NCPA - National Center for Policy Analysis

Obesity a Greater Health Risk than Smoking, Drinking or Poverty

March 12, 2003

Obesity is widely recognized as a health risk. The negative effects of obesity and other known health risks, such as smoking, heavy drinking and poverty, have been well documented. But until now, no one has compared them. Is one problem worse than another? Or are they all equally risky?

Two RAND researchers examined the comparative effects of obesity, smoking, heavy drinking and poverty on chronic health conditions and health expenditures. Their finding: Obesity is the most serious problem. It is linked to a big increase in chronic health conditions and significantly higher health expenditures. And it affects more people than smoking, heavy drinking or poverty.

The study reveals that obesity is linked to very high rates of chronic illnesses -- higher than living in poverty, and much higher than smoking or drinking.

  • When compared with normal-weight individuals of the same age and sex having similar social demographics, obese people suffer from an increase in chronic conditions of approximately 67 percent.
  • In contrast, the increase for normal-weight daily smokers is only 25 percent, and for normal-weight heavy drinkers, only 12 percent.

Obese individuals spend more on both services and medication than daily smokers and heavy drinkers:

  • For example, obese individuals spend approximately 36 percent more than the general baseline population on health services, compared with a 21 percent increase for daily smokers and a 14 percent increase for heavy drinkers.
  • Obese individuals spend 77 percent more on medications -- only aging has a greater effect -- and only on expenditures for medications.

RAND's findings suggest that weight reduction should be an urgent public health priority. The prevalence of obesity, and its strong association with chronic conditions, indicate that weight reduction would mitigate the effects of obesity on the occurrence of specific diseases and would significantly improve quality of life.

Source: RAND, "The Health Risks of Obesity Worse Than Smoking, Drinking, or Poverty," March, 2002; based on Roland Sturm, "The Effects of Obesity, Smoking, and Problem Drinking on Chronic Medical Problems and Health Care Costs," Health Affairs, April 2002; and Roland Sturm and Kenneth Wells, "Does Obesity Contribute as Much to Morbidity as Poverty or Smoking?" Public Health, July 2001.


Browse more articles on Health Issues