Medicaid Recipients Most Likely to Suffer from Preventable Illnesses

A survey conducted by The Gallup-Healthways Well-Being Index shows that those who rely primarily on Medicaid are far more likely to have preventable chronic illnesses than those who receive insurance from their employer, union, as part of a military or veteran's benefit package, and those who are uninsured. More than 1 in 3 recipients of Medicaid are obese compared to 27% of those who receive insurance from their employer or union. Those on Medicaid are also three times more likely to suffer from depression than those who receive their primary insurance from their union or employer, with 22% of the former suffering from depression compared to only 7% of the latter. Also concerning is the fact that 16% of Medicaid recipients suffer from asthma, compared to only 6% of those who receive insurance from an employer or union.
       Although these numbers are certainly cause for concern, it should be noted that recipients of Medicaid are usually living in poverty or are disabled, hence why they receive Medicaid. As Gallup notes, there is a strong correlation between poverty and suffering from poor health. Thus, these findings do not necessarily indicate that those on Medicaid are receiving poor quality care, but perhaps they are simply more likely to suffer from these conditions as a result of their poor socioeconomic status.

U.S. Obesity Rate Ticking Up

According to recent Gallup poll upon which the Gallup-Healthways Well-Being Index is based, the adult obesity rate in the U.S. thus far in 2013, at 27.1%, is on pace to surpass rates in prior years. It is up from 26.2% in 2012 and much higher than the 25.5% found in 2008.

This uptick in obesity is accompanied by slight declines in the percentage of Americans who are classified as overweight and normal weight. The percentage who are overweight fell to 35.6% so far this year from 36.1% in 2012, while the percentage who are a normal weight slipped to 35.4% from 35.9% in 2012.

Gallup and Healthways began tracking Americans' weight in 2008. The 2013 data are based on more than 84,000 interviews conducted from Jan. 1 through June 20 as part of the Gallup-Healthways Well-Being Index. Gallup uses respondents' self-reported height and weight to calculate body mass index (BMI) scores. Individual BMI values of 30 or above are classified as "obese," 25 to 29.9 are "overweight," 18.5 to 24.9 are "normal weight," and 18.4 or less are "underweight."

The upward trend in obesity thus far in 2013 reverses the lower levels found in 2011 and 2012. One possible reason why obesity has increased is that fewer Americans are exercising frequently, in 2013 compared with 2012. Gallup has found that exercising three days per week for 30 minutes per day is closely linked to having a lower BMI.

The American Medical Association officially recognized obesity as a disease, which could have implications for the way physicians, insurance companies, and the general population perceive and treat it. This decision, although controversial, could bring new resources to help with this significant public health problem, which affects more Americans now than it has at any time in the past five years. By classifying obesity as a disease, physicians may be more comfortable addressing the problem of obesity with their patients. At the same time, it could encourage more Americans to rely on complex and expensive medical procedures and treatments, rather than taking steps to lower their weight through exercise, healthy eating, and other lifestyle changes.

The Gallup-Healthways Well-Being Index tracks well-being in the U.S. and provides best-in-class solutions for a healthier world. To learn more, please visit well-beingindex.com.

Lowest Obesity Levels in Rocky Mountain State for Third Year in a Row

According to the Gallup-Healthways Well-Being Index, Colorado is the only state in the nation that has obesity levels below 20%, making it the least obese state since 2010. On the other hand, West Virginia boasts the highest obesity rate, with 33.5% of residents surveyed reporting that they are obese. This is more than 7% higher than the national average of 26.2%. With the exception of four states, there was little change in obesity levels from 2011 to 2012. Delaware was the only state that experienced a slight decrease in obesity levels while obesity rates increased in Georgia, New Jersey, and North Carolina.

As expected, Colorado also had the lowest rates of high blood pressure with only 22% of residents reporting high blood pressure, followed by 23.8% of Minnesotans, and 24.6% of Wyoming residents. West Virginia had the highest level of high blood pressure in the country, with 39.7% of residents reporting high blood pressure, followed by 38.4% if Mississippi residents, and 36.4% of residents in Alabama.

Additionally, many of the states with the lowest obesity levels and lowest rates of high blood pressure also had the lowest diabetes rates. Only 6% of Alaskans reported that they were suffering from diabetes, followed by 7.4% Colorado residents, and 8.1% of Montana residents.  In Mississippi, 15.4% of residents surveyed reported that they had diabetes, marking the highest diabetes rate for any state. West Virginia came in a close second, with 15.2% of residents suffering from diabetes, followed by 13.6% of residents in Alabama.

Little Progress Made in Reducing Obesity Levels

Gallup reports that despite public campaigns aimed at encouraging healthy eating habits and reducing high levels of obesity, it appears that much more work is needed to combat the current health crisis. There were small changes in obesity levels from 2011 to 2012, with obesity increasing by 0.7% from 2011 to 2012. It is estimated that as of 2012, 26.2% of Americans are obese, 36.1% are overweight, and a little more than a third were a normal weight. These results are especially troubling, since obesity rates were expected to decline given that a higher percentage of Americans claimed to exercise frequently and more believed that obesity was a paramount public health issue.

Obesity levels varied by socioeconomic status, race, region, and gender. According to Gallup's study, 20.4% of those with incomes under $36,000 identified as obese. Among those with annual incomes above $90,000, only 21.2% were obese. African Americans continue to have the highest levels of obesity, with 34.9% reporting that they are obese. This is 8% higher than obesity levels among Hispanics, and nearly 10% higher than obesity levels among whites. Obesity levels are also highest in the South, with 28.1% surveyed reporting that they are obese, followed by 27.4% among people in the Midwest, 25% in the East, and 23.2% on the West Coast. Lastly, obesity levels were higher among men, with roughly 27.3% reporting that they are obese compared to 25% of women.

Obesity in America

Gallup’s assessment of obesity in America illustrates some interesting trends.  Blacks are more likely to be obese than any other race.  20.8% of Blacks received the distinction of falling into the obese class I.  8.8% were in obese class II and 6.0% in obese class III. The latter two categories are recognized as very obese.  Asians were the least likely to be obese with only 7.6% falling into obese class I, 2.1% in obese class II, and 1.0% in obese class III.  Overall, men are more likely than women to be obese, but a slightly higher percentage of women are categorized in obese class III (4.0% versus 2.9%).  Additionally, unemployed Americans are more likely to be obese than those who possess a job.  

Finally, both income and education are related to obesity levels.  As Americans obtain higher levels of education (the study tracks those with high school or less up to postgraduate degrees), they are less likely to be obese.  5.2% of those who earn less than $36,000 a year have BMIs high enough to be categorized in obese class III, compared to just 1.8% of Americans who earn greater than $90,000 a year.  

To be considered obese, one must have a body mass index (BMI) of over 30.  For a person who is 5 feet 9 inches, his/her weight would need to rise above 203 pounds to be classified as obese.  To fall under obese class III, that same person would need to weigh over 271 pounds.

Obesity a Continuing Problem for Metropolitan Areas

Despite the public campaigns meant to encourage healthy living styles, obesity rates remain high. Gallup reports that 187 out of 190 metropolitan areas had obesity rates higher than 15% for adults. 38.8% of adults sampled in McAllen-Edinburg-Mission, TX were reported as being obese, which is about 12 points higher than the national average of 26.1%. Boulder, CO reported the lowest adult obesity rate with 12.1%. In less surprising data, those living in areas with the highest obesity rates were more likely to suffer from various illnesses, such as diabetes and depression. Additionally, those living in the top 10 metro areas with the highest obesity rates also collectively paid roughly $1 billion more in healthcare costs than their counterparts living in cities where obesity rates were 15%.

U.S. Diabetes Rate Reverses Course, Declines in 2011

Recent survey data from the Gallup-Healthways Well-Being Index indicates that the U.S. diabetes rate has decreased in 2011, reversing an upward trend that characterized the previous two years. In the third quarter of this year, 11 percent of Americans reported having diabetes, up from 10.6 percent in this year's second quarter, but still "among the lowest levels recorded since 2009." According to Gallup, "The diabetes rate was below 11% throughout 2008, but then began to increase in 2009 and 2010." 11.5 percent of Americans reported having diabetes before January of this year.

The declining diabetes rate mirrors a decline in the percentage of Americans who are obese. Gallup comments: "The obesity rate, which has a well-established relationship with the most common form of diabetes -- Type 2 -- also declined slightly in the second and third quarter of this year, with somewhat lower levels in 2011 compared with 2010."

As the percentage of Americans who are obese declines, so should the percentage of Americans with Type 2 diabetes. "Gallup has found that obese Americans are nearly three times as likely to report having been diagnosed with diabetes as those who are not obese, and that states with the highest obesity rates have much higher diabetes levels than those with the lowest obesity rates."

There is no cure for diabetes, so any decrease in its prevalence should reflect "fewer new cases and a reduction in old cases through mortality." If Americans continue to lose weight, it is likely that a smaller percentage of them will get Type 2 diabetes, and the U.S. diabetes rate will continue to fall.