Department of Health & Inequality, Norwegian Institute of Public Health, Oslo, Norway.
Department of Health Management and Health Economics, University of Oslo, Oslo, Norway.
Health Serv Res. 2018 Jun;53(3):1621-1643. doi: 10.1111/1475-6773.12708. Epub 2017 May 17.
To test the impact of obesity on health and health care use in children, by the use of various methods to account for reverse causality and omitted variables.
DATA SOURCES/STUDY SETTING: Fifteen rounds of the Health Survey for England (1998-2013), which is representative of children and adolescents in England.
We use three methods to account for reverse causality and omitted variables in the relationship between BMI and health/health service use: regression with individual, parent, and household control variables; sibling fixed effects; and instrumental variables based on genetic variation in weight.
DATA COLLECTION/EXTRACTION METHODS: We include all children and adolescents aged 4-18 years old.
We find that obesity has a statistically significant and negative impact on self-rated health and a positive impact on health service use in girls, boys, younger children (aged 4-12), and adolescents (aged 13-18). The findings are comparable in each model in both boys and girls.
Using econometric methods, we have mitigated several confounding factors affecting the impact of obesity in childhood on health and health service use. Our findings suggest that obesity has severe consequences for health and health service use even among children.
通过使用多种方法来考虑反向因果关系和遗漏变量,检验肥胖对儿童健康和医疗保健利用的影响。
数据来源/研究范围:英格兰健康调查的十五轮调查(1998-2013 年),这些数据代表了英格兰的儿童和青少年。
我们使用三种方法来考虑 BMI 与健康/医疗服务使用之间关系中的反向因果关系和遗漏变量:个体、父母和家庭控制变量的回归;兄弟姐妹固定效应;基于体重遗传变异的工具变量。
数据收集/提取方法:我们纳入了所有 4-18 岁的儿童和青少年。
我们发现肥胖对女孩、男孩、年幼儿童(4-12 岁)和青少年(13-18 岁)的自评健康有统计学上显著的负面影响,对医疗服务的利用有积极影响。在男孩和女孩的每个模型中,这些发现都是可比的。
通过使用计量经济学方法,我们减轻了影响肥胖对儿童健康和医疗服务利用的影响的几个混杂因素。我们的研究结果表明,肥胖对健康和医疗服务的利用有着严重的后果,即使是在儿童中。