Obesity and its Impact on a Provincial Health System in Canada

Purpose In Newfoundland and Labrador, 25–35% of adults are obese. Due to the increased prevalence of obesity and its associated adverse health effects, it is assumed obesity has negative clinical and economic consequences. The present study examined the association of BMI level with self reported chronic disease, actual measures of physician and hospital health services utilization and the associated direct costs in the province of Newfoundland and Labrador. Methods In a secondary analysis of the provincial component of the Canadian Community Health Survey (2000/01), survey records for respondents aged 20–64 (n=2345) were linked to 5 years of administrative physician and hospitalization data in order to obtain objective longitudinal HSU. Regression models were used to examine whether BMI level was an independent predictor of physician visits, hospitalization and costs. Results Of the sample, 37%, 39%, 17% and 6% were classified as normal, overweight, obese, and morbidly obese (BMI ≥ 35kg/m2), respectively. The obese (including morbidly obese) were more likely to report serious chronic conditions (e.g. hypertension, Type II diabetes). Analyses identified the morbidly obese group as having a significantly higher number of GP visits over a 5-year period compared with the normal weight group (BMI 18.5–24.9kg/m2), [median 22.0 vs. 17.0, p<0.05], and as having significantly higher average costs of GP (p<0.001) and specialist services (p<0.05). Morbidly obese was a significant independent predictor of GP visits (p<0.001) and total physician costs (p<0.01), after adjusting for chronic conditions and other covariates. Conclusion Being obese is associated with increased presence of chronic diseases, namely those related to lifestyle. Morbid obesity is independently associated with increased family physician utilization and total physician costs. A percentage of future health promotion and education efforts and weight loss interventions should be targeted at this high risk group.