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Canadian Journal of Public Health

, Volume 106, Issue 4, pp e171–e177 | Cite as

Variation across Canada in the economic burden attributable to excess weight, tobacco smoking and physical inactivity

  • Hans KruegerEmail author
  • Joshua Krueger
  • Jacqueline Koot
Quantitative Research
  • 1 Downloads

Abstract

Objectives

Tobacco smoking, excess weight and physical inactivity contribute substantially to the preventable disease burden in Canada. The purpose of this paper is to determine the potential reduction in economic burden if all provinces achieved prevalence rates of these three risk factors (RFs) equivalent to those of the province with the lowest rates, and to update and address a limitation noted in our previous model.

Methods

We used a previously developed approach based on population attributable fractions to estimate the economic burden associated with these RFs. Sex-specific relative risk and age-/sex-specific prevalence data were used in the modelling. The previous model was updated using the most current data for developing resource allocation weights.

Results

In 2012, the prevalence of tobacco smoking, excess weight and physical inactivity was the lowest in British Columbia. If age- and sex-specific prevalence rates from BC were applied to populations living in the other provinces, the annual economic burden attributable to these three RFs would be reduced by $5.3 billion. Updating the model resulted in a considerable shift in economic burden from smoking to excess weight, with the estimated annual economic burden attributable to excess weight now 25% higher compared to that of tobacco smoking ($23.3 vs. $18.7 billion).

Conclusion

Achieving RF prevalence rates equivalent to those of the province with the lowest rates would result in a 10% reduction in economic burden attributable to excess weight, smoking and physical inactivity in Canada. This study shows that using current resource use data is important for this type of economic modelling.

Key words

Economic burden of disease populations at risk risk factors obesity overweight smoking 

Résumé

Objectifs

La cigarette, la surcharge pondérale et l’inactivité physique contribuent sensiblement au fardeau des maladies pouvant être prévenues au Canada. L’objectif du présent document est de déterminer la réduction possible du fardeau économique si toutes les provinces atteignaient un taux de prévalence de ces trois facteurs de risque (FR) équivalent à celui de la province ayant le taux le plus bas, et de mettre à jour et de traiter une limite soulignée dans notre précédent modèle.

Méthodes

Nous avons eu recours à une démarche déjà élaborée fondée sur les fractions attribuables de la population pour estimer le fardeau économique lié à ces FR. Les données sur le risque relatif propre à l’âge et sur la prévalence propre à l’âge et au sexe ont servi à monter le modèle. Le modèle antérieur a été mis à jour au moyen des données les plus courantes pour déterminer le poids de l’allocation des ressources.

Résultats

En 2012, c’est en Colombie-Britannique que la prévalence de la cigarette, de la surcharge pondérale et de l’inactivité physique était la plus faible. Si le taux de prévalence propre à l’âge et au sexe de la C.-B. était appliqué aux populations qui vivent dans les autres provinces, le fardeau économique annuel attribuable à ces trois FR serait réduit de 5,3 milliards $. La mise à jour du modèle a suscité un glissement considérable du fardeau économique de la cigarette à la surcharge pondérale avec le fardeau économique estimé attribuable à la surcharge pondérale maintenant de 25 % supérieur à celui de la cigarette (23,3 milliards $ c. 18,7 milliards $).

Conclusion

L’atteinte des taux de prévalence des FR équivalents à ceux de la province ayant les taux les plus bas entraîne une réduction de 10 % du fardeau économique attribuable à la surcharge pondérale, à la cigarette et à l’inactivité physique au Canada. Cette étude montre que le recours aux données sur l’utilisation actuelle des ressources est important pour ce genre de modèle économique.

Mots Clés

fardeau économique de la maladie populations à risque facteurs de risque obésité surcharge pondérale cigarette 

References

  1. 1.
    Lim SS, Vos T, Flaxman AD, Danaei G, Shibuya K, Adair-Rohani H, et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: A systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012;380(9859): 2224–60. PMID 23245609. doi: 10.1016/S0140-6736(12)61766-8.CrossRefGoogle Scholar
  2. 2.
    Krueger H, Turner D, Krueger J, Ready AE. The economic benefits of risk factor reduction in Canada: Tobacco smoking, excess weight and physical inactivity. Can J Public Health 2014;105(1):e69–e78. PMID: 24735700.CrossRefGoogle Scholar
  3. 3.
    Krueger H, Williams D, Ready AE, Trenaman L, Turner D. Improved estimation of the health and economic burden of chronic disease risk factors in Manitoba. Chronic Dis Inj Can 2013;33(4):236–46. PMID: 23987220.PubMedGoogle Scholar
  4. 4.
    Pirie K, Peto R, Reeves GK, Green J, Beral V. The 21st century hazards of smoking and benefits of stopping: A prospective study of one million women in the UK. Lancet 2013;381(9861):133–41. PMID: 23107252. doi: 10. 1016/S0140-6736(12)61720-6.CrossRefGoogle Scholar
  5. 5.
    Guh DP, Zhang W, Bansback N, Amarsi Z, Birmingham CL, Anis AH. The incidence of co-morbidities related to obesity and overweight: A systematic review and meta-analysis. BMC Public Health 2009;9:88. PMID: 19320986. doi: 10.1186/1471-2458-9-88.CrossRefGoogle Scholar
  6. 6.
    Katzmarzyk PT, Janssen I. The economic costs associated with physical inactivity and obesity in Canada: An update. Can J Appl Physiol 2004;29(1): 90–115. PMID: 15001807.CrossRefGoogle Scholar
  7. 7.
    Canadian Community Health Survey 2011/2012 Public Use Microdata file (Catalogue number 82M0013X2013001). All computations, use and interpretation of these data are entirely those of H Krueger & Associates Inc.Google Scholar
  8. 8.
    Cole T, Bellizzi M, Flegal K, Dietz W. Establishing a standard definition for child overweight and obesity worldwide: International survey. BMJ 2000;320(7244):1240–43. PMID: 10797032.CrossRefGoogle Scholar
  9. 9.
    Canadian Institute for Health Information. National Health Expenditure Trends, 1975 to 2013. Ottawa, ON: CIHI, 2014.Google Scholar
  10. 10.
    Public Health Agency of Canada. Economic Burden of Illness in Canada, 2005-2008. Ottawa, ON: PHAC, 2014.Google Scholar
  11. 11.
    Institute for Health Information. Discharge Abstract Database, 2011/12 (data purchased for this modelling).Google Scholar
  12. 12.
    Health Canada. Economic Burden of Illness in Canada, 1998. Ottawa: Health Canada, 2002.Google Scholar
  13. 13.
    Institute for Health Information. Hospital Morbidity Database Tabular Reports 2000/2001. Available at: https://doi.org/www.statcan.gc.ca/tables-tableaux/sum-som/101/cst01/demo02a-eng.htm (Accessed November 2, 2014).Google Scholar
  14. 14.
    World Health Organization Collaborating Centre on Chronic Non-communicable Disease Policy. Mobilizing Intersectoral Action to Promote Health: The Case of ActNow BC in British Columbia, Canada Geneva: WHO, 2009.Google Scholar
  15. 15.
    BC Healthy Living Alliance. The Winning Legacy: A Plan for Improving the Health of British Columbians by 2010. 2005. Available at: https://doi.org/www.bchealthyliving.ca/engage/reports/ (Accessed April 2, 2015).Google Scholar
  16. 16.
    BC Healthy Living Alliance. Report on the Winning Legacy Initiatives September 2007 to March 2011. 2011. Available at: https://doi.org/www.bchealthyliving.ca/engage/reports/ (Accessed April 7, 2015).Google Scholar
  17. 17.
    Clinical Prevention Policy Review Committee. A Lifetime of Prevention. 2009. Available at: https://doi.org/www.health.gov.bc.ca/library/publications/year/2009/CPPR_Lifetime_of_Prevention_Reportpdf (Accessed April 2, 2015).Google Scholar
  18. 18.
    BC Ministry of Health. Promote, Protect, Prevent Our Health Begins Here. 2013. Available at: https://doi.org/www.health.gov.bc.ca/library/publications/year/2013/BC-guiding-framework-for-public-health.pdf (Accessed April 7, 2015).Google Scholar
  19. 19.
    BC Ministry of Health. Healthy Families BC Policy Framework: A Focused Approach to Chronic Disease and Injury Prevention. 2014. Available at: https://doi.org/www.health.gov.bc.ca/library/publications/year/2014/healthy-families-bc- policy-framework.pdf (Accessed April 3, 2015).Google Scholar
  20. 20.
    Manuel DG, Creatore MI, Rosella LCA, Henry DA. What Does it Take to Make a Healthy Province? Institute for Clinical Evaluative Sciences. 2009. Available at: https://doi.org/www.ices.on.ca/Publications/Atlases-and-Reports/2009/What-does-it-take-to-make-a-healthy-province (Accessed April 1, 2015).Google Scholar
  21. 21.
    Naghavi MWH, Lozano R, Davis A, Liang X, Zhou M, Vollset SE, et al. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: A systematic analysis for the Global Burden of Disease Study 2013. Lancet 2015;385(9963):117–71. PMID: 25530442. doi:10.1016/S0140-6736(14)61682-2.CrossRefGoogle Scholar
  22. 22.
    Scarborough P, Bhatnagar P, Wickramasinghe KK, Allender S, Foster C, Rayner M. The economic burden of ill health due to diet, physical inactivity, smoking, alcohol and obesity in the UK: An update to 2006–07 NHS costs. J Public Health 2011;33(4):527–35. PMID: 21562029. doi: 10.1093/pubmed/fdr033.CrossRefGoogle Scholar
  23. 23.
    Goeree R, O’Brien BJ, Blackhouse F, Agro K, Goering P. The valuation of productivity costs due to premature mortality: A comparison of the humancapital and friction-cost methods for schizophrenia. Can J Psychiatry 1999;44: 455–63. PMID 10389606.CrossRefGoogle Scholar
  24. 24.
    Hutubessy RCW, van Tulder MW, Vondeling H, Bouter LM. Indirect costs of back pain in the Netherlands: A comparison of the human capital method with the friction cost method. Pain 1999;80(1):201–7. PMID: 10204732.CrossRefGoogle Scholar
  25. 25.
    Lofland JG, Locklear JC, Frick KD. Different approaches to valuing the lost productivity of patients with migraine. Pharmacoeconomics 2001;19(9): 917–25. PMID: 11700778.CrossRefGoogle Scholar
  26. 26.
    Yabroff KR, Bradley CJ, Mariotto AB, Brown ML, Feuer EJ. Estimates and projections of value of life lost from cancer deaths in the United States. J Natl Cancer Inst 2008;100(24):1755–62. PMID: 19066267. doi: 10.1093/jnci/djn383.CrossRefGoogle Scholar
  27. 27.
    Tranmer JE, Guerriere DN, Ungar WJ, Coyte PC. Valuing patient and caregiver time: A review of the literature. Pharmacoeconomics 2005;23(5): 449–59. PMID: 15896097.CrossRefGoogle Scholar
  28. 28.
    Jha P, Ramasundarahettige C, Landsman V Rostron B, Thun M, Anderson R, et al. 21st-century hazards of smoking and benefits of cessation in the United States. N Engl J Med 2013;368(4):341–50. PMID: 23343063. doi: 10.1056/NEJMsal211128.CrossRefGoogle Scholar

Copyright information

© The Canadian Public Health Association 2015

Authors and Affiliations

  • Hans Krueger
    • 1
    • 2
    Email author
  • Joshua Krueger
    • 2
  • Jacqueline Koot
    • 2
  1. 1.School of Population and Public HealthUniversity of British ColumbiaVancouverCanada
  2. 2.H. Krueger & Associates Inc.DeltaCanada

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