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Open Access Research article

The health and cost implications of high body mass index in Australian defence force personnel

Jonathan Peake25*, Susan Gargett3, Michael Waller1, Ruth McLaughlin1, Tegan Cosgrove1, Gary Wittert4, Peter Nasveld1 and Peter Warfe1

Author affiliations

1 The University of Queensland, Centre for Military and Veterans’ Health, Brisbane, Australia

2 The University of Queensland, School of Human Movement Studies, Brisbane, Australia

3 The University of Queensland, Centre of National Research on Disability and Rehabilitation Medicine, Brisbane, Australia

4 School of Medicine, The University of Adelaide, Adelaide, Australia

5 The University of Queensland, Centre for Military and Veterans’ Health, Herston QLD 4006, Australia

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Citation and License

BMC Public Health 2012, 12:451  doi:10.1186/1471-2458-12-451

Published: 19 June 2012

Abstract

Background

Frequent illness and injury among workers with high body mass index (BMI) can raise the costs of employee healthcare and reduce workforce maintenance and productivity. These issues are particularly important in vocational settings such as the military, which require good physical health, regular attendance and teamwork to operate efficiently. The purpose of this study was to compare the incidence of injury and illness, absenteeism, productivity, healthcare usage and administrative outcomes among Australian Defence Force personnel with varying BMI.

Methods

Personnel were grouped into cohorts according to the following ranges for (BMI): normal (18.5 − 24.9 kg/m2; n = 197), overweight (25–29.9 kg/m2; n = 154) and obese (≥30 kg/m2) with restricted body fat (≤28% for females, ≤24% for males) (n = 148) and with no restriction on body fat (n = 180). Medical records for each individual were audited retrospectively to record the incidence of injury and illness, absenteeism, productivity, healthcare usage (i.e., consultation with medical specialists, hospital stays, medical investigations, prescriptions) and administrative outcomes (e.g., discharge from service) over one year. These data were then grouped and compared between the cohorts.

Results

The prevalence of injury and illness, cost of medical specialist consultations and cost of medical scans were all higher (p < 0.05) in both obese cohorts compared with the normal cohort. The estimated productivity losses from restricted work days were also higher (p < 0.05) in the obese cohort with no restriction on body fat compared with the normal cohort. Within the obese cohort, the prevalence of injury and illness, healthcare usage and productivity were not significantly greater in the obese cohort with no restriction on body fat compared with the cohort with restricted body fat. The number of restricted work days, the rate of re-classification of Medical Employment Classification and the rate of discharge from service were similar between all four cohorts.

Conclusions

High BMI in the military increases healthcare usage, but does not disrupt workforce maintenance. The greater prevalence of injury and illness, greater healthcare usage and lower productivity in obese Australian Defence Force personnel is not related to higher levels of body fat.