Racial Disparities in Medical Expenditures within Body Weight Categories
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Despite federal guidelines calling for the reduction of obesity and elimination of health disparities, black–white differences in obesity prevalence and in medical expenditures and utilization of health care services persist.
To examine black–white differences in medical expenditures and utilization of health care services (office-based visits, hospital outpatient visits, ER visits, inpatient stays and prescription medication) within body weight categories.
This study used data from the 2006 Medical Expenditures Panel Survey (MEPS) and included 15,164 non-Hispanic white and non-Hispanic black adults. We used a standard two-part econometric model to examine black–white differences in how expenditures (total annual medical expenditures and expenditures for each type of service) vary within body weight categories.
Blacks in each weight category were less likely to use any medical care than their white counterparts, even after controlling for socio-demographic characteristics, perceived health status, health conditions and health beliefs. Among those who received medical care, there is no significant difference in the total amount spent on care between blacks and whites. Compared to whites, blacks in each body weight category were significantly less likely to use office-based visits, hospital outpatient visits, and medications. Among those who used medications, blacks had significantly lower expenditures than whites. Blacks in obese class II/III were significantly less likely to have any medical expenditures on inpatient care than their white counterparts.
Black–white racial differences in total medical expenditures were observed in each body weight category and were significantly different in the obese I class, overweight, and healthy weight categories. Obese blacks also spent a smaller amount than obese whites—the insignificance might be due to the smaller sample size. These differences cannot be fully explained by socio-demographics, health conditions, or health beliefs. Black–white differences in medical expenditures may be largely due to relatively inexpensive types of care (office-based visits, outpatient care, medication) rather than more costly ones (inpatient care, ER).
KEY WORDobesity body weight medical expenditures disparity
- 1.US Department of Health and Human Services, Healthy People 2020. Available at: http://www.healthypeople.gov/2020/topicsobjectives2020/default.aspx Accessed on December 27, 2011.
- 10.Waidmann T. Estimating the cost of racial and ethnic health disparities. The Urban Institute. 2009.Google Scholar
- 14.Ezzati-Rice TM, Kashihara D, Machlin SR. Health care expenses in the United States. 2000 Rockville (MD): Agency for Healthcare Research and Quality; 2004. MEPS Research Findings No. 21. AHRQ Pub. No. 04-0022.Google Scholar
- 15.Executive summary of the clinical guidelines of the identification, evaluation, and treatment of overweight and obesity in adults, Arch Intern Med. 1998; 159:1855–1867.Google Scholar
- 17.Finkelstein E, Fiebelkorn I, Wang G. National medical spending attributable to overweight and obesity: how much and who’s paying? Health Aff. 2003;W3:219–26.Google Scholar
- 18.Cohen SB. Attitudes toward Health Insurance and Their Persistence over Time, Adults 2003–2004. Statistical Brief #161. February 2007. Agency for Healthcare Research and Quality, Rockville, Md. Available at: http://www.meps.ahrq.gov/mepsweb/data_files/publications/st161/stat161.pdf Accessed on December 27, 2011.
- 22.Institute of Medicine. Unequal treatment: confronting racial and ethnic disparities in health care. Washington: National Academies Press; 2002.Google Scholar