Steven Syre | Boston Capital

A growing burden

By Steven Syre
Globe Columnist / July 8, 2011

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The enormous amount of time and energy dedicated to investigating health care costs and explaining why they increase so much over time has produced a lot of answers.

Blame the marquee hospitals with the sheer market power to charge much more. Point the finger at payment systems that compensate providers for individual products and services rather than the actual care of a patient. Don’t leave out the insurance companies. What about that small minority of very expensive patients who account for so much of the system’s overall cost?

There is an element of truth in all those answers and some of them are very serious contributors to the health care cost spiral.

Looking for one more? Look in the mirror.

The explosive growth of obesity in America is hardly news. But I was startled yesterday by research that measured, state by state, the increase in adult obesity and some related health problems like diabetes and high blood pressure over the past 15 years. It shows not just how big a problem obesity has become, but also how quickly it has grown into a serious health hazard.

A couple of simple facts will tell you much of what matters. Colorado, the state with the nation’s lowest current obesity rate (19.8 percent), would have ranked as America’s worst with that number in 1995. Today, obesity rates in 43 states exceeded that of the fattest state in the nation in 2000.

The Trust for America’s Health and the Robert Wood Johnson Foundation conduct research on obesity every year and the latest annual statistics track another step in the wrong direction. But for the first time, their latest report also follows adult obesity trends going back 15 years (state information on childhood obesity only tracks back to 2007).

Of course, some parts of America are fatter than others and those divisions follow fairly predictable patterns. Nine of America’s 10 most obese states are located in the South (Mississippi is the fattest state for the seventh straight year with a rate of 34.4 percent). People who make less money tend to be more obese than those who make more.

But the report’s most compelling statistics show how the obesity phenomena grew so much in virtually every part of America. Fifteen years ago, no state had an obesity rate over 15 percent. Now, 38 states report rates of at least 25 percent, and only one has a rate below 20 percent. Obesity rates in 39 states have increased at least 80 percent in the last 15 years.

The numbers in Massachusetts are relatively good. The state ranked 48th with an obesity rate of 22.3 percent. It also ranked 48th in 1995, but reported a rate of just 11.6 percent at that time.

Related medical problems have also increased in Massachusetts since 1995. The diabetes rate has grown from 4.5 percent to 7.5 percent. Hypertension is up from 22.1 percent in 1995 to 25.6 percent.

Of course, the obesity boom is much more than just a financial drain on the medical system. And, clearly, it is not the biggest single financial problem in health care. I’m not sure it’s among the top three.

But there’s no denying the sizable impact of obesity in dollars and cents. That cost is hard to track because obesity leads to so many other medical problems.

The scale of our obesity boom is relatively new. But the price, in the health of millions of people and the expense to the medical system, will be felt for decades to come.

News alert: Apparently Steward Health Care System won’t buy every Massachusetts hospital up for sale.

Steward was created last year as the new for-profit owner of Caritas Christi, and it quickly struck deals to acquire six more hospitals, most recently adding bankrupt Quincy Medical Center to the list. It had been one of several parties interested in Northeast Health System, the operator of Beverly Hospital and two other health facilities.

But a recent internal e-mail from Northeast chief executive Ken Hanover reported that Steward had “decided to withdraw from merger/affiliation talks.’’ He said Northeast remained “engaged in positive discussions’’ with three other parties. The Globe has previously identified other potential Northeast suitors as Vanguard Health Systems, Beth Israel Deaconess Medical Center, and the Lahey Clinic. Beth Israel and Lahey have also reportedly talked with each other about a merger of their own.

Steven Syre is a Globe columnist. He can be reached at