Gender-specific Effects of Modifiable Health Risk Factors on Coronary Heart Disease and Related Expenditures

Published in: Journal of Occupational and Environmental Medicine, v. 42, no. 11, Nov. 2000, p. 1060-1069

Posted on RAND.org on January 01, 2000

by Jeffrey Wasserman, R. William Whitmer, Terry L. Bazzarre, Sean T. Kennedy, Nancy J. Merrick, Ron Z. Goetzel, Rodney L. Dunn, Ronald J. Ozminkowski

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There is a general lack of health-related research focusing on gender-specific differences within a working population. This research attempts to address that void. The authors' study relied on the Health Enhancement Research Organization (HERO) database, which consists of claims, enrollment information, and health risk data for 39,999 employees of six large employers. The research objective was to determine the gender-specific association between coronary heard disease (CHD) and (1) the prevalence of modifiable health risks and (2) medical expenditures. To accomplish this, the International Classification of Diseases, 9th Revision-Clinical Modification and Current Procedural Terminology codes were use to identify 2452 employees with CHD within the HERO database. These individuals made up the study group, which included 66% male and 34% female participants. Health risk data were obtained from voluntary participation in a health risk appraisal and biometric evaluation provided by the employers. Health risks evaluated were tobacco use, hypertension, obesity, elevated cholesterol, high blood glucose, sedentary lifestyle, stress, depression and excessive use of alcohol. Descriptive and multivariate statistical techniques were used to analyze the HERO database. The authors found that obesity was the most consistent predictor of CHD. It was number one (of 10 health risks) in the male and female group, number two in the male-only group, and number one in the female-only group. High stress was the second most consistent predictor. There was no such consistency relative to medical expenditures. This lack of consistency across the male and female groups relative to the association between health risks and medical expenditures was demonstrated for nearly all other health risks evaluated. This study suggests that within a group of employees with CHD, there are important similarities and differences between men and women with respect to the prevalence of risk factors and the association between health risks and medical expenditures.

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