Obesity: Gobbling California Whole

Today, the California Center for Public Health Advocacy released a study titled The Economic Costs of Overweight, Obesity and Physical Inactivity Among California Adults – 2006.

The CCPHA worked with a consulting firm to estimate just how much obesity, overweight, and physical inactivity cost the state of California in health care expenditures and lost productivity.

So, just how much does obesity cost the Golden State?

CCPHA says 41 billion dollars.

I am wary of the category of "lost productivity" as this seems very difficult to accurately measure. So, lets pretend we cut out the cost of obesity, overweight and inactivity in terms of lost productivity and just focus on the health care costs of these three conditions. The number is still pretty astounding: $20.7 billion in health care costs associated with the three conditions, according to this report.

The state of California started issuing IOUs this week. It is dealing with a budget deficit of about $24.3 billion right now, and counting. Be careful, it would be an over simplification to juxtapose those two numbers and say that California's budget deficit could be solved if everyone the state shaped up and got healthy. But, considering the current budget deficit does put that $20.7 billion number in perspective.

Right now people are panicking about a $24.3 billion budget deficit. That number is high enough to be a panic number. So, I don't think it is too much to say, at least, that any public health issue that is costing us anything in the ballpark of $20 billion (and remember, I am cutting the reported cost estimate of this study in HALF already) is cause for major concern.

The exciting thing about this study is that it makes a good case for some of the preventative measures such as education and social services to reduce obesity that are often cut when funding is tight. It seems that it might really be worth it to invest in creating better food environments and helping people learn to be healthier.

Obesity is really a tough issue though. In one sense, health problems resulting from obesity and overweight can be viewed as voluntarily begotten, like the problems that result from cigarette smoking. NPR ran a story today about the fact that states all over the nation are hiking cigarette or "vice" taxes; apparently this tends to be a popular fund raising tactic in a recession. Mississippi State Rep. Cecil Brown is all for taxing people whose voluntary bad health choices drain the state coffers. He was quoted as saying:

"The Medicaid budget in our state is just about to eat us alive, and a substantial number of people who are on Medicaid are smokers. If people are going to choose to smoke and it's a voluntary activity, and they are costing the other taxpayers in the state money, then they should contribute to the cost."

Does the same go for obesity? Is obesity really a condition arrived at by purely voluntary activity?

My own experience living on a low budget would suggest that it isn't, at least not in all cases. Sourcing healthy and affordable food is quite challenging, and many low income neighborhoods do not support good food choices. As my blog has explored, the elements like time, money, culture, social conditioning, education, and geographical layout of food sources all come into play.

Whats more, the fact that obesity and poverty are very clearly linked suggests that obesity has quite a bit to do with lack of education and financial resources. But, I am not going to totally let the citizens of America and Los Angeles County (where the rates of financial costs of obesity, overweight, and inactivity were the highest) off the hook totally here. A portion of the obesity problem is also the result of laziness, apathy, lack of desire to change, and straight up over consumption of shit quality food items that people know are bad for them. We're at a point where we know Big Macs are too big and no good, but we're still in the drive through line, and that has to be addressed.

I would not say that obesity is voluntary, but it is a condition we can do something about. It is not a disease without a cure. It is the direct result of poor diet and lack of exercise. Punto. As far as I'm concerned, this is just another call to action across the board from dining rooms to urban planning maps and legislative offices.