obesity and disability - musculoskeletal problems

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January 9, 2004 Los Angeles Times

THE NATION - Obesity Blamed as Disability Rates Soar for Those Under 60

(mentions

musculoskeletal problems)

By , Times Staff Writer

Disability rates rose sharply between 1984 and 2000 among Americans

younger than 60, probably because of a rise in obesity, while they

declined among elderly Americans, according to a new study.

The study by Santa -based Rand Corp., published in the January

issue of the Journal of Health Affairs, found that the number of people

aged 30 to 49 who could not care for themselves or perform routine

household tasks jumped by 50%.

By contrast, the disability rate declined by more than 10% for people

aged 60 to 69,

the study found.

" Younger people are actually doing worse when it comes to disability, "

said Dana

Goldman, director of health economics at Rand. " And disability is

important because it's a very significant marker for people who have a

lot of health-care expenses and are likely to need nursing home care

when they get older. "

The study was based on answers to a national health interview survey

from 1984 to 2000.

People between ages 30 and 49 experienced the largest increase in

disabilities. Between 1984 and 1996, reported disabilities among adults

aged 30 to 39 rose from 118 per 10,000 to 182. Among adults aged 40 to

49, the number rose from 212 per 10,000 to 278.

The study found smaller but still significant increases in disability

among those aged 18 to 29 and those aged 50 to 59.

The two main causes of disability among people under age 60 were

musculoskeletal problems and mental illness, the study said. But

disability from musculoskeletal problems, mostly back-related, and from

diabetes are growing more rapidly than those from other ailments.

" We're seeing rates of disability rising 60% to 80% between people 30 to

60 years of age, " Goldman said, " and you have to say, 'What's explaining

that?' "

Researchers suspect increasing obesity is a major culprit.

" We know that after people get gastric-bypass surgery, small clinical

trials have shown they have fewer musculoskeletal problems. When you're

carrying around all this weight, it's putting an extra stress on you, "

Goldman said.

Dr. L. Atkinson, president of the American Obesity Assn., said

obesity increases the likelihood of diabetes, heart disease or stroke —

all significant causes of disability.

" People with diabetes can go blind, have kidney failure and have to go

on dialysis. They can have vascular diseases that require legs and feet

and limbs to be amputated, and all of those dramatically decrease the

ability of people to go to work or to get around, " Atkinson said.

He said another obesity-related condition that can become disabling is

sleep apnea, a disorder in which breathing is disrupted during sleep.

Public attention and funding would best be directed toward studying

obesity and developing drugs to treat it, Atkinson said.

The study emphasized, however, that factors other than obesity are

likely to be partly responsible for the rise in disability.

In fact, technological advances keeping sick people alive " might

actually reflect improvements in overall health when viewed in the

larger context of survival and mortality, " the study said.

Also, more workers might be reporting they are unable to work to collect

disability benefits that are growing faster than their market wages.