93 Appendix 10: Social externalities Appendices value by which we adjust the national prevalence data on smoking to each state. For example, 12.8% of New York adults were smokers in 2018, relative to 15.9% for the nation. We thus apply a scalar of 0.80 to the national probabilities of smoking in order to adjust them to the state of New York. Alcohol dependence Although alcohol dependence has large public and private costs, it is difficult to measure and define. There are many patterns of drinking, ranging from abstinence to heavy drinking. Alcohol abuse is riddled with social costs, including health care expenditures for treatment, prevention, and support; workplace losses due to reduced worker productivity; and other effects. Figure A10.2 compares the percentage of adults, 18 and older, that abuse or depend on alcohol by education level, based on data from the Substance Abuse and Mental Health Services Administration (SAMHSA).50 These statistics give an indication of the correlation between education and the reduced probability of alcohol dependence. Adults with an associate degree or some college have higher rates of alcohol dependence than adults with a high school diploma or lower. Prevalence rates are lower for adults with a bachelor’s degree or higher than those with an associate degree or some college. Although the data do not maintain a pattern of decreased alcohol dependence at every level of increased education, we include these rates in our model to ensure we provide a comprehensive view of the social benefits and costs correlated with education. Obesity The rise in obesity and diet-related chronic diseases has led to increased attention on how expenditures relating to obesity have increased in recent years. The average cost of obesity-related medical conditions is calculated using information from the Journal of Occupational and Environmental Medicine, which reports incremental medical expenditures and productivity losses due to excess weight.51 Data for Figure A10.3 is derived from the National Center for Health Statistics which shows the prevalence of obesity among adults aged 20 years and over by education, gender, and ethnicity.52 As indicated, college graduates are less likely to be obese than individuals with a high school diploma. However, the prevalence of obesity among adults with some college is actually greater than those with just a high school diploma. In general, though, obesity tends to decline with increasing levels of education. 50 Substance Abuse and Mental Health Services Administration. “Table 5.4B—Alcohol Use Disorder in Past Year among Persons Aged 12 or Older, by Age Group and Demographic Characteristics: Percentages, 2017 and 2018.” SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2017 and 2018. 51 Eric A. Finkelstein, Marco da Costa DiBonaventura, Somali M. Burgess, and Brent C. Hale, “The Costs of Obesity in the Workplace,” Journal of Occupational and Environmental Medicine 52, no. 10 (October 2010): 971-976. 52 Ogden Cynthia L., Tala H. Fakhouri, Margaret D. Carroll, Craig M. Hales, Cheryl D. Fryar, Xianfen Li, David S. Freedman. “Prevalence of Obesity Among Adults, by Household Income and Education—United States, 2011–2014” National Center for Health Statistics, Morbidity and Mortality Weekly Report, 66:1369–1373 (2017). Figure A10.2: Prevalence of alcohol dependence or abuse by education level Source: Centers for Disease Control and Prevention. 8% 6% 4% 2% 0% 79 + 89 + 100 + 92 Bachelor’s degree Less than high school High school graduate Associate degree or some college Figure A10.3: Prevalence of obesity by education level Source: Derived from data provided by the National Center for Health Statistics. 99 + 100 + 69 College graduate High school graduate Some college 50% 30% 20% 10% 0% 40%
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