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Author: Bhattacharya, Jay
Resulting in 3 citations.
1. Bhattacharya, Jay
Bundorf, M. Kate
The Incidence of the Healthcare Costs of Obesity
Journal of Health Economics 28,3 (May 2009): 649-658.
Cohort(s): NLSY79
Publisher: Elsevier
Keyword(s): Discrimination, Employer; Discrimination, Sex; Gender Differences; Health Care; Insurance, Health; Obesity; Wage Levels

Who pays the healthcare costs associated with obesity? Among workers, this is largely a question of the incidence of the costs of employer-sponsored coverage. Using data from the National Longitudinal Survey of Youth and the Medical Expenditure Panel Survey, we find that the incremental healthcare costs associated with obesity are passed on to obese workers with employer-sponsored health insurance in the form of lower cash wages. Obese workers without employer-sponsored insurance do not have a wage offset relative to their non-obese counterparts. A substantial part of the lower wages among obese women attributed to labor market discrimination can be explained by their higher health insurance premiums. [Copyright 2009 Elsevier]

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Bibliography Citation
Bhattacharya, Jay and M. Kate Bundorf. "The Incidence of the Healthcare Costs of Obesity." Journal of Health Economics 28,3 (May 2009): 649-658.
2. Bhattacharya, Jay
Kate Bundorf, Kate
Pace, Noemi
Sood, Neeraj
Does Health Insurance Make You Fat?
NBER Working Paper No. 15163, National Bureau of Economic Research, July 2009.
Cohort(s): NLSY79
Publisher: National Bureau of Economic Research (NBER)
Keyword(s): Body Mass Index (BMI); Endogeneity; Health Care; Health/Health Status/SF-12 Scale; Insurance, Health; Obesity

The prevalence of obesity has been rising dramatically in the U.S., leading to poor health and rising health care expenditures. The role of policy in addressing rising rates of obesity, however, is controversial. Policy recommendations for interventions intended to influence body weight decisions often assume the obesity creates negative externalities for the non-obese. We build on earlier work demonstrating that this argument depends on two important assumptions: 1) that the obese do not pay for their higher medical expenditures through differential payments for health care and health insurance, and 2) that body weight decisions are responsive to the incidence of medical care costs associated with obesity. In this paper, we test the latter proposition – that body weight is influenced by insurance coverage - using two approaches. First, we use data from the Rand Health Insurance Experiment, in which people were randomly assigned to varying levels of health insurance, to examine the effect of generosity of insurance coverage on body weight along the intensive coverage margin. Second, we use instrumental variables methods to estimate the effect of type of insurance coverage (private, public and none) on body weight along the extensive margin. We explicitly address the discrete nature of the endogenous indicator of health insurance coverage by estimating a nonlinear instrumental variables model. We find weak evidence that more generous insurance coverage increases body mass index. We find stronger evidence that being insured increases body mass index and obesity.
Bibliography Citation
Bhattacharya, Jay, Kate Kate Bundorf, Noemi Pace and Neeraj Sood. "Does Health Insurance Make You Fat?" NBER Working Paper No. 15163, National Bureau of Economic Research, July 2009.
3. Goldhaber-Fiebert, Jeremy D.
Rubinfeld, Rachel E.
Bhattacharya, Jay
Robinson, Thomas N.
Wise, Paul H.
The Utility of Childhood and Adolescent Obesity Assessment in Relation to Adult Health
Medical Decision Making 33,2 (February 2013): 163-175.
Cohort(s): Children of the NLSY79, NLSY79 Young Adult
Publisher: Sage Publications
Keyword(s): Body Mass Index (BMI); Child Health; Children, Health Care; Health/Health Status/SF-12 Scale; National Health and Nutrition Examination Survey (NHANES); Obesity; Panel Study of Income Dynamics (PSID); Weight

Permission to reprint the abstract has not been received from the publisher.

Background: High childhood obesity prevalence has raised concerns about future adult health, generating calls for obesity screening of young children.

Objective: To estimate how well childhood obesity predicts adult obesity and to forecast obesity-related health of future US adults.

Design: Longitudinal statistical analyses; microsimulations combining multiple data sets.

Data Sources: National Longitudinal Survey of Youth, Population Study of Income Dynamics, and National Health and Nutrition Evaluation Surveys. Methods: The authors estimated test characteristics and predictive values of childhood body mass index to identify 2-, 5-, 10-, and 15 year-olds who will become obese adults. The authors constructed models relating childhood body mass index to obesity-related diseases through middle age stratified by sex and race.

Results: Twelve percent of 18-year-olds were obese. While screening at age 5 would miss 50% of those who become obese adults, screening at age 15 would miss 9%. The predictive value of obesity screening below age 10 was low even when maternal obesity was included as a predictor. Obesity at age 5 was a substantially worse predictor of health in middle age than was obesity at age 15. For example, the relative risk of developing diabetes as adults for obese white male 15-year-olds was 4.5 versus otherwise similar nonobese 15-year-olds. For obese 5-year-olds, the relative risk was 1.6. Limitation: Main results do not include Hispanics due to sample size. Past relationships between childhood and adult obesity and health may change in the future.

Bibliography Citation
Goldhaber-Fiebert, Jeremy D., Rachel E. Rubinfeld, Jay Bhattacharya, Thomas N. Robinson and Paul H. Wise. "The Utility of Childhood and Adolescent Obesity Assessment in Relation to Adult Health." Medical Decision Making 33,2 (February 2013): 163-175.