Ovid (publius_ovidius) wrote,

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Fat People Need to Eat More

Executive summary: if you're fat, eat more. If you smoke, smoke more. You're doing your part to save civilization.

It's always astounding how a superficial analysis of complex problems can fail in substantial ways, including in ways that seem blow common sense out of the water. For example, death penalty opponents have long pointed out that putting someone to death in the United States is far more expensive then keeping them in prison for the rest of their life[1]. It doesn't seem logical, but even a brief willingness to look at the numbers verifies it.

In a similar vein, I was astonished in college when one of my economic classes taught about a computer model of long-term economic scenarios which examined what would happen if we eliminated pollution, eliminated disease, eliminated war, instituted population control, etc. Regrettably, my economic texts are back in the US, so I can't find the study, but the overall conclusion was that such elimination would be disastrous to the world economy. Why? Because old people would live longer relative to young people. They would get sick less often (eliminating disease and pollution), would die less often (war), or there would simply be fewer young people (population control).

In these scenarios with an ever-growing elderly society, more young people would be required to support the growing elderly population. Since we wouldn't have enough young people, economies would struggle and potentially collapse. Raising the retirement age wouldn't help. The average healthy 75 year old simply cannot perform at the same level as the average 25 year old, either physically or mentally.

The pessimistic results shocked us, but it was difficult to see a clear way out. Even the desperately needed population control flies in the face of countries trying to maintain growth economies (which is a hint that the current world economic model is not viable in the long run).

Which leads me to a fascinating study[2] funded by the Dutch Ministry of Health, Welfare and Sports[3]. This study was analyzing the long-term financial impact of obesity. They also threw smokers into the mix. What they found, not surprisingly, is that individual health care costs for a smoker or obese person are higher than for healthy people. However, their life expectancies are short enough that long term health costs are lower than for healthy people. Specifically, from their findings:

Until age 56 y, annual health expenditure was highest for obese people. At older ages, smokers incurred higher costs. Because of differences in life expectancy, however, lifetime health expenditure was highest among healthy-living people and lowest for smokers. Obese individuals held an intermediate position. Alternative values of epidemiologic parameters and cost definitions did not alter these conclusions.

So what does all of this mean? Well, it could mean that since obese people and smokers have more medical problems while alive, they'll contribute less economically then others. However, it could mean that they'll live through their economically productive years and conveniently die before becoming economically unproductive. If that's true, then pushing morality aside, it could easily be in society's best interest to encourage obesity and smoking.

Any wonder why economics is often referred to as "the dismal science"? It's also worth noting that just because being unhealthy might (I can't stress that word enough) have hidden benefits to society, it's little consolation to the 50-year old mom dying of lung cancer.

If we want to take all of this to its logical conclusion, we might mistakenly conclude that a "Logan's Run" scenario where "mandatory retirement age" means killing people off when they become an economic drain actually helps to curtail many of the disaster scenarios we currently face, but this omits (as economics is wont to do) the human factor. There would be an instant uprising, throwing the murderers out of power and bringing us back, once again, to business as usual. But if we quietly step down on certain public health campaigns, we've an inefficient way of potentially achieving a similar result. What a nightmare scenario.

Anyone got a light?

(Of course, just to remind you that simplistic analyses don't do complex problems justice ...)

1. This is easy to research and has the knock-off effect of diverting financial resources from crime prevention.

2. I was tipped off to this by my friend Piers Cawley's wonderful blog post Fat is an economic issue.

3. The authors assert that "the funder did not have any role in study design, data collection and analysis, decision to publish, or preparation of the manuscript."
Tags: economics
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