The Rise in Pediatric Obesity-Related Conditions and Costs in Public Insurance Programs: Evidence from Alabama

Area of Science:

• Public Health
• Pediatric Health
• Health Economics

Background:

• Pediatric obesity rates are rising globally.
• The impact on obesity-related conditions (Ob-Cs) and healthcare costs in publicly insured children remains unclear.
• Understanding these trends is crucial for resource allocation and intervention strategies.

Purpose of the Study:

• To quantify the increase in Ob-C diagnoses among children enrolled in Alabama's Children's Health Insurance Program (ALL Kids).
• To assess the associated changes in medical costs for these children from 1999 to 2015.
• To identify demographic disparities in the trends of Ob-C diagnoses and costs.

Main Methods:

• Retrospective analysis of linked claims and demographic data from Alabama's ALL Kids program (1999-2015).
• Multivariate linear probability models estimated the likelihood of Ob-C diagnoses.
• Two-part models analyzed inpatient, outpatient, emergency department, and overall healthcare costs.

Main Results:

• The proportion of children with Ob-C diagnoses nearly doubled, from 1.3% to 2.5%.
• Diagnosis likelihood increased annually, with higher rates among minority, low-income enrollees, and those receiving preventive care.
• Healthcare costs for children with Ob-Cs rose significantly relative to those without, especially inpatient and outpatient expenses.

Conclusions:

• Obesity-related conditions and associated medical costs have substantially increased in publicly insured children.
• While past underdiagnosis may contribute, current underdiagnosis remains a significant issue.
• Targeted interventions and improved diagnostic practices are needed, particularly for vulnerable populations.