Longevity costlier than obesity, smoking
In financial terms only, a study says more has to be spent to care for people who live longer.
LONDON - Preventing obesity and smoking can save lives, but it doesn't save money for health systems, researchers reported yesterday.
It costs more to care for healthy people who live years longer, according to a Dutch study that counters the common perception that preventing obesity would save governments millions of dollars.
"It was a small surprise," said Pieter van Baal, an economist at the Netherlands' National Institute for Public Health and the Environment, who led the study. "But it also makes sense. If you live longer, then you cost the health system more."
In a paper published online in the journal Public Library of Science Medicine, the researchers found that the health costs of thin and healthy people in adulthood are higher than those of either fat people or smokers.
Van Baal and colleagues created a model to simulate lifetime health costs for three groups of 1,000 people: the "healthy-living" group (thin and nonsmoking), obese people, and smokers. The model relied on "cost of illness" data and disease prevalence in the Netherlands in 2003.
The researchers found that from age 20 to 56, obese people racked up the highest health costs. But because both the smokers and the obese died sooner than the healthy group, it cost less to treat them in the long run.
On average, healthy people lived 84 years. Smokers lived 77 years, and obese people lived 80 years. Smokers and obese people tended to have more heart disease.
Cancer incidence, except for lung cancer, was the same in all three groups. Obese people had the most diabetes, and healthy people had the most strokes.
Ultimately, the thin and healthy group cost the most - $417,000, from age 20 on. The cost of care for obese people was $371,000, and for smokers, $326,000.
"This throws a bucket of cold water onto the idea that obesity is going to cost trillions of dollars," said Patrick Basham, a professor of health politics at Johns Hopkins University who was unconnected to the study. Government projections about obesity costs are frequently based on guesswork, political agendas and changing science, he said.
"If we're going to worry about the future of obesity," he said, "we should stop worrying about its financial impact."