Monday, October 26, 2009

Interesting link with obesity

In the October 26 Baltimore Sun, there is a very short article on the link between childhood neglect and obesity.   While there is nothing particularly economic about the article, I would draw your attention to this as it illustrates how difficult it can be to determine where to "draw the boundary" when we are conducting a cost-benefit or cost-effectiveness analysis.

The article comments on a study in the journal Obesity shows that children who are subject to various types of abuse and neglect are more likely to be obese as adults.

So, if we were to do a cost-effectiveness analysis or cost-benefit analysis of a program to reduce childhood abuse and neglect, we could think of a whole bunch of things that would be offset by a successful program of this sort.  We'd have less use of child social services, we'd have less use of criminal justice departments, we'd have less use of a few other types of services.  These are all important and are much more short run than the problem with obesity as adults.

However, given the quality and length of of life impact of obesity, a team trying to demonstrate the cost-effectiveness of an abuse and neglect prevention program would do well to include the obesity relationship.  Of course, this only works if the relationship that has been shown in one study generalizes.

Why did I not mention the costs of obesity?  At least one study has shown that over a lifetime healthy adults may spend as much as obese adults.  Why?  In any given year that both individuals are alive, it is probably the case that the health adult will spend less.  However, healthy adults are likely to live longer and accumulate expenditures that are as great over a lifetime.

All of this goes to show how complicated an analysis of abuse and neglect prevention is when we try to extend beyond the simplest relationships and associations with the most directly affected outcomes.


  1. I recently read a similar study (Whitaker, Phillips, Orzol and Burdette 2007, "The association between maltreatment and obesity among preschool children", Child Abuse & Neglect 31(11-12), 1187-1199) that demonstrated a connection between neglect and obesity at an even earlier age. Whether or not it is a causal relationship, this still seems to be an interesting association.

  2. I actually consulted on a project a while ago looking at a combined social work, health, and legal intervention for families to try to avoid abuse and neglect. This was a great idea. It did not seem very cost effective at the time, but perhaps as a long term prevention strategy it would make more sense.