Adult ; Aged ; Aged, 80 and over ; Alcohol Drinking/epidemiology ; Body Mass Index ; Female ; Health Behavior ; Health Expenditures/statistics & numerical data* ; Humans ; Life Style* ; Male ; Middle Aged ; Obesity/economics ; Obesity/epidemiology* ; Overweight/economics ; Overweight/epidemiology* ; Regression Analysis ; Republic of Korea/epidemiology ; Risk Factors ; Sex Factors ; Young Adult
BACKGROUND: Overweight/obesity is a growing health risk in Korea. The impact of overweight/obesity on pharmaceutical expenditure can be larger if individuals have multiple risk factors and multiple comorbidities. The current study estimated the combined effects of overweight/obesity and other unhealthy behaviors on pharmaceutical expenditure.
METHODS: An instrumental variable quantile regression model was estimated using Korea Health Panel Study data. The current study extracted data from 3 waves (2009, 2010, and 2011).
RESULTS: The final sample included 7148 person-year observations for adults aged 20 years or older. Overweight/obese individuals had higher pharmaceutical expenditure than their non-obese counterparts only at the upper quantiles of the conditional distribution of pharmaceutical expenditure (by 119% at the 90th quantile and 115% at the 95th). The current study found a stronger association at the upper quantiles among men (152%, 144%, and 150% at the 75th, 90th, and 95th quantiles, respectively) than among women (152%, 150%, and 148% at the 75th, 90th, and 95th quantiles, respectively). The association at the upper quantiles was stronger when combined with moderate to heavy drinking and no regular physical check-up, particularly among males.
CONCLUSION: The current study confirms that the association of overweight/obesity with modifiable unhealthy behaviors on pharmaceutical expenditure is larger than with overweight/obesity alone. Assessing the effect of overweight/obesity with lifestyle risk factors can help target groups for public health intervention programs.