Obesity Prevalence Trends and the Impact on Emergency Department Utilization

September 10, 2014  |  David White

To continue our discussion of Emergency Department utilization and regional utilization trends, today we examine the adult obesity rate data published last week by the CDC.

These results suggested some interesting insights, including the fact that the two states with the highest self-reported adult obesity rates also have the highest statewide ED use rates (visits per 1000 persons) in the country. More than 35% of the citizens of West Virginia and Mississippi are obese. West Virginia has an ED use rate of 660 and Mississippi 592 compared to the nationwide average of 420.

Recently we studied 160+ demographic, lifestyle, and health related variables to understand their relationship to Medicare ED Visits and higher ED utilization. As you can imagine, the percent of population that was obese correlated strongly to ED utilization.

obese and ED use rate

Obesity rates graphed with Medicare ED use rates per 1000 for every county in the United States shows a strong correlation. 

Given the fact that higher obesity rates lead to higher incidences of diabetes and cardiovascular disease one would expect a strong relationship between the high rates of obesity and high ED utilization.

More surprising, however, is the historical trend between the two. This visualization shows the change in both statewide ED utilization and obesity rates from 1996-2011.

Note: the prevalence estimates reflect Behavioral Risk Factors Surveillance System methodological changes started in 2011, use caution when comparing these to estimates prior to 2011.

There were some interesting changes between 1996 and 2012:

      • In 1996 there were no states with a prevalence of obesity greater than or equal to 20%, and 16 states had obesity prevalence under 15%. Also in 1996 there were only 7 states with an ED use rate over 425, and 25 states were under 350.
      • By 2004 there were only 7 states that had a prevalence of obesity under 20%, and there were 12 states over 25%. On the ED side there were 15 states with an ED use rate over 425 and only 16 states were below 350.
      • For 2012 there were no states with a prevalence of obesity under 20% and 13 states above 30%. There were only 8 states with an ED use rate below 350. There were 26 states with an ED use rate above 425, and of those 12 states were over 500.

obese and ED use rate percentage changeThere is a strong link between the prevalence of obesity in adult Americans and emergency department utilization, and this issue impacts utilization as well as healthcare costs. In 2008, the estimated medical cost of obesity in the US was $147 million, and the medical costs for those that were obese were $1,429 more than those of normal weight. This is a sobering trend that needs to be turned around and programs such as the one developed by First Lady Michelle Obama are a step in the right direction; however, it’s tough to counteract the impact that some restaurant chains may have on obesity with recent promotional deals such as at TGI Fridays and the Olive Garden.

Image Source: CC Image courtesy of Mike_Fleming on Flickr

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