Cost associated with being overweight and with obesity, high alcohol consumption, and tobacco use within the military health system's TRICARE prime-enrolled population.

PURPOSE To estimate medical and indirect costs to the Department of Defense (DoD) that are associated with tobacco use, being overweight or obese, and high alcohol consumption. DESIGN Retrospective, quantitative research. SETTING Healthcare provided in military treatment facilities and by providers participating in the military health system. SUBJECTS The 4.3 million beneficiaries under age 65 years who were enrolled in the military TRICARE Prime health plan option in 2006. MEASURES The findings come from a cost-of-disease model developed by combining information from DoD and civilian health surveys and studies; DoD healthcare encounter data for 4.1 million beneficiaries; and epidemiology literature on the increased risk of comorbidities from unhealthy behaviors. RESULTS DoD spends an estimated $2.1 billion per year for medical care associated with tobacco use ($564 million), excess weight and obesity ($1.1 billion), and high alcohol consumption ($425 million). DoD incurs nonmedical costs related to tobacco use, excess weight and obesity, and high alcohol consumption in excess of $965 million per year. CONCLUSION Unhealthy lifestyles are significant contributors to the cost of providing healthcare services to the nation's military personnel, military retirees, and their dependents. The continued rise in healthcare costs could impact other DoD programs and could potentially affect areas related to military capability and readiness. In 2006, DoD initiated Healthy Choices for Life initiatives to address the high cost of unhealthy lifestyles and behaviors, and the DoD continues to monitor lifestyle trends through the DoD Lifestyle Assessment Program.