Differences in Health Care Costs and Utilization among Adults with Selected Lifestyle-Related Risk Factors

Purpose. This study examined the relationship between lifestyle-related health risks and health care costs and utilization in adults. Design. A 2-year prospective study with no intervention was used to compare health care utilization and costs in employees with different levels of health risks. Setting. Data were collected at a primarily white-collar worksite during 1994 and 1995. Subjects. Subjects included 982 employees and spouses, mean age 32.1 ± 10.1 years. Measures. Employee medical claims obtained from a third-party administrator were analyzed with respect to health care expenses and utilization. Exercise habits, stress, and overall wellness were assessed by self-report and obesity by the body mass index (BMI). Regression, regression with outliers removed, and odds ratios were used to analyze the associations. Results. Employees who were at high risk for overall wellness (2.4 times), stress (1.9 times), and obesity (1.7 times) were more likely to have high health care costs (>$5,000) than subjects not at high risk. Mean total medical costs also were greater for high-risk subjects compared to lower risk subjects for overall wellness (difference = $1,973; F = 10.65, p = .001), stress (difference = $1,137; F = 7.35, p = .007), and obesity (difference = $1,092; F = 9.09, p = .003). The exercise habits measure was not significantly associated with health care costs or utilization. Conclusions. Results indicate that health risks, particularly obesity, stress, and general lifestyle, are significant predictors of health care costs and utilization in employed young adults.