The cost of being overweight in New Zealand

Health Sciences

Being overweight contributes to health problems that cost the country at least $ 2 billion a year – or 8% of our total health care budget – and billions more in economic impacts, but the problem is being carefully ignored by politicians. governments, writes Professor Boyd Swinburn

The latest results from the New Zealand health survey show a substantial increase in the prevalence of obesity among children and adults after plateauing for a decade.

This is very concerning and it makes a new report from the Sapere research group on the economic impact of being overweight in Aotearoa all the more important. The report was commissioned by Hapai Te Hauora and it is a welcome update on the two previous studies I participated in using data from 1991 and 2006.

Over the past three decades, the prevalence of obesity has increased dramatically, as have health care costs and population size, so it is useful to have up-to-date data on the costs of being overweight and overweight. ‘obesity. The main figure, before going into details, is that the direct health costs attributable to overweight and obesity amount to about $ 2 billion per year, which is about eight percent of the total budget of health. successive governments to be carefully ignored.

Cost of illness studies, like this one, have important uses and limitations. They essentially try to monetize the burden of a condition by estimating the health costs that can be attributed to the condition (direct costs), the associated loss of productivity (indirect costs) and the price society would put in the event of death. premature birth, disability or loss of quality of life attributed to the disease (intangible costs). However, these are only estimates and they can have very wide ranges, especially for intangible costs, depending on the methodology used and the assumptions made.

Before turning to each of these types of costs in turn, it is important to note two things. First of all, this report did not build costs from scratch, which the studies on data from 1991 and 2006 did (this is a long and laborious task). Instead, Sapere used a number of different and shorter methods to triangulate a range of plausible estimates for each of the cost types. I think this is perfectly adequate for the purposes of this type of study which essentially attempts to measure the burden of overweight and obesity on society.

The second very important point is that obesity is an unresolved societal problem driven by societal determinants (especially business) that all of society pays for – taxpayers, businesses and especially people living with obesity. The costs identified in this report should be interpreted as costs to the company of a societal problem. Children and adults living with obesity should not be blamed for any economic impact.

Direct costs are the most closely measured types of costs, and the analyzes use population-attributable fractions that estimate the extent to which major obesity-related diseases (in this report, type 2 diabetes, cardiovascular disease, breast and colorectal cancers and osteoarthritis) can be attributed to the excess weight of the population. Diabetes is the most difficult of the consequences of obesity to assess because it leads to many complications (it affects almost every organ in the body) and mechanisms of increased costs (for example, average longer hospital stays for all). admissions) which are not necessarily taken into account in the health data. like hospital discharges. Fortunately, PWC’s recent Type 2 Diabetes Costing Report had already done the heavy lifting to make these estimates.

A recently published 8-country study on the costs of overweight and obesity included Australia and a simple trans-Tasman per capita calculation yielded a very similar result to the $ 2 billion in direct costs per year or 8% of health spending. An OECD report on the cost of overweight and obesity for 52 countries also helped triangulate the estimate of eight percent of the health cost figure for New Zealand. I think we can have good faith in the direct costs of being overweight and note that this level of burden on taxpayers for a preventable condition really warrants more policy action than the current government is giving it.

The best estimates of indirect costs are between $ 7 billion and $ 9 billion per year. The lower estimate comes from the same OECD report and about half of this loss in productivity is due to presenteeism, with a quarter each attributed to absenteeism and lower employment levels. Economic commentators routinely lament New Zealand’s low productivity levels, but we rarely hear about how a healthier workforce can increase productivity.

Intangible costs are the most difficult and controversial costs to estimate because it is about monetizing the value of health and life. The two most common methods involve willingness to pay (estimating how much people would be willing to pay for years of life or for more quality of life or less disability) and break-even points (for example, Pharmac approves of drugs that cost between $ 4,200 and $ 32,300 per grade). adjusted life year gained). Using a variety of these methods, Sapere came up with a range of $ 2 billion to $ 26 billion. This is a wide range, as one would expect, and I would expect it to be closer to the upper figure to be consistent with other intangible cost estimates for studies of the cost of disease. However, although these numbers are the least robust of the cost estimates, they remind us that there is a price to be paid, in terms of shortened life and lower quality of life, by people living with obesity.

Since the arrival of Covid-19, all of this has been onerous for the government, the public, the media, and the health care system, leaving little bandwidth to deal with other pressing, but chronic, issues. Hopefully this new report, along with the latest one on the increasing prevalence of obesity, will serve as a reminder that there is still critical work to be done to convert all of the WHO recommendations on preventing obesity. obesity in children and adults in action.

This article was originally published on the Sciblogs site.

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