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Rand study and insurers agree: obesity causes disabilities.

The obesity crisis in the United States, which has long been known to rack up health-care costs, has caused a sharp rise in disability rates over the past two decades as Americans have become obese at younger ages.

About 127 million adult Americans, of 64.5% of the population, are overweight or obese, according to the American Obesity Association. As Americans get heavier, a study published by the Rand Corp. in the October 2003 Archives of Internal Medicine found that the category of severe obesity is growing the fastest. In 2000, 1 in 50 adults were severely obese, or 100 or more pounds over-weight, compared with 1 in 200 in 1986, the study said.

Even so, Rand researchers who studied disability rates in a subsequent study said they were surprised to see a sharp rise in disability rates among Americans younger than 60, which they attributed to obesity and warned could have "severe consequences" on future U.S. health costs. According to the study, which was published in January in Health Affairs, the number of disabled people between ages 30 and 49 rose more than 50% from 1984 to 2000.

Disability insurers said they're seeing an increase in claims, as well. UnumProvident Corp. has seen a 10-fold increase since 1997 in short-term disability claims based solely on the diagnosis of obesity, said Dr. Robert Anfield, vice president and medical director. Other claims for conditions such as fibromyalgia and cardiovascular problems are linked to obesity, he said.

At Cigna Corp., disability claims stemming from obesity rose 37% in 2003 from 2002, mostly manifesting itself into other conditions such as diabetes and hypertension, according to Cigna spokeswoman Gloria Barone.

MetLife Disability also has seen an increase in short-term claims specifically for obesity, but they represent the "tip of the iceberg," said Dr. Ronald Leopold, vice president and medical director. MetLife identified three conditions--diabetes, arthritis and heart disease--that are linked to obesity and estimated to cost employers more than $220 billion annually in medical care and lost productivity.

In 1996, the number of people in their 30s reporting disabilities rose to 182 in 10,000 people, compared with 118 in 10,000 people in 1984 the Rand Study found. For people in their 40s, 278 in 10,000 people reported disabilities in 1996, compared with 212 in 10,000 in 1984. Among people who fell in the 18 to 29 age group and the 50 to 59 age group, the study found smaller but significant increases, Rand said.

The Rand researchers knew disability was declining among the elderly because of medical technology and because they're more healthy. "We were hopeful that we would see similar trends among the young," said study co-author Dana Goldman. But the study found that the young are more unhealthy than their older counterparts.

Although some of the increase may be a result of disability insurance incentives and medical advances that save people's lives, researchers said obesity was a major factor in the large jump. "Obesity is the only trend that is commensurate in size with what we found happening in disability," said Darius Lakdawalla, Rand economist and lead author of the report. "Much more research is needed to nail it down, but obesity is the most plausible candidate."

The Rand researchers predicted the higher disability rates could lead to a 10% to 25% rise in the nursing home population. Also, Medicare expenditures could be 10% to 15% higher than they would be if disability wasn't expanding.

The nation's health-care system would be impacted even more, the study said. As disability rates rise, health-care costs follow. On average during any given year, about 11% of an employer's employee population is out on disability, but they account for 53% of the employer's medical costs, said Carol Harnett, a spokeswoman for Hartford Financial Services Group.

Studies have shown that insurers have long borne much of the brunt of costs associated with rising obesity. A study of health-care costs among members of Kaiser Permanente Northwest from 1990 to 1998 showed that total costs, including pharmacy services, outpatient services and inpatient care, were $15,583 for those with a body-mass index between 20 and 24.9. That figure rose to $18,484 for those who were overweight, and $21,711 for those who were obese.
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Title Annotation:The Last Word; disability claims up
Author:Green, Meg
Publication:Best's Review
Geographic Code:1USA
Date:Mar 1, 2004
Previous Article:UnitedHealth is remaining in the individual line.
Next Article:Safe at home and away.

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