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This Article Figures Only Full Text Full Text (PDF) Supplemental Data All Versions of this Article: AJPH.2009.172627v1 99/11/2096    most recent Submit a response View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (2) Citing Articles via Google Scholar Google Scholar Articles by Goldman, D. P. Articles by Rowe, J. W. Search for Related Content PubMed PubMed Citation Articles by Goldman, D. P. Articles by Rowe, J. W. Related Collections Aging Other Health Financing Health Promotion

Dana P. Goldman, PhD, Yuhui Zheng, PhD, Federico Girosi, PhD, Pierre-Carl Michaud, PhD, S. Jay Olshansky, PhD, David Cutler, PhD and John W. Rowe, MD

Dana P. Goldman, Yuhui Zheng, Federico Girosi, and Pierre-Carl Michaud are with the RAND Corporation, Santa Monica, CA. Dana P. Goldman is also with the Schools of Pharmacy and Policy, Planning, and Development, University of Southern California, Los Angeles. S. Jay Olshansky is with the School of Public Health, University of Illinois at Chicago. David Cutler is with the Economics Department, Harvard University, Cambridge, MA. John W. Rowe is with the Mailman School of Public Health, Columbia University, New York, NY.

Correspondence: Correspondence should be sent to Dana P. Goldman, RAND Corporation, 1776 Main St, Santa Monica, CA 90407-2138 (e-mail: dgoldman{at}rand.org). Reprints can be ordered at http://www.ajph.org by clicking the "Reprints/Eprints" link.

Objectives. We assessed the potential health and economic benefits of reducing common risk factors in older Americans.

Methods. A dynamic simulation model tracked a national cohort of persons 51 and 52 years of age to project their health and medical spending in prevention scenarios for diabetes, hypertension, obesity, and smoking.

Results. The gain in life span from successful treatment of a person aged 51 or 52 years for obesity would be 0.85 years; for hypertension, 2.05 years; and for diabetes, 3.17 years. A 51- or 52-year-old person who quit smoking would gain 3.44 years. Despite living longer, those successfully treated for obesity, hypertension, or diabetes would have lower lifetime medical spending, exclusive of prevention costs. Smoking cessation would lead to increased lifetime spending. We used traditional valuations for a life-year to calculate that successful treatments would be worth, per capita, $198 018 (diabetes), $137 964 (hypertension), $118 946 (smoking), and $51 750 (obesity).

Conclusions. Effective prevention could substantially improve the health of older Americans, and—despite increases in longevity—such benefits could be achieved with little or no additional lifetime medical spending.

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