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Modifiable health risks linked to more than $730 billion in U.S. healthcare costs

Costs were driven largely by modifiable risk factors such as obesity, high blood pressure, smoking and poor diet.

Jeff Lagasse, Associate Editor

Modifiable health risks, such as obesity, high blood pressure and smoking, were linked to more than $730 billion in healthcare spending in the U.S. in 2016, according to a study published in The Lancet Public Health

Researchers from the Institute for Health Metrics and Evaluation (IHME), an independent global health research center at the University of Washington School of Medicine, and Vitality Group found that the costs were largely due to five risk factors: overweight and obesity, high blood pressure, high blood sugar, poor diet and smoking. Spending associated with risk factors in 2016 constituted 27% of the $2.7 trillion spent on healthcare.


The work was spurred in part by healthcare expenses in the U.S. that are almost double that of other, comparable developed nations. The goal was to understand how much of those costs were attributable to modifiable risk factors, and to draw a financial link between lifestyle risks and medical conditions. The COVID-19 pandemic also spurred the investigation by highlighting the need for prevention to protect both personal and economic health.

Prior to the study, information had not been available on the combined effects of all major risks and the association with healthcare spending. The new findings fill a gap in understanding the potential impact of private and public health promotion and prevention initiatives.

Among the findings are that controllable and treatable risk was strongly related to costly medical conditions – including cardiovascular disease, cancers, diabetes and chronic respiratory diseases.

Costs were driven largely by five modifiable risk factors: overweight and obesity (high body mass index), $238.5 billion; high blood pressure, $179.9 billion; high fasting plasma glucose, $171.9 billion; dietary risks, $143.6 billion; and tobacco smoke, $130 billion.

Healthcare spending increases significantly with age, findings showed, with the greatest proportion of risk-attributable spending associated with those aged 65 and older (44.8%).


Building on a companion analysis by the Institute of Health Metrics and Evaluation of U.S. healthcare spending published earlier this year in JAMA, the study extends findings from that research by estimating the proportion of spending attributable to 84 modifiable risk factors by health condition, age group and sex. 

The findings have implications for public healthcare spending and private health insurance in both the U.S. and other high-income countries. While it's not feasible to realize the full potential savings estimate from this research, significant improvements in health, reductions in medical conditions and control of associated healthcare costs may be possible over time.

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