"Between 1959 and 2010, the percentage of eligible civilians who exceed the weight-for-height and body fat standards of the PHSCC rose from 9.05% to 18.24% among men, and from 6.13% to 23.10% among women."

Econ Hum Biol. 2014 Jan 7. pii: S1570-677X(13)00130-5. doi: 10.1016/j.ehb.2013.12.007. [Epub ahead of print]

The effect of rising obesity on eligibility to serve in the U.S. public health service commissioned corps.

Maclean JC1, Cawley J2.

Author information

• 1Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States. Electronic address: macleanc@upenn.edu.
• 2Department of Policy Analysis and Management, Cornell University, Ithaca, NY, United States; Department of Economics, Cornell University, Ithaca, NY, United States. Electronic address: JHC38@cornell.edu.

Abstract

This study investigates how rising obesity has affected eligibility to serve in the United States Public Health Service Commissioned Corps (PHSCC), the uniformed service charged with protecting and promoting public health in the U.S. Data are drawn from the National Health and Nutrition Examination Surveys. Between 1959 and 2010, the percentage of eligible civilians who exceed the weight-for-height and body fat standards of the PHSCC rose from 9.05% to 18.24% among men, and from 6.13% to 23.10% among women. Simulations indicate that a further 1% increase in population body weight will result in an additional 3.42% of men and 5.08% of women exceeding PHSCC accession standards. This study documents an under appreciated consequence of the rise in obesity: fewer Americans eligible to develop and implement a public health response to obesity through the PHSCC. This illustrates how a public health problem can undermine the public health labor force, compromising a response and risking a self-reinforcing trend. These findings are timely as the Patient Protection and Affordable Care Act (ACA) calls for a major expansion of the PHSCC.