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TACKLING UNHEALTHY DIETS
AND OBESITY: THE HEALTH
EFFECTS OF PREVENTION
POLICIESThe Economics of PreventionOECD – Health Division
In Any Given Moment, Obese Patients Cost More
Normal-weight patient
Obese patient (US) Obese patient (EU)90
95
100
105
110
115
Rela
tive c
ost
of
pati
ents
Source: Brunello et al., 2008Bhattacharia & Sood, 2005
The Burden of Obesity on Health Systems
US
Portugal
New Zealand
Canada
Germany
Australia
France
0% 1% 2% 3% 4% 5% 6% 7%
% of total healthcare budgetRoux & Donaldson, 2004Konnopka, Bodemann, Konig, 2011
A Comprehensive & Affordable Prevention Package to Tackle Obesity
OECD Countries Emerging Economies
Mass media campaigns Mass media campaigns
Compulsory food labelling Compulsory food labelling
Industry self-regulation of food advertising to children
Government regulation of food advertising to children
Physician-dietician counselling Fiscal measures
School-based interventions
Canada Europe Brazil China
24.03 $/cap 22.45 $/cap 0.40 $/cap 0.20 $/cap
Expectations Must Be Realistic
• Does prevention improve health?
• Does it reduce health expenditure?
• Does it improve health inequalities?
• Is it cost-effective?
Prevention Saves LivesLife Years Saved Every Year by Preventing Obesity
China
Europe
Brazil
Canada
Life years (millions)
1 LY / 19 persons.
1 LY / 8
1 LY / 20
1 / 8
Prevention Keeps HealthyYears of Life Free of Chronic Diseases
0 7 14 21 28 35 42 490
10000000
20000000
30000000
40000000
50000000
60000000
70000000
80000000
90000000
100000000
Time (years)
Mil
lion
lif
e ye
ars
0 7 14 21 28 35 42 490
10000000
20000000
30000000
40000000
50000000
60000000
70000000
80000000
90000000
100000000
Time (years)
Mil
lion
lif
e ye
ars
Europe China Brazil Canada
Cancers (lung, colorectal, breast) Cardiovascular diseases
Prevention is a Good InvestmentImpact on Health Expenditure of Preventing Obesity
0 5 10 15 20 25 30 35 40 45 50
-140
-120
-100
-80
-60
-40
-20
0
EuropeCanadaBrazilChina
Time (years)
$ /
capit
a
Cost-Effectiveness of Prevention
Brazil
China
Canada
Europe
Thousand $ / DALY
After 20 years After 50 years
0
5,00
0
10,0
00
15,0
00
20,0
00
25,0
00
30,0
00
35,0
00
Thousand $ / DALY
Key Policy Implications
• Obesity and NCDs are global economic issues
• Prices and regulations work best in emerging economies. Primary care doctors play a role in countries with stronger health systems
• Comprehensive intersectoral prevention strategies are more efficient and generate larger health gains
• We can afford to tackle obesity and prevention is good value for money
• OECD Obesity update 2014 – [The economic crisis & obesity]
• OECD/WHO-Euro/Europ. Observatory book
• OECD health working papers HWP 32, 45, 46, 48, [65], 66
• Lancet papers on NCDs and priority interventions
• WHO/OECD “Best buys” paper for the UN Summit on NCDs
OECD Work on Health Behaviours
http://www.oecd.org/health/economics-of-prevention.htm
http://www.oecd.org/health/obesity-update.htm