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An examination of the relationships between service use and alternative measures of obesity among community-dwelling adults in Ireland

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Abstract

Obesity has received increased attention arising from its increasing prevalence and the implications of obesity-related problems for society and the wider economy. To estimate healthcare and non-healthcare obesity impacts, many studies rely on body mass index (BMI) as a measure of obesity. However BMI is considered to be a noisy measure of total body fat that unlike some other measures does not capture fat distribution. This study uses one such measure, the waist-to-hip ratio, as both an alternative and in conjunction with BMI in the estimation of the relationship between adiposity and health service use. The article uses data from a large-scale study of older adults living in Ireland (the Tilda data set). The findings indicate that studies that include both measures of general and central adiposity may provide a more comprehensive characterisation of the relationship between healthcare service use and adiposity.

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Notes

  1. The residual term is created by using the adiposity measures as the only regressors on a count model with the number of chronic conditions as the dependent variable. The difference between the predicted and actual number of counts of chronic health conditions is the residual. The same approach was adopted by Doherty et al. [10] but for self-reported BMI.

  2. We tested how sensitive the adiposity marginal effects were to the inclusion of sampling weights. We did not observe any significant differences; therefore the results presented in the paper are for the unweighted sample with robust standard errors.

References

  1. Flegal, K.M., et al.: Prevalence and trends in obesity among US adults, 1999–2008. JAMA 303(3), 235–241 (2010)

    Article  CAS  PubMed  Google Scholar 

  2. National Centre for Health Statistics: Health US 2004: with chartbook on trends in the health of Americans. Centre for Disease Control, Atlanta (2004)

    Google Scholar 

  3. Dee, A., Staines, A., McVeigh, T., Sweeney, M.R., O'Neill, C., Callan, A., Doherty, E., O’Dwyer, V., Kearns, K., Sharp, L., Kee, F., Hughes, J., Balanda, K., Perry, I.J.: The cost of overweight and obesity on the island of Ireland (Executive summary) Safefood November (2012)

  4. Guh, D.P., et al.: The incidence of co-morbidities related to obesity and overweight: a systematic review and meta-analysis. BMC public health 9(1), 88 (2009)

    Article  PubMed Central  PubMed  Google Scholar 

  5. Allender, S., Rayner, M.: The burden of overweight and obesity-related ill health in the UK. Obes. Rev. 8(5), 467–473 (2007)

    Article  CAS  PubMed  Google Scholar 

  6. Butland, B.G. Britain, tackling obesities: future choices: Project Report. 2007: Department of Innovation Universities and Skills

  7. Anis, A.H., et al.: Obesity and overweight in Canada: an updated cost-of-illness study. Obes. Rev. 11(1), 31–40 (2010)

    Article  CAS  PubMed  Google Scholar 

  8. Finkelstein, E.A., et al.: The costs of obesity in the workplace. J. Occup. Environ. Med. 52(10), 971–976 (2010)

    Article  PubMed  Google Scholar 

  9. Konnopka, A., Bödemann, M., König, H.-H.: Health burden and costs of obesity and overweight in Germany. Eur. J. Health Econ. 12(4), 345–352 (2011)

    Article  CAS  PubMed  Google Scholar 

  10. Doherty, E., Dee, A., O’Neill, C.: Estimating the amount of overweight and obesity related health-care use in the Republic of Ireland using SLÁN data. Econ. Soc. Rev. 43(2), 227–250 (2012)

    Google Scholar 

  11. National Obesity Obervatory, Measures of central adiposity as an indicator of obesity (2009). http://www.noo.org.uk/uploads/doc/vid_3798_MEASURES_OF_CENTRAL_ADIPOSITY_%20AS_AN_INDICATOR_OFOBESITYAugust09.pdf. Accessed June 2014

  12. Panel, N.O.E.I.E., Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults (1998)

  13. Lean, M., Han, T., Morrison, C.: Waist circumference as a measure for indicating need for weight management. BMJ 311(6998), 158–161 (1995)

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  14. Ho-Pham, L.T., Campbell,L.V., Nguyen T.V. More on body fat cutoff points. In Mayo Clinic Proceedings, Elsevier (2011)

  15. Pischon, T., et al.: General and abdominal adiposity and risk of death in Europe. N. Engl. J. Med. 359(20), 2105–2120 (2008)

    Article  CAS  PubMed  Google Scholar 

  16. Wang, Y., et al.: Comparison of abdominal adiposity and overall obesity in predicting risk of type 2 diabetes among men. Am. J. Clin. Nutr. 81(3), 555–563 (2005)

    CAS  PubMed  Google Scholar 

  17. Schneider, H.J., et al.: Accuracy of anthropometric indicators of obesity to predict cardiovascular risk. J. Clin. Endocrinol. Metab. 92(2), 589–594 (2007)

    Article  CAS  PubMed  Google Scholar 

  18. Lee, C.M.Y., et al.: Indices of abdominal obesity are better discriminators of cardiovascular risk factors than BMI: a meta-analysis. J. Clin. Epidemiol. 61(7), 646–653 (2008)

    Article  PubMed  Google Scholar 

  19. Finkelstein, E.A., et al.: Obesity and severe obesity forecasts through 2030. Am. J. Prev. Med. 42(6), 563–570 (2012)

    Article  PubMed  Google Scholar 

  20. Tsai, A.G., Williamson, D.F., Glick, H.A.: Direct medical cost of overweight and obesity in the USA: a quantitative systematic review. Obes. Rev. 12(1), 50–61 (2011)

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  21. Cornier, M.A., et al.: Relationship between waist circumference, body mass index, and medical care costs. Obes. Res. 10(11), 1167–1172 (2002)

    Article  PubMed  Google Scholar 

  22. Colagiuri, S., et al.: The cost of overweight and obesity in Australia. Med. J. Aust. 192(5), 260–264 (2010)

    PubMed  Google Scholar 

  23. Burkhauser, R.V., Cawley, J.: Beyond BMI: the value of more accurate measures of fatness and obesity in social science research. J. Health Econ. 27(2), 519–529 (2008)

    Article  PubMed  Google Scholar 

  24. Johansson, E., et al.: Obesity and labour market success in Finland: The difference between having a high BMI and being fat. Econ. Human Biol. 7(1), 36–45 (2009)

    Article  Google Scholar 

  25. Mosca, I., Obesity and employment in Ireland: moving beyond BMI (2012). http://www.thehealthwell.info/node/660299. Accessed June 2014

  26. Kenny, R.A., Nolan, A., T.C.D., The over 50 s in a changing Ireland: economic circumstances, health and well-being (2014). http://tilda.tcd.ie/assets/pdf/Wave2-Key-Findings-Report.pdf. Accessed June 2014

  27. Berkman, L.F., Syme, S.L.: Social networks, host resistance, and mortality: a nine-year follow-up study of Alameda County residents. Am. J. Epidemiol. 109(2), 186–204 (1979)

    CAS  PubMed  Google Scholar 

  28. McGregor, P., McKee, P., O’Neill, C.: GP utilisation in Northern Ireland: exploiting the gatekeeper function. Econ. Soc. Rev. 37(1), 71 (2006)

    Google Scholar 

  29. Bertakis, K.D., Azari, R.: Obesity and the use of health care services. Obes. Res. 13(2), 372–379 (2005)

    Article  PubMed  Google Scholar 

  30. Heithoff, K.A., et al.: The association between body mass and health care expenditures. Clin. Ther. 19(4), 811–820 (1997)

    Article  CAS  PubMed  Google Scholar 

  31. Quesenberry, C.P., Caan, B., Jacobson, A.: Obesity, health services use, and health care costs among members of a health maintenance organization. Arch. Intern. Med. 158(5), 466–472 (1998)

    Article  PubMed  Google Scholar 

  32. Raebel, M.A., et al.: Health services use and health care costs of obese and nonobese individuals. Arch. Intern. Med. 164(19), 2135–2140 (2004)

    Article  PubMed  Google Scholar 

  33. Wolf, A.M.: Economic outcomes of the obese patient. Obes. Res. 10(S1), 58S–62S (2012)

    Google Scholar 

  34. Højgaard, B., et al.: Waist circumference and body mass index as predictors of health care costs. PLoS One 3(7), e2619 (2008)

    Article  PubMed Central  PubMed  Google Scholar 

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Authors and Affiliations

  1. Discipline of Economics, J.E. Cairnes School of Business and Economics, Galway, Ireland

    Edel Doherty, Michelle Queally & Ciaran O’Neill

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  1. Edel Doherty
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  2. Michelle Queally
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  3. Ciaran O’Neill
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Correspondence to Ciaran O’Neill.

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Doherty, E., Queally, M. & O’Neill, C. An examination of the relationships between service use and alternative measures of obesity among community-dwelling adults in Ireland. Eur J Health Econ 16, 951–956 (2015). https://doi.org/10.1007/s10198-014-0643-z

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  • DOI: https://doi.org/10.1007/s10198-014-0643-z

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