Overweight in Adolescents and Implications for Health Expenditures
- Presenter:
Chair: Albert Okunade; Discussant: TBA Tue June 6, 2006 8:00-9:30 Room 309
Rationale: Adolescents who are overweight (> 95th percentile of the age and gender-adjusted body mass index [BMI] distribution) or at risk of overweight (85th to 95th percentiles) are likely to become overweight adults and be at risk for health conditions associated with high adult health expenditures. However, little is known as to whether being overweight leads to higher health expenditures during adolescence compared to those of normal weight and thus, whether the health expenditures of overweight adults are also present during adolescence. Moreover, little is known regarding the relative contribution of economic factors, parental and family characteristics, and neighborhood attributes in explaining variation in adolescent bodyweight.
Objectives: This paper has two objectives. First, we examine the contribution of economic factors, parental and family attributes, and neighborhood characteristics to adolescent bodyweight, the likelihood of being overweight, or being at risk for overweight. Controlling for parent’s BMI, and thus for adolescent susceptibility to being overweight, we consider whether adolescent weight status is responsive to the price and availability of fast food, the labor supply, educational levels, and health habits of parents, and neighborhood characteristics. Next, we consider the relationship between adolescent bodyweight and health expenditures, controlling for health insurance status, parental educational levels, and household attributes. We consider the sensitivity of our findings to possible endogeneity arising from unobserved attributes of adolescent health status that may be correlated with bodyweight and expenditures, and from measurement error in reported bodyweight.
Methodology: We use data from the Medical Expenditure Panel Survey (MEPS) merged with geographic data on the price/availability of fast food and neighborhood attributes to model variation in bodyweight status among adolescents aged 12 to 19. Our models include a crucial and often omitted variable: parental bodyweight which can reflect both genetic predisposition for adolescent overweight as well as attitudes toward good nutrition. These models also include a comprehensive set of variables capturing economic, household, and neighborhood characteristics. We estimate models of health expenditures to consider whether overweight in adolescents results in enhanced levels of medical spending, and use these results to predict expenditures for adolescents by bodyweight status. We examine the sensitivity of our expenditure estimates to alternative models and to the use of instrumental variable estimates of adolescent bodyweight using parents’ bodyweight and prices of fast and convenience foods as instruments.
Results: Preliminary econometric results restricted to parental and household characteristics reveal that adolescents who are overweight/at risk for being overweight have increased health expenditures compared to those of normal weight in both single-parent and two-parent families. Adolescent overweight is strongly correlated with parental bodyweight and to other factors such as parental educational levels, smoking activity, and high family incomes.
Conclusions: Our findings to date indicate that adolescents who are overweight/at risk of being overweight incur higher health expenditures than those of normal weight. Thus, it appears that high health expenditures associated with being an overweight adult may also be present during adolescence.
