Heterogeneity in the effect of obesity on future long-term care use in England

Although there is some recent evidence around the effects of obesity on health care utilisation and costs, not much is known about the relationship between obesity and long-term care utilisation (Public Health England, 2013). Few studies from the USA find that obesity increases the risk of nursing home admissions and use of personal care assistance (Elkins et al. 2006, Ziza et al. 2002, Resnik et al. 2005, Yang and Zhang 2014). Nizalova, Gousia and Forder (2017) show that obesity leads to higher use of informal care but find no effect on other types of long-term care. In this study we explore whether the effect on various types of care differs depending on the degree of obesity among older people in England and whether the findings are sensitive to the incorporation of information on long-term care use prior to death. We find that in addition to the obesity at the level of BMI between 25 and 45 representing a risk for future use of informal care, (super) obesity at the level of BMI at 45 and greater represents a significant risk for all types of care use, including social care and nursing home/residential care.