Diabetes, Chronic Conditions Linked With Higher Health Spending

Chronic conditions, such as high blood pressure, heart disease, stroke, emphysema, high cholesterol, cancer, diabetes, arthritis, and asthma, are linked with food insecurity and higher health care spending, according to results of a recent study.

Researchers from the department of health management and policy at the University of Miami Herbert Business School, Coral Gables, FL, explained that social determinants are a top focus recently by policy makers and government agencies, and their study was designed to disentangle the relationships among food insecurity, health care utilization, and health care expenditures.

Using food insecurity measures data from the 2016 Medical Expenditure Panel Survey for 13,465 adults, aged 18 years or older, the researchers designed two-stage empirical models controlling for demographics, health insurance, poverty status, chronic conditions, and other predictors

Results of the study showed that health care expenditure—total, inpatient, emergency department, outpatient, and pharmaceutical—is increased for marginal, low, and very low food secure individuals.

“Relative to food secure households, very low food secure households are 5.1 percentage points (P< .001) more likely to have any health care expenditure and have total health care expenditures that are 24.8% higher (P=.011),” explained the researchers.

When chronic conditions, like diabetes, were included in the models, these underlying health conditions mitigate the differences in expenditures by food insecurity status. The researchers added that only the likelihood of any having any health care expenditure for very low food secure households remains statistically significant.

“Our results indicate that chronic conditions are strongly associated with food insecurity and higher health care spending. Efforts to alleviate food insecurity should consider the dual burden of chronic conditions,” concluded the researchers of the study. “Finally, future research can address specific mechanisms underlying the relationships between food security, health, and health care.”

—Edan Stanley

Reference:

Dean EB, French MT, Mortensen K. Food insecurity, health care utilization, and health care expenditures [published online ahead of print, 2020 Mar 18]. Health Serv Res. 2020;10.1111/1475-6773.13283. doi:10.1111/1475-6773.13283