An overweight man walks the streets of Washington Tuesday, July 22, 2003. The political debate on fat has spilled over into public policy, with proposals
An overweight man walks the streets of Washington Tuesday, July 22, 2003. The political debate on fat has spilled over into public policy, with proposals for a junk-food tax, limits on food advertising, demands for more details on labeling and lawsuits against food manufacturers. (AP Photo/Ron Edmonds)

The excess weight and inactive habits of many Californians don't only exact a personal toll, they're saddling businesses and taxpayers with more than $41 billion in annual costs, according to a report released today.

"We think mostly about the health implications," said Harold Goldstein, executive director of the California Center for Public Health Advocacy, speaking of the 59 percent of Californians who are obese or overweight, and the 48 percent who are physically inactive.

"But there's also this enormous burden on the already-burdened California economy," said Goldstein, whose center released the data.

If the trend continues the economic toll of excess weight and inactivity will rise to $52.7 billion in 2011, the report noted. Half the costs were attributed to health care expenses, and half to lost productivity, such as absenteeism.

The figures alarm state Controller John Chiang, who is grappling with California's devastating $26.3 billion budget shortfall this fiscal year.

"These figures demonstrate the real and very unsettling financial impact of the obesity epidemic on a California economy already in crisis," he said. "We need to stop unnecessary use of precious dollars in this area as quickly as possible."

Goldstein, however, isn't despairing over the seeming futility of numerous public health campaigns to halt a doubling of the costs over six years. This latest report, which addresses cost in 2006, follows an earlier one, which reported that health care costs and lost productivity linked to overweight and inactive Californians totaled nearly $22 billion in 2000.

Public health movements in the past, such as those to discourage smoking, faced numerous obstacles and well-funded opponents, but nonetheless succeeded in large part through federal, state and local policy changes in sharply reducing the number of adults smoking, he pointed out.

"Every public health movement has shown that people can only be healthy if public policies are in place to support healthy choices," he said.

That message underscores the report's finding: To solve this crisis, government agencies of every stripe, from transportation and education departments to city planning offices, must integrate strategies into their decision making for preventing unhealthy weight gain and encouraging physical activity.

"The idea of health being a priority and not an afterthought hasn't been on the agenda," Goldstein said.

And the national debate over health care reform needs to include prevention as a primary tactic for controlling costs, he said.

"This is the cutting-edge of health care," he said. "Make prevention and wellness the cornerstone of a new national health care system."

Both excess weight and inactivity are known to trigger or worsen numerous conditions that lead to disability and premature death, including coronary heart disease, type 2 diabetes, some forms of cancer and stroke.

To assess the economic toll of excess weight and inactivity, researchers analyzed records such as government-compiled databases tracking health insurance claims, industry drug-utilization reports, Medi-Cal claims, and state and national surveys on rates of physical activity.

Health care expenses were tallied through direct costs as well as "indirect costs," such as lingering health problems and a reduced quality of life that affects a person's earning capacity.

Productivity costs were assessed by analyzing rates of job absenteeism, short-term disability and "presenteeism," or the portion of work an employee can't perform because of compromised health.

For years, the rising rates of excess weight among Americans defied efforts to halt the trend. But some good news recently arrived, with the Centers for Disease Control and Prevention releasing data showing a leveling off of obesity rates in adults from 2004 to 2006, the most recent years for which data is available.

A few government agencies are factoring health promotion into their planning decisions, but the record thus far is spotty, Goldstein said. Among other measures, the report urges national political leaders to include in health care reform proposals a well-funded program for fostering healthful lifestyles. The report also urges state leaders to use remaining American Recovery and Reinvestment Act grants to fund projects that both create jobs and promote community health.

The issue is ignored at the state's financial peril, Goldstein said.

"We can't afford it anymore," he said. "It's both a major health issue, but it's also a critical economic issue."

To view a copy of the report, "The Economic Costs of Overweight, Obesity, and Physical Inactivity Among California Adults — 2006," visit www.publichealthadvocacy.org.

Reach Suzanne Bohan at 510-262-2789 or sbohan@bayareanewsgroup.com.

Medical conditions associated with excess weight and inactivity
(partial list)

Cardiovascular disease
Congestive heart failure
Hypertension
Liver disease
Hip fracture
Surgical complications
Depressive disorder
Anxiety states
Impaired immune response
Low back pain
Lymphoma
Colon, breast and prostate cancer
Carpal tunnel syndrome
Impaired respiratory function