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The Impact of Obesity on Adult Mortality: Assessment of Estimates with Applications

Author

Listed:
  • Alberto Palloni

    (University of Wisconsin–Madison)

  • Hiram Beltrán-Sánchez

Abstract

In this paper we assess properties of commonly used estimates of total effects of obesity on mortality and identify consequences of these properties for inferences. We argue that standard estimates have important shortcomings that at best limit the reach of inferences and at worst lead to misleading conclusions. Although some of these limitations are routinely acknowledged, rarely is their use accompanied by careful scrutiny of their weaknesses, let alone by a quantitative assessment of their sensitivity to violations of some stringent assumptions on which they are based. In this paper we develop an integrated framework based on a multistate hazard model to describe properties of the simpler standard estimates, identify conditions under which their performance is best, and define the nature of biases and interpretational ambiguities that emerge when empirical conditions depart more than modestly from optimal ones. In particular, we show formally that estimates from limited panel data and two-state hazard models with obesity as a covariate, the workhorse in this area, produce estimates that are difficult to interpret and compare across studies and, in some cases, biased. Finally, we propose a simple procedure that can be employed when the use of conventional two-state models is risky and illustrate its application to an a empirical case.

Suggested Citation

  • Alberto Palloni & Hiram Beltrán-Sánchez, 2017. "The Impact of Obesity on Adult Mortality: Assessment of Estimates with Applications," Working Papers 2017-044, Human Capital and Economic Opportunity Working Group.
  • Handle: RePEc:hka:wpaper:2017-044
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    File URL: http://humcap.uchicago.edu/RePEc/hka/wpaper/Palloni_Beltran-Sanchez_2017_obesity-adult-mortality_v2.pdf
    File Function: Second version, June 26, 2017
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    References listed on IDEAS

    as
    1. Preston, S.H. & Stokes, A., 2011. "Contribution of obesity to international differences in life expectancy," American Journal of Public Health, American Public Health Association, vol. 101(11), pages 2137-2143.
    2. Samuel Preston & Andrew Stokes & Neil Mehta & Bochen Cao, 2014. "Projecting the Effect of Changes in Smoking and Obesity on Future Life Expectancy in the United States," Demography, Springer;Population Association of America (PAA), vol. 51(1), pages 27-49, February.
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    More about this item

    Keywords

    obesity; T2D; mortality; multistate hazard model; two-state hazard model;
    All these keywords.

    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • C33 - Mathematical and Quantitative Methods - - Multiple or Simultaneous Equation Models; Multiple Variables - - - Models with Panel Data; Spatio-temporal Models
    • D81 - Microeconomics - - Information, Knowledge, and Uncertainty - - - Criteria for Decision-Making under Risk and Uncertainty

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