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Forecasting the Effects of Obesity and Smoking on U.S. Life Expectancy


  • Rosen, Allison B.
  • Stewart, Susan T.
  • Cutler, David M.


Background: While increases in obesity over the past 30 years have adversely affected population health, there have been concomitant improvements due to reductions in smoking. Better understanding of the joint effects of these trends on longevity and quality of life will help policymakers target resources more efficiently. Methods: For each year from 2005 to 2020, we forecast life expectancy and qualityadjusted life expectancy for a representative 18 year old, assuming a continuation of past trends in smoking from the National Health Interview Survey (1978-79, 1990-91 and 2004-06), and past trends in body-mass index (BMI) from the National Health and Nutrition Examination Survey (1971-75, 1998-1994, and 2003-06). The 2003 Medical Expenditure Panel Survey was used to examine the effects of smoking and BMI on health-related quality of life. Results: The negative effects of increasing BMI overwhelmed the positive effects of declines in smoking in multiple scenarios. In the base case, increases in the remaining life expectancy of a typical 18 year old are held back by 0.71 years or 0.91 quality-adjusted years between 2005 and 2020. If all U.S. adults became normal weight non-smokers by 2020, LE is forecast to increase by 3.76 life years or 5.16 quality-adjusted years. Conclusions: If past obesity trends continue unchecked, the negative impact on U.S. population health is forecast to overtake the positive effect from declining smoking rates, which could erode the pattern of steady gains in health experienced since early in the 20th century.

Suggested Citation

  • Rosen, Allison B. & Stewart, Susan T. & Cutler, David M., 2009. "Forecasting the Effects of Obesity and Smoking on U.S. Life Expectancy," Scholarly Articles 5344184, Harvard University Department of Economics.
  • Handle: RePEc:hrv:faseco:5344184

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    Cited by:

    1. Dora L. Costa, 2015. "Health and the Economy in the United States from 1750 to the Present," Journal of Economic Literature, American Economic Association, vol. 53(3), pages 503-570, September.
    2. Aysit Tansel & Deniz Karaoglan, 2014. "Health Behaviors and Education in Turkey," ERC Working Papers 1406, ERC - Economic Research Center, Middle East Technical University, revised Jun 2014.
    3. Ljungvall, Åsa & Zimmerman, Frederick J., 2012. "Bigger bodies: Long-term trends and disparities in obesity and body-mass index among U.S. adults, 1960–2008," Social Science & Medicine, Elsevier, vol. 75(1), pages 109-119.
    4. Karaoglan, Deniz & Tansel, Aysit, 2017. "Determinants of Obesity in Turkey: A Quantile Regression Analysis from a Developing Country," MPRA Paper 76250, University Library of Munich, Germany.
    5. Cutler, David M. & Lange, Fabian & Meara, Ellen & Richards-Shubik, Seth & Ruhm, Christopher J., 2011. "Rising educational gradients in mortality: The role of behavioral risk factors," Journal of Health Economics, Elsevier, vol. 30(6), pages 1174-1187.
    6. Aysit Tansel & Deniz Karaoğlan, 2016. "The Causal Effect Of Education On Health Behaviors: Evidence From Turkey," Working Papers 2016/2, Turkish Economic Association.
    7. Kulhánová, Ivana & Hoffmann, Rasmus & Judge, Ken & Looman, Caspar W.N. & Eikemo, Terje A. & Bopp, Matthias & Deboosere, Patrick & Leinsalu, Mall & Martikainen, Pekka & Rychtaříková, Jitka & Wojtyniak,, 2014. "Assessing the potential impact of increased participation in higher education on mortality: Evidence from 21 European populations," Social Science & Medicine, Elsevier, vol. 117(C), pages 142-149.
    8. repec:eee:socmed:v:190:y:2017:i:c:p:174-180 is not listed on IDEAS
    9. Michael Chernew & David M. Cutler & Kaushik Ghosh & Mary Beth Landrum, 2016. "Understanding the Improvement in Disability-Free Life Expectancy in the U.S. Elderly Population," NBER Chapters,in: Insights in the Economics of Aging, pages 161-201 National Bureau of Economic Research, Inc.
    10. repec:bla:ijhplm:v:32:y:2017:i:4:p:e279-e298 is not listed on IDEAS
    11. Bansal, Sangeeta & Zilberman, David, 2016. "Does health care expenditure counter adverse effects of obesity on health: Evidence from global data," 2017 Allied Social Science Association (ASSA) Annual Meeting, January 6-8, 2017, Chicago, Illinois 250115, Agricultural and Applied Economics Association.
    12. Zheng, Hui & Yang, Yang, 2012. "Population heterogeneity in the impact of body weight on mortality," Social Science & Medicine, Elsevier, vol. 75(6), pages 990-996.

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