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WASHINGTON, D.C. — The sustained high wellbeing that residents of Southern California’s Beach Cities show across key metrics results in much lower healthcare utilization costs for them than for Americans nationwide. Adults living in Manhattan Beach, Redondo Beach and Hermosa Beach — “the Beach Cities” — in Los Angeles County are estimated to save $182.4 million on healthcare costs each year thanks to lower rates of obesity, diabetes and smoking there. Gallup estimates Beach Cities residents spend $95.3 million more on healthcare each year because of obesity, diabetes and smoking than what would be expected if all residents were of normal weight, did not have diabetes and did not smoke. By comparison, the estimated extra expenditures for the Beach Cities would nearly triple, jumping to $277.7 million annually, if these indicators mirrored the national rates; so for residents of Hermosa Beach, Manhattan Beach and Redondo Beach, their collective high level of wellbeing represents $182.4 million in healthcare cost savings.
These data — which control for the overlap in costs associated with BMI and diabetes — are based on a Sept. 11-Oct. 23, 2023, mail survey in the Beach Cities that included a web option, and an Aug. 30-Sept. 8, 2023, web survey of U.S. adults who are part of the probability-based Gallup Panel. The Beach Cities survey was funded by the Beach Cities Health District.
For all dollarization calculations, the Beach Cities population is estimated at 94,216 adults, including 56,088 working adults. Based on credible and published secondary sources, incremental healthcare utilization annually assumes $2,618 per obese person relative to normal-weight individuals, $6,895 per smoker relative to nonsmokers and $8,758 per person with diabetes relative to those without diabetes.
Residents of the Beach Cities have much lower rates on all three metrics (plus above-normal weight) than the average for American adults. Obesity in the Beach Cities is currently estimated at 13.3% compared with 38.4% nationally, while above-normal weight (obese and overweight combined) is 45.5% in the Beach Cities compared with 71.3% nationally. The associated diabetes rate of 4.9% is predictably much lower than the 13.6% across the U.S., while the smoking rate is also less than half national levels (3.4% and 10.9%, respectively).
Beach Cities adults’ low rates of obesity, diabetes and smoking are also associated with less unplanned absenteeism from work because of poor health compared with U.S. adults nationally. After controlling for all relevant demographics, all three conditions result in extra missed work.
Prior research has found that obese workers miss 0.74 days of work each month due to poor health compared with 0.49 days among those who are not obese, equating to about nine additional workdays of lost productivity each year. Conservatively assuming $344 in salary and benefits per day, lost productivity because of obesity among working-adult residents of the Beach Cities is an estimated $6.9 million each year for their employers, compared with an estimated $20.1 million if national obesity rates are used. This amounts to a productivity savings of $13.2 million for the Beach Cities because of their much lower obesity rate.
Smoking is also costly. Workers who smoke miss an average of 0.72 days per month compared with 0.51 days among nonsmokers. This, coupled with lost productivity due to smoking breaks (estimated to cost employers $3,077 per smoker annually), results in an estimated $14.4 million in lost productivity for employers of Beach Cities adult workers. But this rate climbs to an estimated $46.3 million if Beach Cities adults smoked at the same rate as do American adults generally.
The same general pattern holds for diabetes. After controlling for BMI, prior research has found that workers with diabetes miss an average of 0.85 days per month because of poor health compared with 0.39 among those without diabetes. This results in an estimated $14.5 million in lost productivity among Beach Cities workers but would be a far higher $40.1 million if diabetes among Beach Cities adults matched the rate found nationally.
According to the U.S. government’s Centers for Medicare & Medicaid Services, health spending in 2022 was $4.5 trillion, amounting to 17.3% of Gross Domestic Product (GDP). This means $1.73 out of every $10 spent in the U.S. for any reason was on healthcare that year. Recent projections have healthcare expenditures growing to 19.7% by 2032, with nearly $2 out of every $10 spent in the U.S. dedicated to paying for care.
Amid these daunting statistics is that managing and treating chronic disease states and mental health conditions accounts for 90% of total healthcare expenditures, according to the Centers for Disease Control and Prevention. By maintaining comparably low levels of obesity, diabetes and smoking (among other disease states and associated risk factors not summarized in this article), Beach Cities residents are meaningfully bending this curve.
The good health exhibited by many adults in the Beach Cities area is likely in part the result of efforts of the Beach Cities Health District (BCHD), which regularly organizes events and activities meant to enhance various aspects of wellbeing for local residents. Offerings range from mental health first aid training to social events to free healthy cooking and yoga classes. One important aspect of these efforts by the BCHD was sponsoring the involvement of the Blue Zones Project (BZP), which specializes in transforming the local culture of wellbeing through various means, including modifying the built structure — such as adding bike paths — and recruiting local businesses, restaurants, grocery stores and schools to participate in local initiatives. Since 2010, the BZP has had an ongoing presence in the community to help create a culture of wellbeing.
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