What is the Economic Cost of Overweight Children?

Childhood overweight is now considered the most common health problem for children in the U.S. An important question is whether parents and policymakers will see rising medical expenditures for these children while they are still young. We estimate the overweight attributable fraction (OAF) of children’s medical expenditures, controlling for other factors that may cause expenditures to differ. We find that medical expenditures for overweight children are on average $12.09 higher per year (OAF = 0.5 percent), but confidence intervals are large and include zero. We also find little difference in the types of principal diagnoses per visit reported by weight status.

Physical Activity: Economic and Policy Factors

While much research has focused on the costs of obesity and economic factors that drive obesity growth, little economic research has examined the factors that contribute to obesity -- physical inactivity and poor nutrition. This paper will examine correlates and predictors of physical activity over time with emphasis on economic factors. We use data for adults from the 2000-2005 Behavioral Risk Factor Surveillance System (BRFSS) survey that includes state and county codes for each individual that allows us to add supplementary data on state beer and cigarette taxes, local transportation costs, availability of gyms and recreational facilities, county unemployment, crime rates, and prices of related goods. We find that income and education has a strong and consistently positive effect on physical activity across specifications. Sin taxes have no effect on the likelihood of any exercise but generally have negative effects on vigorous exercise or moderate and vigorous exercise. Physical activity is more likely when there are more parks per capita in a county. Our results above are robust to the inclusion of weight status and use of flu shots (a measure of an individual's tendency towards prevention).

Gambling Prevalence in Maryland: A Baseline Analysis

Corrected final versionThe purpose of the telephone survey was to obtain baseline information on the extent of problem gambling in Maryland prior to the expansion of gambling in the State through the introduction of slot machine gambling in 2010. The results will inform the State’s actions in developing prevention and treatment services for problem gamblers and their families in Maryland.YesDepartment of Health and Mental Hygiene (DHMH

Methodological framework to identify possible adverse drug reactions using population-based administrative data [v1; ref status: indexed, http://f1000r.es/3ys]

Purpose: We present a framework for detecting possible adverse drug reactions (ADRs) using the Utah Medicaid administrative data. We examined four classes of ADRs associated with treatment of dementia by acetylcholinesterase inhibitors (AChEIs): known reactions (gastrointestinal, psychological disturbances), potential reactions (respiratory disturbance), novel reactions (hepatic, hematological disturbances), and death. Methods: Our cohort design linked drug utilization data to medical claims from Utah Medicaid recipients. We restricted the analysis to 50 years-old and older beneficiaries diagnosed with dementia-related diseases. We compared patients treated with AChEI to patients untreated with anti-dementia medication therapy. We attempted to remove confounding by establishing propensity-score-matched cohorts for each outcome investigated; we then evaluated the effects of drug treatment by conditional multivariable Cox-proportional-hazard regression. Acute and transient effects were evaluated by a crossover design using conditional logistic regression. Results: Propensity-matched analysis of expected reactions revealed that AChEI treatment was associated with gastrointestinal episodes (Hazard Ratio [HR]: 2.02; 95%CI: 1.28-3.2), but not psychological episodes, respiratory disturbance, or death. Among the unexpected reactions, the risk of hematological episodes was higher (HR: 2.32; 95%CI: 1.47-3.6) in patients exposed to AChEI. AChEI exposure was not associated with an increase in hepatic episodes. We also noted a trend, identified in the case-crossover design, toward increase odds of experiencing acute hematological events during AChEI exposure (Odds Ratio: 3.0; 95% CI: 0.97 - 9.3). Conclusions: We observed an expected association between AChEIs treatment and gastrointestinal disturbances and detected a signal of possible hematological ADR after treatment with AChEIs in this pilot study. Using this analytic framework may raise awareness of potential ADEs and generate hypotheses for future investigations. Early findings, or signal detection, are considered hypothesis generating since confirmatory studies must be designed to determine if the signal represents a true drug safety problem