONS
  Additional action is needed to reduce the economic impact of disease-associated malnutrition, particularly at the state level. Nutrition may be a cost-effective way to help address high health care costs.
authors.affiliation: Abbott Nutrition, Research & Development, Columbus, Ohio, United States of America.
authors.forename: Scott
authors.initials: S
authors.lastname: Goates
authors.affiliation: Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Champaign, Illinois, United States of America.|Abbott Nutrition, Research Park at the University of Illinois, Champaign, Illinois, United States of America.
authors.forename: Kristy
authors.initials: K
authors.lastname: Du
authors.affiliation: Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Champaign, Illinois, United States of America.|Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, Illinois, United States of America.
authors.forename: Carol A
authors.initials: CA
authors.lastname: Braunschweig
authors.affiliation: Abbott Nutrition Products Division of Abbott, Columbus, Ohio, United States of America.
authors.forename: Mary Beth
authors.initials: MB
authors.lastname: Arensberg