OBJECTIVES: To examine racial differences in lifetime healthcare cost (LHC) and lifetime healthcare cost differential (LCD) for obesity-related multimorbidity (ORM) in the U.S. population age ≥40.

METHODS: Medical Expenditure Panel Survey (MEPS) data from 2008-2012 were stratified by gender (female, male), age (40-49, 50-59, 60-69, 70-79 years), and race (Black, White). ORM was defined as ever being diagnosed with ≥2 obesity-related diseases (ORDs), including diabetes, hypertension, coronary heart disease, or stroke. A Markov model with 1-year cycle length and 17 health states (i.e., no ORD and any combination of the four ORDs) was used to compute individuals’ life histories of disease development/progression and average LHC for each population. LCD for ORM was computed by subtracting LHC for members of that population with multimorbidity from LHC for members of that population without any ORD. Racial differences in LHC and LCD between Black and White were assessed. Analyses were adjusted for the complex design of MEPS.

RESULTS: Higher proportion of Blacks than Whites had ORM (21.2% vs 13.4%). Whites had higher LHCs for ORM than their Black counterparts. For e.g., LHC were $267,899 for White women aged 40-49 vs $236,864 for their Black counterparts; LHC’s were $205,234 for White men aged 40-49 vs $161,639 for their Black counterparts. For women, LCD was higher among Blacks than Whites in the older age groups: $99,515 vs. $96,949 for 60-69 years and $66,833 vs $55,309 for 70-79 years. For men, LCD was $86,106 for Whites vs. $78,680 for Blacks aged 60 to 69 years, and $53,723 for Whites vs. $49,858 for Blacks aged 70 to 79 years.

CONCLUSIONS: Racial differences in LHCs and LCDs for ORM vary considerably between Blacks and Whites in the U.S. Future studies investigating access to timely preventive care for ORM may be crucial to improve health equity in ORM burden.