The Medical Cost Attributable to Obesity and Overweight in China: Estimation Based on Longitudinal Surveys

Abstract

With its rapid economic growth and fast changing lifestyle, China witnessed expansionary prevalence of obesity and overweight during the recent decades. This paper provides the first nationally representative estimate of the medical cost attributable to obesity and overweight in China. We improve upon the traditional estimation methodology (two-part model) by jointly adopting the instrumental variable approach and the panel data methods in order to correct for the potential endogeneity of body size and the individual heterogeneity in medical expenditure. Using longitudinal data from 2000-2009 China Health and Nutrition Surveys, we find that body size has a significant impact on the individual expected medical expenditure and the per capita medical cost attributable to obesity and overweight in a single medical event is estimated to be 6.18 Yuan, or 5.29% of the total personal medical expenditure. This translates to 24.35 billion Yuan annual cost on the national scale, accounting for 2.46% of China's national health care expenditure. The subsample analyses also show that such cost is higher for the urban, women, and better educated people and increases over time. Our results contribute to the literature on the economic impact of obesity in developing countries and bear policy implications on controlling the rising health care costs in China. Copyright © 2015 John Wiley & Sons, Ltd.

Depression hurts, depression costs: The medical spending attributable to depression and depressive symptoms in China

“…Putting together, we conclude that about 14.7% of the personal medical expenditure among Chinese adults can be attributed to depressive symptoms and depression. In comparison to a recent study on the impact of overweight and obesity on health care costs (Qin & Pan, ), our results indicate that both depressive symptoms and depression are very costly to individuals and the society as a whole.…”

“…In addition, about 7.8% of total medical expenditure is attributable to the depressive symptoms. Putting together, our empirical study shows that about 14.7% of total personal medical expenditures in China are attributed to depression and depressive symptoms, which is almost 3 times as large as the impact of obesity and overweight on health care costs obtained from a previous study by Qin and Pan (). The significant impact of depression and depressive symptoms on health care costs indicates that reforming China's mental health care system to cope with the increase in the disease burden is an urgent need.…”

“…On the basis of a similar research method and data obtained from Spain, Mora, Gil, and Sicras‐Mainar () find that the obesity‐induced cost varies with the severity of the condition: Being severely obese is associated with 26% increase in medical costs, and this share reduces to 16% and 8.5% for moderate obesity and overweight, respectively. Using longitudinal data obtained from China, Qin and Pan () find that 5.29% of the total personal medical expenditures are attributable to obesity and overweight, which is equivalent to about 2.46% of China's national health expenditure.…”

The impact of changes in dietary knowledge on adult overweight and obesity in China

“…As the prevalence of overweight and obesity has significantly increased in China, these issues have begun to catch the attention of the public and academia [3–4]. Results from the Chinese Residents Nutrition and Chronic Disease Status Report (2015 ) (From the official website of National Health and Family Planning Commission of People's Republic of China: http://www.nhfpc.gov.cn/jkj/s5879/201506/4505528e65f3460fb88685081ff158a2.shtml) reveal that the overweight rate of adults in China aged 18 and older is 30.15%, and the obesity rate is 11.9%; these rates represent increases of 7.3% and 4.8%, respectively, since 2002.…”

“…Accordingly, it is believed that the rising prevalence of overweight and obesity will put a heavy burden on the social security system. China currently spends 24.35 billion Yuan annually to address overweight, obesity, and their complications, accounting for 2.46% of China’s annual national health care expenditures [4]. Also, overweight and obesity may decrease human capital, causing huge indirect losses due to productivity differentials between obese and non-obese individuals.…”