Are investments in disease prevention complements? The case of statins and health behaviors

J Health Econ. 2014 Jul;36:151-63. doi: 10.1016/j.jhealeco.2014.04.006. Epub 2014 Apr 16.


We obtain estimates of associations between statin use and health behaviors. Statin use is associated with a small increase in BMI and moderate (20-33%) increases in the probability of being obese. Statin use was also associated with a significant (e.g., 15% of mean) increase in moderate alcohol use among men. There was no consistent evidence of a decrease in smoking associated with statin use, and exercise worsened somewhat for females. Statin use was associated with increased physical activity among males. Finally, there was evidence that statin use increased the use of blood pressure medication and aspirin for both males and females, although estimates varied considerably in magnitude. These results are consistent with the hypothesis that healthy diet is a strong substitute for statins, but there is only uneven evidence for the hypothesis that investments in disease prevention are complementary.

Keywords: Complementarity; Health behaviors; Health investment; Prevention; Statins.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Age Distribution
  • Aged
  • Body Mass Index
  • Cholesterol / adverse effects
  • Cholesterol / blood*
  • Coronary Disease / etiology
  • Coronary Disease / mortality
  • Coronary Disease / prevention & control*
  • Diet / adverse effects
  • Diet / psychology
  • Diet / standards
  • Exercise / physiology
  • Exercise / psychology
  • Female
  • Health Behavior*
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
  • Hyperlipidemias / complications
  • Hyperlipidemias / drug therapy*
  • Hyperlipidemias / prevention & control
  • Interviews as Topic
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Mortality / trends
  • Primary Prevention / methods*
  • Socioeconomic Factors


  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Cholesterol