Sturm Roland
Economic and Policy Research Program, UCLA/RAND Managed Care Center for Psychiatric Disorders, CA, USA.
Health Aff (Millwood). 2002 Mar-Apr;21(2):245-53. doi: 10.1377/hlthaff.21.2.245.
This paper compares the effects of obesity, overweight, smoking, and problem drinking on health care use and health status based on national survey data. Obesity has roughly the same association with chronic health conditions as does twenty years' aging; this greatly exceeds the associations of smoking or problem drinking. Utilization effects mirrors the health effects. Obesity is associated with a 36 percent increase in inpatient and outpatient spending and a 77 percent increase in medications, compared with a 21 percent increase in inpatient and outpatient spending and a 28 percent increase in medications for current smokers and smaller effects for problem drinkers. Nevertheless, the latter two groups have received more consistent attention in recent decades in clinical practice and public health policy.
本文基于全国调查数据，比较了肥胖、超重、吸烟和问题饮酒对医疗保健使用和健康状况的影响。肥胖与慢性健康状况的关联程度大致与二十年的衰老相当；这大大超过了吸烟或问题饮酒的关联程度。利用效应反映了健康效应。与当前吸烟者住院和门诊支出增加21%、药物支出增加28%以及问题饮酒者的影响较小相比，肥胖与住院和门诊支出增加36%以及药物支出增加77%相关。然而，近几十年来，后两组在临床实践和公共卫生政策中受到了更持续的关注。
