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Is a Healthy diet economically sustainable? The health effects of prevention policies. Michele Cecchini OECD – Health Division. The Burden of Obesity on Health Systems. In any given moment, obese patients cost more. Source: Brunello et al., 2008 Bhattacharia & Sood , 2005 . - PowerPoint PPT Presentation
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IS A HEALTHY DIET ECONOMICALLY SUSTAINABLE?THE HEALTH EFFECTS OF PREVENTION POLICIESMichele CecchiniOECD – Health Division
The Burden of Obesity on Health Systems
Normal-weight patient
Obese patient (US) Obese patient (EU)90
95
100
105
110
115
Rel
ativ
e co
st o
f pat
ient
s
In any given moment, obese patients cost more
Source: Brunello et al., 2008Bhattacharia & Sood, 2005
The OECD/WHO CDP Model
Physical activityadequate physical actinsuff .physical act
Body mass index
normal weightpre-obesityobesity
Blood pressurenormalhypertension
Cholesterolnormal
hypercholesterolemia
Glycaemianormaldiabetes
Cancers
Stroke
Ischemic heart
disease
Fatlow fat intakemedium fat intakehigh fat intake
Fibreadequate fibre intakelow fibre intake
Socio-economic statusupperlower
A Comprehensive & Affordable Prevention Package
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
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 NCDs
0 7 14 21 28 35 42 490
100000002000000030000000400000005000000060000000700000008000000090000000
100000000
Time (years)
Mill
ion
life
year
s
0 7 14 21 28 35 42 490
100000002000000030000000400000005000000060000000700000008000000090000000
100000000
Time (years)
Mill
ion
life
year
s
Europe China Brazil Canada
Cancers (lung, colorectal, breast) Cardiovascular diseases
Prevention is a Good InvestmentImpact on Health Expenditure
0 5 10 15 20 25 30 35 40 45 50
-140
-120
-100
-80
-60
-40
-20
0
EuropeCanadaBrazilChina
Time (years)
$ / c
apit
a
Cost-Effectiveness of Prevention
Brazil
China
Canada
Europe
Thousand $ / DALY
After 20 years After 50 years
05,0
00
10,00
0
15,00
0
20,00
0
25,00
0
30,00
0
35,00
0
Thousand $ / DALY
Impact on InequalitiesFiscal measures in Europe
0-1011
-2021
-3031
-4041
-5051
-6061
-7071
-8081
-90
91-10
00.0%
0.1%
0.2%
0.3%
0.4%
0.5%
0.6%
0.7%
high SES low SES
Different social groups:
• Different risk profiles:– Larger benefits in
those most at risk (~)
• Different responses to interventions:– Larger benefits with a
greater response
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
Health Effects of a Healthy Diet10% of Energy from Saturated Fats
Source: Lock et al., 2010
satu
rate
d fa
t
YLL
(IH
D)
YL w
ith
IHD
prem
atur
e de
aths
satu
rate
d fa
t
YLL
(IH
D)
YL w
ith
IHD
prem
atur
e de
aths
United Kingdom Brazil
-14%
-12%
-10%
-8%
-6%
-4%
-2%
0%
-22%
OECD Work on Health Behaviours
• OECD health working papers HWP 32, 45, 46, 48
• Paper in Lancet series on chronic diseases
• Lancet paper on priority interventions
• “Best buys” paper for the UN Summit on NCDs
• OECD/Euro Observatory book
[email protected] www.oecd.org/health/prevention