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Study Finds Depression Is A Leading Risk For Higher Health Spending

By Jordan Rau

November 6th, 2012, 6:00 AM

Depression was the most costly among 10 common risk factors linked to higher health spending for employees, according to a new study of seven companies. The study published in Health Affairs found that the 10 factors — which also included obesity, high blood sugar and high blood pressure — were associated with nearly a quarter of the money spent on the health care of the workers.

Researchers looked at 92,486 workers from seven different employers. The employees were first assessed for health risks. Then researchers tracked their medical spending, using a MarketScan insurance claims database covering the years 2005 through 2009. The average annual medical expenditure for each employee was $3,961. In total, $82 million, or 22.4 percent, of the $366 million annually spent on health care for the workers was attributed to the 10 risk factors, the study found.

The relationship between higher spending and depression was the strongest, with a 48 percent higher spending level for workers with a propensity for that widespread mood disorder. People with high blood sugar had 32 percent higher medical expenses, as did people with high blood pressure. Obesity was associated with 27 percent higher spending. Tobacco use, sedentary behavior and high stress also were related to increased spending, although not as much as those other risk factors. People with multiple risk factors tended to have especially high health care costs.

The study could not show that any of these risk factors caused the higher spending, merely that they were related. And the study discovered that three risk factors — high cholesterol, poor nutrition and eating habits and alcohol consumption — were actually linked to slightly lower health spending. The researchers suggested various explanations for this counterintuitive finding.  Regarding alcohol, they wrote that “the nationally recognized threshold for high risk (three drinks a day for men and two for women) may need to be revisited, because drinking at these levels would not constitute alcohol abuse.” They questioned the usefulness of the way the study measured a nutritious diet, writing it might not be enough to simply measure fruit and vegetable consumption. As for cholesterol, they asserted that its impact on health might be more complicated than a simple causal relationship.

The study was led by Ron Goetzel, director of Emory University’s Institute for Health and Productivity Studies and an executive at Truven Health Analytics in Washington, D.C.

The researchers said the overall results of the study could offer encouragement to employers to do more to screen workers for high risk behaviors and to try to treat them proactively. On the question of whether employers might try to screen out prospective employees with these risk factors, the authors said that so many people in the nation have one or more of these risk factors that any such effort might crimp hiring. “More important,” the authors wrote, “taking this approach would also be unethical and illegal.”

One Response to “Study Finds Depression Is A Leading Risk For Higher Health Spending”

  1. Ted says:

    A recent article on the Accountable Care Act (ACA) attempting to dispell myths about the ACA, failed to mention an important yet subtle issue the Act does in fact do.

    The ACA includes many quality initiatives such as the value based purchasing, readmission penalties, mortality measures, case coding offsets, etc. These provisions of the law also preclude judicial and administrative review of anything the Medicare program does in implementing these provisions. As of today many of these provisions have been implemented in a manner that could cause harm to Medicare beneficiaries and these aspects have been commented on but ignored by the agency. With these provisions in place a beneficiary’s appeal rights are limited.

    Placed in context this means that in passing the ACA the congress (the Legislation Branch) wrote broad legislative language, tasked the Medicare program (the Executive Branch) with implementing it; but, prevented the Judicial Branch from any review.

    The presence of these preclusion provisions raises a very critical threshold question that no one in the press has sought to cover but that is of critical importance to every Medicare beneficiary: what is it that Congress and the Administration (the Medicare program) is going to do that provoked the drafters of the ACA to include preclusion of judicial and administrative review provisions (provisions that violate the separation of powers provision in the Constitution) that prevent me as a Medicare beneficiary from any appeal whatsoever?

    I can tell you that we have discussed this fact with many citizens and 100% of these folks once they find out these provisions are included in the ACA say “that’s not right.” “100%.” That’s clerks, gas station attendants, tree trimmers, computer analysts, lawyers, accountants, doctors, financial analyst, etc.

    Its curious that this has not been discussed in the press at all, don’t you think?