{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T19:26:51Z","timestamp":1786649211496,"version":"build-2736575974"},"posted":{"date-parts":[[2026,8,11]]},"group-title":"Health Economics","reference-count":48,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T00:00:00Z","timestamp":1786406400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"award":["U54 CA 155496"],"award-info":[{"award-number":["U54 CA 155496"]}],"id":[{"id":"https:\/\/ror.org\/01cwqze88","id-type":"ROR","asserted-by":"publisher"}]},{"award":["R21 DK110530"],"award-info":[{"award-number":["R21 DK110530"]}],"id":[{"id":"https:\/\/ror.org\/01cwqze88","id-type":"ROR","asserted-by":"publisher"}]},{"award":["U01CA265735"],"award-info":[{"award-number":["U01CA265735"]}],"id":[{"id":"https:\/\/ror.org\/01cwqze88","id-type":"ROR","asserted-by":"publisher"}]},{"award":["P30 AG0666 I 9"],"award-info":[{"award-number":["P30 AG0666 I 9"]}],"id":[{"id":"https:\/\/ror.org\/049v75w11","id-type":"ROR","asserted-by":"publisher"}]},{"award":["KO1 HS022330"],"award-info":[{"award-number":["KO1 HS022330"]}],"id":[{"id":"https:\/\/ror.org\/03jmfdf59","id-type":"ROR","asserted-by":"publisher"}]},{"id":[{"id":"https:\/\/ror.org\/04wyvkr12","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2026,8,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Obesity is a costly cause of morbidity and disability. Previous research has well documented that Black persons bear a disproportionate financial burden of obesity-related multimorbidity (ORM); however, healthcare costs have not been examined over the lifespan.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>Among U.S. general population age \u226540 years, we quantified racial difference in 1) lifetime healthcare costs (LHC\u2019s), and 2) lifetime healthcare cost differential (LCD) associated with ORM.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We used data from the Medical Expenditure Panel Survey, 2008-2012, and targeted four obesity-related diseases (ORDs): diabetes, hypertension, coronary heart disease, and stroke. A published Markov model was used to model individuals\u2019 life histories of ORDs and to compute LHC\u2019s. LCD associated with ORM was computed by taking the difference between LHC for those with ORM and LHC for members without ORD. Racial differences were quantified by taking the differences in LHC or LCD between White and Black men\/women.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We included 53,035 Black and White individuals representing 97,229,611 (se=2,104,365) U.S. Black (12.4%) and White (87.6%) populations aged \u226540 years. ORM was more prevalent in the Black (21.2%) than the White populations (13.4%). Racial difference in LHC\u2019s for women\/men with ORM and LCDs associated with ORM (2012$) was $31,035\/43,595 and $11,350\/26,948 for age 40-49, $21,567\/25,615 and $3,846\/9,808 for 50-59, $9,863\/18,515 and \u2212$2,566\/7,426 for 60-69, \u2212$8,220\/16,285 and \u2212$11,524\/3,865 for 70-79.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Racial differences in LHC\u2019s and LCD associated with ORM persist and the scale varies by subpopulation. Future interventions designed to prevent\/manage ORM are crucial to prioritize populations burdening with high LHC\u2019s and health disparities.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Highlights<\/jats:title>\n                  <jats:p>Racial disparities in the prevalence of obesity and obesity-related multimorbidity (ORM), and financial burden of managing ORM are well-established. We quantified racial differences in lifetime healthcare costs associated with ORM to inform future interventions and policies aiming at reducing health disparities.<\/jats:p>\n                <\/jats:sec>","DOI":"10.64898\/2026.08.09.26360041","type":"posted-content","created":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T14:56:10Z","timestamp":1786460170000},"source":"Crossref","is-referenced-by-count":0,"title":["Racial differences in lifetime healthcare costs associated with obesity-related multimorbidity among the U.S. population aged 40 years or older"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1521-9809","authenticated-orcid":false,"given":"Preeti Pushpalata","family":"Zanwar","sequence":"first","affiliation":[{"name":"Applied Health Economics and Outcomes Research, Jefferson College of Population Health, Thomas Jefferson University, Philadelphia, PA"},{"name":"NIA Funded Network on Life Course Health Dynamics and Disparities, University of Southern California, Los Angeles, CA"},{"name":"NIA Funded Network on Life Course Health Dynamics and Disparities, University of Southern California, Los Angeles, CA"},{"name":"NIA Funded Economics & Demography of Aging Center on Healthy Aging Behaviors & Longitudinal Investigations"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3560-9460","authenticated-orcid":false,"given":"Mei","family":"Wang","sequence":"additional","affiliation":[{"name":"Division of Public Health Sciences, Department of Surgery, School of Medicine, Washington University in St. Louis, St. Louis, MO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan","family":"Logan","sequence":"additional","affiliation":[{"name":"School of Medicine, Saint Louis University, St. Louis, MO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5872-9556","authenticated-orcid":false,"given":"Su-Hsin","family":"Chang","sequence":"additional","affiliation":[{"name":"School of Medicine, Saint Louis University, St. Louis, MO"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"54368","reference":[{"key":"2026081311300558000_2026.08.09.26360041v1.1","first-page":"i","article-title":"Report of a WHO consultation","volume":"894","author":"Obesity: preventing and managing the global epidemic","year":"2000","journal-title":"World Health Organ Tech Rep Ser"},{"key":"2026081311300558000_2026.08.09.26360041v1.2","unstructured":"Hales CM , Carroll MD , Fryar CD , Ogden CL . 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