Obesity and Smoking: Major Contributors To Healthcare Costs
By Dr. James Palermo // April 29, 2012
A study out of the Mayo Clinic in Rochester and published in the March Journal of Occupational and Environmental Medicine, analyzed the additional healthcare costs of smoking and obesity among more than 30,000 Mayo Clinic employees and retirees, who had continuous health insurance coverage from 2001 to 2007.
Lead researcher, James P. Moriarty, MSc, and his Mayo coauthors confirmed that both obesity and smoking contribute to higher individual healthcare costs. Compared to nonsmokers, average healthcare costs were $1,275 higher for smokers, with incremental costs associated with obesity even higher at $1,850 more than for normal-weight individuals. For those with morbid obesity the excess costs were up to $5,500 per year.
Today, 20% of the adult U.S. population smokes, and 35% of adults are considered obese, defined as having a body mass index (BMI) of 30 or higher.
Smoking and obesity place a growing strain on a healthcare system that is already battling progressive cost challenges. Employers and payers are evaluating incentives for wellness programs — such as quit-smoking and fitness programs — to lower costs by reducing health risk factors.
In an attempt to create and foster a complete culture of wellness, some employers–primarily hospitals, in states where allowed by law, have or are considering not hiring applicants whose urine tests positive for nicotine use, whether cigarettes, smokeless tobacco or even patches.
However hiring policies that may discriminate against a smoker have come under fire, and 29 states and the District of Columbia have laws that protect smoker’s rights. Proponents of these laws suggest that the hiring restrictions punish smokers rather than helping them quit.
Likewise, an increasing number of employers are being influenced by an applicant’s weight during the hiring process – although most companies which discriminate against the obese don’t have a written policy for fear of legal action.
It is well established, and this recent Mayo Clinic study affirms that poor life-style and health choices cost companies thousands of dollars annually in preventable medical care costs. Add to that lower productivity, higher disability payments and more time lost from work from the complications associated with these conditions.
Also, based on the logical expectation that an employee or associate should reflect favorably on his/her employer, especially if the business involves health, we can expect more scrutiny at the time of hiring related to smoking and obesity, more stringent expectations to quit smoking and slim down, and the provision by employers and payers of more effective programs to support better health and life-style choices.