Racial differences in lifetime healthcare costs associated with obesity-related multimorbidity among the U.S....

Obesity is a costly cause of morbidity and disability. Previous research has well documented that Black persons bear a disproportionate financial burden of obesity-related multimorbidity (ORM); however, healthcare costs have not been examined over the lifespan.

Among U.S. general population age ≥40 years, we quantified racial difference in 1) lifetime healthcare costs (LHC's), and 2) lifetime healthcare cost differential (LCD) associated with ORM.

We used data from the Medical Expenditure Panel Survey, 2008-2012, and targeted four obesity-related diseases (ORDs): diabetes, hypertension, coronary heart disease, and stroke. A published Markov model was used to model individuals' life histories of ORDs and to compute LHC's. LCD associated with ORM was computed by taking the difference between LHC for those with ORM and LHC for members without ORD. Racial differences were quantified by taking the differences in LHC or LCD between White and Black men/women.

We included 53,035 Black and White individuals representing 97,229,611 (se=2,104,365) U.S. Black (12.4%) and White (87.6%) populations aged ≥40 years. ORM was more prevalent in the Black (21.2%) than the White populations (13.4%). Racial difference in LHC's for women/men with ORM and LCDs associated with ORM (2012$) was $31,035/43,595 and $11,350/26,948 for age 40-49, $21,567/25,615 and $3,846/9,808 for 50-59, $9,863/18,515 and -$2,566/7,426 for 60-69, -$8,220/16,285 and -$11,524/3,865 for 70-79.

Racial differences in LHC's and LCD associated with ORM persist and the scale varies by subpopulation. Future interventions designed to prevent/manage ORM are crucial to prioritize populations burdening with high LHC's and health disparities.