Health Status, Emotional/Behavioral Problems, Health Care Use, and Expenditures in Overweight/Obese US Children/Adolescents

doi:10.1016/j.acap.2013.02.005

Academic Pediatrics

Volume 13, Issue 3, May–June 2013, Pages 251-258

https://doi.org/10.1016/j.acap.2013.02.005 Get rights and content

Abstract

Objective

To examine the association of overweight/obesity with health, health care utilization, and expenditures in a national sample of 10- to 17-year-old children and adolescents.

Methods

Secondary analysis of 2005 to 2009 Medical Expenditure Panel Survey data (n = 17,224). Outcome measures included suboptimal health, emotional/behavioral problems, health care utilization, and expenditures.

Results

Overweight and obese children and adolescents had greater risk of suboptimal health (adjusted risk ratio [ARR], 1.4 and 1.7; P < .01), use of prescriptions (ARR, both 1.1; P = .01), and emergency department visits (ARR, 1.2 and 1.1; P = .01); overweight children/adolescents had lower mean out-of-pocket expenditures (∼$100, P < .01); and obese children/adolescents had greater risk of emotional/behavioral problems (ARR, 1.2; P < .01) and specialist visits (ARR, 1.1; P = .01). The most common specialty referral among obese children/adolescents was psychiatry. Overweight and obesity were not associated with office visits or total expenditures. A greater proportions of children and adolescents with suboptimal health and emotional/behavioral problems had health care expenditures, and those with suboptimal health were more likely to have out-of-pocket expenditures.

Conclusions

Pediatric overweight and obesity affect child and adolescent health status, emotional/behavioral problems, and specific domains of health care utilization, but do not appear to be associated with total health care expenditures. Out-of-pocket expenditures are lower among overweight children and adolescents. These findings highlight the need for early intervention in overweight children/adolescents, when health care expenditures may not be greater, and suggest that it may prove useful to pay special attention to the health status and emotional/behavioral problems of overweight and obese children/adolescents in weight-management interventions.

Section snippets

Methods

The data source was MEPS, a national probability survey conducted annually by the Agency for Healthcare Research and Quality. MEPS is considered one of the most comprehensive surveys of health, health care use, and expenditures. MEPS utilizes an overlapping panel design, with each panel undergoing 6 interviews over 2 years. Estimates based on sampling weights generalize to the entire population of noninstitutionalized US children/adolescents. A detailed description of the MEPS design, methods,

Sociodemographics

Of 17,224 children/adolescents in the sample, which, when weighted, represent 20,901,650 10- to 17-year-old children/adolescents in the United States each year, 17% were overweight and 16% were obese (Table 1). Characteristics significantly associated with overweight and obesity include male gender, younger age, minority race/ethnicity, poverty, non-MSA residence, and public insurance; having a usual source of care and MEPS survey year were not associated with BMI-percentile category.

Health Status and Emotional/Behavioral Problems

Compared

Discussion

This is the first study to report in a national sample that, compared with healthy-weight children/adolescents, overweight and obese children/adolescents have higher odds of suboptimal health over a 2-year period, but similar office-visit use and total expenditures, and overweight children/adolescents have lower out-of-pocket expenditures. These study findings highlight an apparent incongruity between the presence of poorer self-rated health among overweight and obese children/adolescents, but

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OverweightHealth Status, Emotional/Behavioral Problems, Health Care Use, and Expenditures in Overweight/Obese US Children/Adolescents

Abstract

Objective

Methods

Results

Conclusions

Section snippets

Methods

Sociodemographics

Health Status and Emotional/Behavioral Problems

Discussion

Econ Hum Biol

Lancet

J Am Acad Child Adolesc Psychiatry

J Health Econ

J Natl Med Assoc

Ann Allergy Asthma Immunol

Prevalence of obesity and trends in body mass index among US children and adolescents, 1999–2010

JAMA

Health consequences of obesity in youth: childhood predictors of adult disease

Pediatrics

The medical cost of cardiometabolic risk factor clusters in the United States

Obesity

Health-care expenditures of overweight and obese males and females in the medical expenditures panel survey by age cohort

Obesity

Children’s health care use: a prospective investigation of factors related to care-seeking

Med Care

Dynamics of obesity and chronic health conditions among children and youth

JAMA

Health-related quality of life in obese children and adolescents

Int J Obes

Health status and health care expenditures in a nationally representative sample: how do overweight and healthy-weight children compare?

Pediatrics

Health-related quality of life of severely obese children and adolescents

JAMA

Association of overweight with academic performance and social and behavioral problems: an update from the Early Childhood Longitudinal Study

J Sch Health

The impact of obesity on health service utilization and costs in childhood

Obesity

Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: summary report

Pediatrics

Childhood overweight prevalence in the United States: the impact of parent-reported height and weight

Obesity

Global measures of impairment for epidemiologic and clinical use with children and adolescents

Int J Methods Psychiatric Res

Overweight
Health Status, Emotional/Behavioral Problems, Health Care Use, and Expenditures in Overweight/Obese US Children/Adolescents