Lehnert T., Stuhldreher N., Streltchenia P., Riedel-Heller S.G., Konig H.H. [38], only inpatient and outpatient costs were included for the estimation of the direct costs, while in another Brazilian study, by de Oliveira et al. Alter et al. De Oliveira M.L., Santos L.M., Da Silva E.N. Strum R. The economics of physical activity: societal trends and rationales for interventions. By having an explicit framework to inform decisions this will improve efficiency on how local resources are managed to prevent population obesity. Direct per-capita costs of obesity were reported in seven studies [31,35,36,37,43,48,52] and indirect per-capita costs were calculated in one study in Sweden [49]. The measures of PAF and/or PAR were used in seven studies [38,40,44,45,46,50,53], while four studies did not mention the approach to estimating the costs [29,30,39,41]. Economic costs of overweight and obesity. What is already known? World Health Organization Obesity. This work will have an explicit focus on the local system and adopt scenario analyses to predict how the costs associated with obesity will alter if local population trends were to change over time. Ordoez AM, Madalozzo Schieferdecker ME, Cestonaro T, et al.. Nutritional status influences the length of stay and clinical outcomes in patients hospitalized in internal medicine wards, Gender differences in the longitudinal association between obesity, and disability with workplace absenteeism in the Australian working population, Chronic non-communicable diseases (NCDS), absenteeism and workplace wellness initiatives at a consumer goods company in South Africa. The report, carried out by the Women's Regional Consortium and Ulster University, indicates the crisis is having a negative impact on women's mental and physical health. Hammond R.A., Levine R. The economic impact of obesity in the United States. The https:// ensures that you are connecting to the Workstream 3 aims to bridge the current knowledge gap by exploring the resource requirements and impact on health and education outcomes from adhering to the UK national School Food Standards [37] and the School Food Plan [38]. A position statement of the world obesity Federation, Global burden of 87 risk factors in 204 countries and territories, 1990-2019: a systematic analysis for the global burden of disease study 2019, Individuals with obesity and COVID19: a global perspective on the epidemiology and biological relationships, Use of healthcare services and expenditure in the US in 2025: the effect of obesity and morbid obesity. Alter et al. Hastings J, Shapiro JM. Centre for Economics of Obesity. Cost analyses of obesity in Canada: Scope, quality, and implications. Lichtman M.A. Building upon evidence from several other reports, it identifies an action agenda for countries to follow, with support from the World Bank and the international development community. 10.1016/S0140-6736(17)32129-3 Vainio H., Kaaks R., Bianchini F. Weight control and physical activity in cancer prevention: International evaluation of the evidence. As per capita income increases, the burden of obesity shifts to the poor and to rural areas. Mora T., Gil J., Sicras-Mainar A. Maximilian Tremmel and Sanjib Saha conceived and designed the systematic literature search; Maximilian Tremmel performed the systematic literature search; Sanjib Saha contributed to the search strategy, and the selection and extraction of literature; Maximilian Tremmel analysed and extracted the literature; Maximilian Tremmel wrote the first draft; Sanjib Saha, Ulf-G Gerdtham and Peter M. Nilsson contributed to the writing of the manuscript. Neovius K., Rehnberg C., Rasmussen F., Neovius M. Lifetime productivity losses associated with obesity status in early adulthood: A population-based study of Swedish men. Two studies estimated the obesity burden in Brazil from a health care perspective. Dobbs R, et al. Younossi Z.M., Henry L. Economic and quality-of-life implications of non-alcoholic fatty liver disease. 2017;20(2):20612. Applied Health Economics and Health Policy Two out of 3 men are overweight and 1 in 4 people are obese in the United Kingdom. Green space is defined as an area of vegetated land within an urban area such as parks or gardens, and blue space is an outdoor environment that can be natural or man-made that prominently features water. National Child Measurement Programme, National Child Measurement Programme, England 2020/21 School Year,, in National Child Measurement Programme,, NHS DIgital, Editor. [44] included neoplasms of the oesophagus, stomach, colon, liver, gallbladder, pancreas, postmenopausal breast, cervix uteri, ovary, prostate, and kidney, non-Hodgkins lymphoma, multiple myeloma, and leukaemia, while Kang et al. The Centre for Economics of Obesity Research is funded by the National Institute for Health Research (NIHR) [Research Professorship Award NIHR300773]. In 2016, more than 2 billion people worldwide were overweight or obese, and over 70 percent of them lived in low- or middle-income countries. The reported costs due to cancers need to be interpreted with the knowledge that different types of cancer were included in the different studies, which may have led to over- or underestimation of costs. [49] state that using an FCA, compared with the HCA, reduced the estimated productivity losses by about 80%. The PAF is calculated by using the RRs for co-morbidities related to obesity. Finch D. Public health grant allocations represent a 24$ (1bn) real terms cut compared to 2015/16 Health Foundation, Editor. PLoS Med. Resource utilisation and costs of depressive patients in Germany: Results from the primary care monitoring for depressive patients trial. Microsimulation models can predict the future cost and can incorporate data from other countries, if data are missing in a specific case or if data from another country are known to be valid and sufficiently reliable to be incorporated. 10.1111/obr.13128 10. How interventions are judged to be effective will depend on impact upon these indicators alongside consideration of the joint strategic needs assessment; and the criteria for judging value will be determined by a collective group of local government decision makers, including the Director of Public Health and the elected members who are voted in by the public. [52], who calculated lifetime costs from 65 years onwards. A body mass index (BMI) over 25 is considered overweight, and over 30 is obese. used average earnings to measure indirect costs [37]. 8600 Rockville Pike The worldwide prevalence of overweight and obesity increased from 921 million to 2.1 billion people from 1980 to 2013, while total population rose from 4.4 billion to 7.2 billion during the same time period; this represents an increased prevalence of 27.5% for adults and 47.1% for . If the United Kingdom, for example, were to deploy all 44 interventions, it could rein in obesity rates and help roughly 20% of its overweight and obese population return to . Cawley J., Meyerhoefer C. The medical care costs of obesity: An instrumental variables approach. These actions can be local authority-led (local authority-funded and implemented) or can be led by local stakeholders as a result of the engagement work done by local authorities across the system to develop a shared strategy and coordinated response. [44] used the concept of attributable fractions based on German prevalence data and relative risks from US studies as well as statistics from the German Federal Statistics Office and the German Retirement Insurance Office. Indirect costs of obesity: A review of the current literature. 2021: London. Comparative Quantification of Health Risks. Therefore, these studies provide a good picture of the increase in the societal COO in Germany, from 9.8 million in 2002 to 12.2 million in 2008. Economics offers insight into the real price of food, recognising that it is not just about the relationship between income and food prices. Workstream 4: Retail Workstream 4 is about the retail sector and understanding what retailers can do to create an environment that promotes healthy behaviours. It is also about the time and effort it takes to obtain food so that it becomes cheaper and more accessible, then this combined effect causes obesity levels to rise [23]. The attributable burden of obesity differs across studies. 2018;11(15):36071. For example, NAFLD, a very common chronic liver disease worldwide, is on the rise following the trend of increasing prevalence of obesity, and is the second most common indication for liver transplantation, and an important cause of hepatocellular carcinoma [77]. [(accessed on 27 November 2016)]; Ezzati M., Lopez A. The theory of economic evaluation is based on the principles of scarcity, that there is limited funding available for all services and therefore these services must compete for the same pool of resources. Nevertheless, the costs estimated in these two studies differ crucially from those reported by Krueger et al. Li J., Song J., Zaytseva Y.Y., Liu Y., Rychahou P., Jiang K., Starr M.E., Kim J.T., Harris J.W., Yiannikouris F.B., et al. Using microsimulation modelling, this book analyses the burden of obesity and overweight in 52 countries (including OECD, European Union and G20 countries), showing how overweight reduces life expectancy, increases healthcare costs, decreases workers' productivity and lowers GDP. A BMI of 25 to <30 kg/m is defined as overweight and BMI 30 kg/m is classified as obese [4,5]. Organization for Economic Co-Operation and Development (OECD) Glossary of Statistical TermsDeveloped, Developing Countries. Palomo L, Flix-Redondo F-J, Lozano-Mera L, et al.. Cardiovascular risk factors, lifestyle, and social determinants: a cross-sectional population study, The association of health and employment in mature women: a longitudinal study. Data is presented at upper and lower tier local. Health burden and costs of obesity and overweight in Germany. CAS Second, we will work closely with the UK National Canal and River Trust to assess the economic value of blue space and develop an economic model that predicts how alternative uses of Trust funding alters population outcomes at the local level. Besides excess health care expenditure, obesity also imposes costs in the form of lost productivity and . Liu J.L.Y., Maniadakis N., Gray A., Rayner M. The economic burden of coronary heart disease in the UK. As best described by Odelia Rosin, " [o]besity has major economic aspects. Higher physical activity at work may not only lead to a reduction in BMI and obesity, but also increase the health status of the employees. [53] included only colon cancer among the cancers. Ananthapavan J, et al. London: UK Government; 2019. In addition, obesity and its associated health problems have a significant economic impact on the US health care system. Tran B.X., Nair A.V., Kuhle S., Ohinmaa A., Veugelers P.J. A disadvantage of microsimulations is that a number of assumptions are made that may or may not be valid; these assumptions have to be checked using sensitivity analysis to evaluate how sensitive indicators can react to changes in input parameters. All these documents together show positive signs that the obesity policy is now being considered more holistically with multiple actions being taken to address the wide range of determinants. 10.1016/S0140-6736(20)30752-2 It will introduce the new Centre for Economics of Obesity and describe the research that is being conducted to illustrate how economics is being used to generate evidence that can help decision makers with managing finite resources to achieve efficiency and/or equity gains. HM Uk Government. When comparing the results of two studies in the USA [36,39] estimating annual direct costs per capita, the costs increased from US $2741 in 2005 to US $6899 in 2011. NCD Risk Factor Collaboration (NCD RisC). Trends in morbid obesity and in bariatric surgeries covered by the Brazilian public health system. London: UK Government; 2018. There are many economic reasons why reducing population obesity should be a priority, and global targets have been set . Foreman KJ, Marquez N, Dolgert A, et al.. Forecasting life expectancy, years of life lost, and all-cause and cause-specific mortality for 250 causes of death: reference and alternative scenarios for 201640 for 195 countries and territories, Adjusting for inflation and currency changes within health economic studies. The Centre for Economics of Obesity will adopt a shared learning approach to adapt methods of economic evaluation and decision modelling to generate economic evidence to inform local obesity policy. A prevention green paper [15] and the National Health Service (NHS) Long- Term Plan [16] have also outlined the start of a process to reduce levels of obesity with an emphasis away from treatment towards investing in changes that prevent the onset of disease. It will then describe how economics can offer a theoretical explanation for the rising rates and how economic analyses can help inform a policy response, paying particular attention to the regional or local policy making context. A disadvantage of the top-down approach is that all possible confounding variables need to be adjusted for when estimating the PAF. Agency, Editor. Cookson R, et al. Many low- and middle- income countries face a double burden: a high prevalence of both undernutrition and obesity. 2017;390(10113):262742. An independent report by the Chief Medical Officer. London: Health Foundation; 2021. Both these studies used data from the Medical Expenditure Panel Survey. After removing studies that met the exclusion criteria during the initial screening, the full text of the remaining studies was assessed against the inclusion criteria and any differences were discussed and a consensus was reached. Therefore, it has to be noted that using overall average earnings may overestimate average earnings for obese workers, especially women, in light of evidence that obesity is associated with low socioeconomic status [79]. Methods: A systematic literature search of studies in the English language was carried out in Medline (PubMed) and Web of Science databases to select cost-of-illness studies calculating the cost of obesity in a study population aged 18 years with obesity, as defined by a body mass index of 30 kg/m, for the whole selected country. This might require extensive resources and may not be always practical (e.g., for estimating the future cost) [62]. [(accessed on 6 September 2016)]; Kitahara C.M., Platz E.A., Freeman L.E., Hsing A.W., Linet M.S., Park Y., Schairer C., Schatzkin A., Shikany J.M., Berrington De Gonzalez A. Obesity and thyroid cancer risk among US men and women: A pooled analysis of five prospective studies. Within Europe, the costs associated with obesity account for 28% of the health budget [4] and in the UK, the direct annual costs from treating health complications associated with obesity is over 6 billion, with wider costs to society of 27 billion [5]. However, there was a crucial heterogeneity between the studies that included different types of cancer. Shrestha N., Pedisic Z., Neil-Sztramko S., Kukkonen-Harjula K.T., Hermans V. The Impact of obesity in the workplace: A review of contributing factors, consequences and potential solutions. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. The cost of obesity in Canada. [46] 6 years later using the same method to calculate the cost burden. This may in turn further reduce indirect costs due to absenteeism and disability pension. All of the abovementioned diseases were included only in the studies by Pitayatienanan et al. We included studies that satisfied the following criteria: (1) obesity was defined as BMI 30 kg/m; (2) the estimation was based on the entire country and a representative population; (3) the estimated COO could be either direct or indirect or both; (4) estimated costs were specific to obesity and not overweight; (5) the research was reported in English in a peer-reviewed journal; and (6) studies with any perspective (e.g., societal, health care or third-party payers) in cost estimations. The total economic impact of obesity is about $2 trillion a year, or 2.8% of world GDProughly equivalent to the economic damage caused by smoking or armed violence, . Discounting allows calculation of the present value of payments that will be made in the future and should be applied when the duration of the analysis is longer than 1 year, otherwise the calculated costs might overestimate the true costs. Economic Impact of Obesity Parallel to rising obesity rates is an increase in costs associated with excess weight. . Bahia et al. Obesity was first recognized by the UK government as a population health challenge in 1991. Local authorities are in a position that they understand the needs of their local populations and can work with communities and local businesses to adopt a health in all policies approach recognising the multiple determinants of the disease. [38] calculated the costs over 3 years from 2008 to 2010 to be US $1.1 billion per year and de Oliveira et al. In 14 studies, researchers mentioned obesity-related diseases in the cost calculation [29,30,31,35,38,40,44,45,46,47,50,52,53,54]. The macroeconomic objective of economic growth is underpinned by increased consumption of goods, including food and drink [22], and the obesogenic environment in relation to the availability, affordability, and accessibility of food alongside our interaction with the education, workplace and home environment have all contributed to the obesity epidemic. This prevents an informative comparison between most of the studies. Su et al. Thompson D . Authors. Economic Impact Military Readiness References People who have obesity, compared to those with a healthy weight, are at increased risk for many serious diseases and health conditions. Obesity-related diseases included in the studies. Professor Dame Sally Davies, Time to Solve Childhood Obesity. Although there is a substantial international literature on COO, we have found that a review and synthesis of the results based on homogeneous methods and costing approaches is hindered by a wide range of sources, as well as methodological approaches, perspectives, target groups and included diseases, used to estimate the prevalence of obesity. However, it is commonly disputed that BMI is simply a weight-height ratio and does not measure fatness (Cawley, 2015). Health-economic burden of obesity in Europe. 2004; World Health Organization: Geneva. 6 Since then, 14 government strategies . For example, Lehnert et al. There was also variation in the calculation of indirect costs. -. Total per-capita costs in the USA were predicted, using a Markov-based microsimulation, to be US $33,900 and US $70,200 (2013) over a time frame of 5 and 10 years, respectively [31]. Since 2015, the majority of UK schools have been mandated to adhere to the UK national School Food Standards that outline the nutritional principles for food provided at schools and support pupils healthy eating behaviour. Obesity as an independent risk factor for cardiovascular disease: A 26-year follow-up of participants in the Framingham Heart Study. 10.1371/journal.pone.0206703 In a study from the USA [52], direct costs were estimated from a third-party payer perspective and in another study from Germany [42] both direct and indirect costs were estimated from a third-party payer perspective. Childhood obesity a plan for action. Summarizing these results, we can state that obesity is responsible for a large fraction of costs, not only to the health care system but also to society at large. The intention is to generate economic evidence that resonates with all stakeholders who are part of the local system and thus provide a common language that facilitates co-production and a shared approach to obesity prevention and thus in turn support the functions of the local authority. For example, in England, 39.5% of women who live in the most deprived areas compared to 21.9% of women who live in the least deprived areas are living with obesity [6]. This artic Health Res Policy Syst. [47] and Neovius et al. Systematic reviews in the context of cost of obesity (COO) summarize the results of available studies in order to provide a high level of evidence on the cost burden due to obesity, which may help decision makers to develop policies to tackle the burden of obesity [16]. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. De Oliveira et al. How to tell if you're living with obesity
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