The Agency for Healthcare Research and Quality issued its 2009 National Healthcare Quality Report and National Healthcare Disparities Report on April 13.  The 2009 reports include a new section on lifestyle modifications because preventing or reducing obesity is a crucial national goal. The reports found:

  • One-third of obese adults have NEVER received advice from their doctor about exercise.
  • Obese adults who are black, Hispanic, poor or have less than a high school education are LESS likely to receive diet advice from their doctors.
  • Most overweight children and one-third of obese adults report that they have NOT been told by their doctor that they are overweight.
  • Most American children have NEVER received counseling from their health care provider about exercise, and almost half have NEVER received counseling about healthy eating.

The reports indicate that the lack of health insurance slows improvement in health care quality and reduction of disparities.  For many services, not having insurance is the single strongest predictor of poor quality care, exceeding the effects of race,  ethnicity, income or education.

So, the BIG question....will expanding health insurance to more people change some of these statistics????   Let's hope so.



I've gotta say, I totally agree and I totally disagree. The main reason that our children's health suffers so much nowadays is not because they don't have health insurance. I've had health insurance my whole life, gone to only the best doctors, and yet the advice that I was given my whole life is nothing but pure nonsense. Example: When I was in elementary school, I put on a few pounds, so what did the doctor tell me......drink diet soda. Eat food with saccharin and other artificial sweeteners.......Really? Look I could go on and on about this subject, but to sum it all up, we as a society need to reevaluate our eating habits in general. Don't rely solely on the advice of doctors, they are just people too, granted they have an education that we do not have, but they're just people. They have their own opinions and what's to say that what they have been taught is the even correct. You always hear about how this new report debunks the old way of thinking and the reality is.......most of it is just plain old common sense. Eat as much raw, organic foods as possible, drink lots of water (not diet soda), and get a little bit of exercise. These basic fundamentals have seemed to elude out Western lifestyles and I believe it to be the reason that a lot of us have the health issues that we have today. Just my 2 cents.

The problems include - will people care enough to change their diet? Will poor people be able to afford healthy foods, rather than a $1 cheeseburger?

Hi I'm a family doctor in Scotland where of course under the UK NHS all patients have state funded health coverage. Obesity rates and associated morbidiy here continue to rise unchecked so, sad to say, I don't think better US coverage will make any significant difference .. !

I am going to answer NO - increasing health insurance coverage for more people will NOT reduce obesity in the US. Just as the report states, doctors aren't talking to their patients about healthy eating habits and exercise anyways, so having coverage for more people is not going to change this doctor-patient interaction. If anything, doctors are going to have less and less time with their patients so this topic will definitely not be covered in routine visits. Another example is some data from our Illinois Women's Health Registry. The overwhelming majority of women in our database have some sort of health insurance coverage, yet as a group, the women have a BMI score within the range of overweight. This suggests that having health insurance coverage does not really matter. Healthy eating and exercise have to be learned habits that are instilled in people at a young age, AT HOME. It would be nice if doctors had more nutrition training in medical school so they could make it an important discussion point during visits, but it's a personal responsibility issue. Parents are responsible for teaching these habits to their children and getting involved with their local schools to advocate for good nutrition programs.

Sadly, I would have to say "no" as well. It's unfortunate that in our health care system doctors are encouraged (i.e. insurance pays for it) to prescribe medications, weight loss surgery, and other reactive measures, but rarely are preventative measures advocated. Starting to put on a little weight? Headed for diabetes? No, you can't have dietary counseling. Come back when you need a prescription for insulin.

Better health insurance coverage should also mean better information on our nutritional habits and the causes of obesity. If people are informed and the obesity still doesn't drop than the state must take some more drastic measures like public informative campaigns and even forbid "junk" food in schools.

People who are overweight and obese face many difficulties their normal weight peers do not. Frequent doctor visits are a fact of life for overweight and obese people, due to the development of weight-related disorders such as diabetes and osteoarthritis. Along with the daily difficulties associated with these diseases, the overweight or obese person may be personally affected financially as a result of weight-related expenses and reduced income.

If healthcare coverage takes the responsibility away from the individual I think it would be bad. This is an area where people can take control and prevent a bad outcome. If they keep relying on pills and surgery the outcome will not be nearly as healthy as it could be.

No! Having health insurance has its benefits. But it could not be blamed for obesity now. People are not informed well enough to have a healthy lifestyle. Which becomes a big problem at the end.

Hi I’m a family doctor in Scotland where of course under the UK NHS all patients have state funded health coverage. Obesity rates and associated morbidiy here continue to rise unchecked so, sad to say, I don’t think better US coverage will make any significant difference ..

Health insurance will have little if anything to do with obesity. Obesity is more of an issue with self-esteem and role models.

I do not think so. It sad that so few people can take control over theirselves and what their eating. I'm a doctor in Sweden and I've watching way to many cases of obesity.

Health insurance is a misnomer. It doesn't "insure" against disease. It just means that once you get sick you might not have to pay out the yang for medical treatment. Until our disease care system changes from treating symptoms after the fact to preventative medicine, there will be no change in the general well being of the population.

I doubt it. People in this country with little money rely on high calorie, high fat dollar-menu fast food, where there are few healthy choices. Exercise is not stressed in schools, and as your article states, health care providers rarely advise it.

Insurance is good to ensure that the family stays healthy but I don't think it would reduce obesity. Obesity is more of a lifestyle disease that needs a lifestyle adjustment.

No, of course not. Very few people take advice from their doctors about diet now. It's absurd to think they'll start listening just because they might have more access.

Health insurance only has to do with preventing disease. Since obesity is really a lifestyle decision for most people it doesn't really apply.

We should start getting our kids exercising right and ensure they continue the habit throughout their life.

You really load this blog with interesting content. Good work keep it up. Taking advice from doctors can it really help reduce weight?

No. I don't think a better health insurance coverage will reduce obesity. Obesity has more to do with lifestyle. Its a choice. Obese people prefer to eat unhealthy foods even though they have the power to eat healthy.

Unfortunately, unless people are educated and are motivated, things will probably never change for them. Health insurance is great to have, but many doctors have been taught to treat the symptoms and rarely advocate changing the behavior that causes the diseases. People who don't have health insurance but are motivated to make their health better, can indeed do much to reach that goal on their own by modifying their lifestyle.

Time is gold as education is. Again and again, education plays an important role in health promotion and prevention. We don't actually need to depend on health insurance alone, let our government advertise more ads pertaining on health promotion. It benefits the whole society and in return, people could function on its maximum potential. Nowadays, we live in an instant world, so it is always easy to have our wants rather than our needs. My suggestion, limit ads of fast food chains, and substitute it to health awareness program.

Private health insurance policies usually cost more than group policies. Many people go for the latter. However, if you really need health coverage and the group plans are not available, you have to go for the private ones. Therefore, you have to know how to compare private health insurance plans.

I don't think that expanding health insurance will definitely reduce the statistics of obesity! Physicians or health instructor must give information/advice and some encouragement to their obese patients the best thing to do to loosen their weight. Maybe through it, the statistic of obesity will be reduced.

Unless we implement a system like they have in England then no, it won't have an affect on obesity. Doctors and pharmaceutical companies make too much money treating the disease rather than preventing them.

Many people object, but I like the idea that the Mayor of NY will soon ban extra large sugary soft drinks in NY. We really need affordable single payer health insurance and just like car insurance, we need to have the largest pool of participants paying into the system in order to keep the costs at their lowest levels for all.I have no problem with mandated participation. If we applied a .25 cent tax on every soft drink sold in the USA we could probably cover half our population with availability to the worlds best healthcare system at very little cost. Most people dont understand that an insurance company holds the premiums and rations out coverage while trying to make as much money for their stockholders as possible. There is no ethical reason to profit from Health Insurance. Car insurance yes. Health insurance no!

The American society was brought up on fast food, Insurance is not going to make a difference.

Weight has not affected me too adversely. However, the fact that every stone extra you weigh knocks an average of 6 years off your life should be enough to make some people sit up and take notice. I'm also too heavy for my moped these days.