Obesity on rise among school, state employees

Center reports effects on health costs

Almost 48% of public school and state employees and their spouses who filled out an online health questionnaire last year reported a height and weight classifying them as obese, up from about 44% a year earlier, according to an analysis by the Arkansas Center for Health Improvement.

The state research agency also found that employees and their spouses who were obese were more costly to insure.

The median cost to their health plan of covering an obese employee or spouse in 2018 was $690, compared with $535 for a nonobese employee or spouse, according to a report of the center's findings.

The center, an arm of the University of Arkansas for Medical Sciences, presented the report on Monday to the board that administers the health plans covering state and public school employees.

The plans cover about 158,000 people, including employees and retirees and their spouses and dependents.

Center for Health Improvement analytics director Mike Motley and policy analyst Izzy Montgomery told the State and Public School Life and Health Insurance Board that the increase in the obesity rate was similar to the statewide trend among all Arkansas adults.

According to a survey by the U.S. Centers for Disease Control and Prevention, 37.1% of the state's adults were considered obese based on their reported height and weight last year, up from 35% in 2017.

The increase in the rate among state and school employees comes despite an online weight-loss program that the board began offering last year to a limited number of employees.

Since 2012, a state law has also required that the health plans cover up to $6 million a year worth of weight-loss surgeries for morbidly obese employees under a pilot project scheduled to last until at least 2021.

Chris Howlett, director of the state Department of Transformation and Shared Services' Employee Benefits Division, which manages the heath plans, said he plans to meet early next month with the companies hired by the plans to help employees manage chronic conditions to develop more recommendations on measures that could lower employees' health care costs.

"We're going to dial in a little bit harder on some of the areas where we need the most help," Howlett said.

The CDC and health plan surveys use a person's height and weight to calculate a "body mass index" that determines whether a person is obese.

A 6-foot-tall person would be considered overweight if he weighed more than 184 pounds and obese if he weighed more than 221 pounds, according to the formula used to calculate the index.

The 47.6% of employees and spouses who were considered obese last year was up from 43.7% in 2017 and 43% in both 2016 and 2015.

Compared with previous years, fewer people took the survey last year.

That's because in previous years, employees were required to fill out the survey to qualify for a $75 a month discount on their health insurance premiums.

Since last year, employees have also been able to qualify for the discount by undergoing a health screening offered at schools and state offices by Dallas-based Catapult Health.

Employees screened by Catapult Health filled out a health assessment that was different from the online one.

According to the Center for Health Improvement, the number of employees and spouses filling out the online survey used to calculate the obesity rate fell from 65,497 in 2017 to 36,901 in 2018.

Despite the drop, the survey respondents in the two years were similar in their makeup by age and sex, the center's researchers said.

The survey also found increases in the number of employees or spouses who reported being smokers, that they were physically inactive or had been diagnosed with chronic conditions such as high blood pressure or diabetes.

The smoking rate increased from 8.7% in 2017 to 9.3% in 2018, which the center researchers noted is still well below the statewide rate among adults of 22.7% reported by the CDC.

The median annual cost to the plans of an employee or spouse who was a smoker was $606, compared with $554 for a nonsmoker, the Center for Health Improvement found.

The median is the point at which half the employees' annual costs were higher and half were lower.

Among respondents who reported being physically inactive, meaning that they had not exercised for at least 20 minutes in the past week, the median annual cost to the plan was $871.

That compared with a median cost of $532 for those who exercised at least 20 minutes during four of the previous seven days.

The report did find some improvements, including a slight increase in the percentage of respondents who had gotten a flu shot in the past 12 months. It increased from 55.5% in 2017 to 56.2% in 2018, a rate that the researchers considered to still be low.

Also, the number of respondents who reported five or more alcoholic drinks within a two-hour span during the previous six months fell from 5.2% to 4.6%.

In both years, more than 90% of respondents said they considered themselves to be in good, very good or excellent health, but the percentage fell from 94.7% in 2017 to 91.1% in 2018.

The researchers recommended that the insurance plans consider offering more help to members with chronic health conditions, encouraging more employees to get flu shots and using the same questionnaire for all employees and spouses.

A Section on 10/22/2019

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