Saturday, October 1 2022

Quantifying the financial costs of overweight and obesity is important for national policy, say the SA researchers.

  • Overweight and obesity significantly increase the risk of non-communicable diseases, such as diabetes.
  • New analysis from Wits University shows that overweight and obesity cost South Africa’s healthcare system R33 billion a year.
  • Researchers say there is an urgent need for preventive interventions at the population level to reduce rates of overweight and obesity.

Globally, it is widely recognized that obesity-related conditions and their complications dramatically increase health care costs and lost productivity. This, in turn, adds a heavy burden to individuals, their families and governments.

One estimate suggests that of the total health expenditure on the continent, 9% is awarded dealing with overweight and obese people.

We have managed to research to calculate the cost of obesity to the South African health system. Our objective was to estimate the direct health costs associated with the treatment of weight-related conditions based on public sector tariffs.

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By our calculations, overweight and obesity cost the South African healthcare system R33 billion ($1.9 billion) a year. This represents 15.38% of public health expenditure and is equivalent to 0.67% of GDP. The annual cost per person of overweight and obesity is R2,769.

Among the most costly conditions to manage are diabetes and cardiovascular disease.

Our analysis shows that overweight and obesity impose a huge financial burden on the public health system in South Africa. This suggests an urgent need for preventive interventions at the population level to reduce rates of overweight and obesity. This reduction will reduce the incidence, prevalence and health expenditure on non-communicable diseases.

Quantifying the financial costs of overweight and obesity also gives national policy makers an idea of ​​the magnitude of the cost to the state, to managing their illnesses and to the costs to the community.

Scale of the problem

Half of all adults in South Africa are overweight (23%) or obese (27%). And the World Obesity Federation anticipates a further increase of 10% (37%) adult obesity by 2030. Overweight and obesity significantly increase the risk of non-communicable diseases. This burden contributes to the high prevalence of diabetes in the country, or eg. It is estimated that 11% of people over the age of 15 had diabetes in 2021. This is much higher than the prevalence of 4%.

About 12 million people suffer from weight-related diseases for which they receive treatment in the public sector. These include diabetes, hypertension, cardiovascular disease, arthritis and certain cancers.

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This does not include the many undiagnosed people with diabetes and hypertension who are not on treatment. It also does not include people treated in the private sector.

These non-communicable diseases cause life-changing illnesses, disabilities and premature death.

What we found

Our research calculated the cost of obesity from the age of 15. In our calculations, we looked at the following: cancers, cardiovascular diseases, diabetes, musculoskeletal disorders, respiratory diseases and digestive diseases.

We have costed each in detail and used the prevalence of these diseases to measure the cost to the system, taking into account patterns of healthcare utilization.

In South Africa, the largest share of the R33 billion ($1.9 billion) annual cost comes from the treatment of diabetes (R19.86 billion). Cardiovascular diseases (ZAR 8.87 billion) accounted for the second largest share.

These costs are, in turn, mainly driven by the cost of medication and hospitalization. Diabetes and hypertension-related conditions are among the top ten causes of death in South Africa. Digestive diseases, such as gallstones and gallbladder disease, contribute the least (R395 million).

Diabetes (95%) and arthritis (58%) are the diseases most often caused by overweight and obesity.

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Overall, 53% of the total health care costs related to the management and treatment of these diseases in the public sector were attributable to the problem of overweight and obesity. South Africa shares this dubious distinction with other high- and middle-income countries like Brazil, South Korea, Thailand and Colombia. Our results are similar to the World Obesity Federation estimate of R36 billion.

We also caution that the R33 billion is an underestimate of the economic cost. We used public sector tariffs, which we calculated as 60% of private sector costs. We also excluded costs such as clinical screening and treatment of comorbidities, such as amputations, as well as potential costs for those undiagnosed.

And our results do not include the indirect costs of lost productivity resulting from absenteeism. We also did not take into account premature deaths due to diseases related to overweight and obesity.

Next steps

Putting a health problem in monetary terms can create a sense of urgency to find ways to reduce future outlays on direct health care costs and reduce future losses to the state from the consequences of illness and disease. premature death, including the ripple effects of deepening poverty as a result.

This is particularly problematic in a context like South Africa, which already has a significantly underfunded public health system, shockingly high unemploymentand crises of under and overnutrition aggravated by obesogenic environments and food choices motivated by poverty.

Until now, there was no detailed information by country on the economic cost of overweight and obesity in sub-Saharan Africa. According to our research, South Africa’s burden is even higher than the African or global averages: 15.38%of the government’s overall health budget, which is equivalent to 0.67% of GDP.

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Unless swift action is taken to reduce obesity and overweight, the health care system will collapse under this pressure and the planned health insurance scheme will fail to produce equity in health services.

The opportunity costs of overweight and obesity – and the diseases they often cause – are both personal and national. It is difficult to quantify personal disability in monetary terms – the benefits of vastly improved quality of life are invaluable.The conversation

Michael Boachieprincipal researcher, University of the Witwatersrand

This article is republished from The conversation under Creative Commons license. Read it original article.


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