Παρουσίαση Μ. Cecchini (Ειδικός Ερευνητής ΟΟΣΑ)
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Transcript of Παρουσίαση Μ. Cecchini (Ειδικός Ερευνητής ΟΟΣΑ)
Improving Lifestyles, Improving Lifestyles, Tackling Obesity: the Tackling Obesity: the Health and Economic Health and Economic Impact of PreventionImpact of Prevention
Michele CecchiniOECD - Health Division
Obesity: a Growing ProblemObesity: a Growing Problem
United StatesCanadaGreece
ItalyIceland
PortugalSpain
FinlandAustriaOECD
HungaryLuxembourg
GermanyNorwaySwedenIrelandTurkey
Czech RepublicFrance
SwitzerlandDenmark
United KingdomBelgiumPoland
Slovak RepublicNetherlands
Change in obesity rates 2001-02 vs 2005-06Change in obesity rates 2001-02 vs 2005-0615 year-olds
boys girls
OECD analysis on: Currie et al. international report from the HSBC Survey, WHO Europe
Scope of OECD/WHO AnalysesScope of OECD/WHO Analyses
Regional analysis Country analyses
Physical activityP0 adequate physical actP1 insuff .physical act
Body mass index
N normal weightU pre-obesityV obesity
Blood pressureZ0 normalZ1 hypertension
CholesterolA0 normal
A1 hypercholesterolemia
GlycaemiaB0 normalB1 diabetes
Cancers
Stroke
Ischemic heart
disease
FatF0 low fat intakeF1 medium fat intakeF2 high fat intake
FibreY0 adequate fibre intakeY1 low fibre intake
Socio-economic statusI0 upperI1 lower
InterventionsInterventions
Health education and health promotion
Regulationand fiscal measures
Primary-care basedinterventions
Mass media campaignsFiscal measures
(fruit and vegetables and foodshigh in fat)
Physician counsellingof individuals at risk
School-based interventions
Government regulation or industry self-regulation of
food advertising to children
Intensive physician and dietician counselling of
individuals at risk
Worksite interventions Compulsory food labelling
Expectations Must Be RealisticExpectations Must Be Realistic
• Does prevention improve health?
• Does it reduce health expenditure?
• Does it improve health inequalities?
• Is it cost-effective?
Prevention Does Save Lives…Prevention Does Save Lives…
1 LY/DALY every 115/121 people
1 LY/DALY every 12/10 people
… … But Does Not Necessarily Save Money!But Does Not Necessarily Save Money!
Health Outcomes and ExpenditureHealth Outcomes and ExpenditurePhysician-Dietician Counselling
Health outcomes Impact on health expenditure
Interventions vs. AgeInterventions vs. Age
Note: risk equals to 1 for 50 year olds and no intervention
Spending on prevention is a Spending on prevention is a goodgood long-termlong-term investment investment
Distributional ImpactDistributional Impact
School-based interventions Fiscal measures
Multiple interventionsMultiple interventionsHealth outcomes Impact on health expenditure
(selected diseases)
Multiple int. 1 : school-based intervention + mass media camp + physician-dietician counsellingMultiple int. 2 : food labelling + food advert self-regulation + school-based interventions + mass media
campaigns + physician-dietician counselling
Policy ImplicationsPolicy Implications
• Prevention is an effective and cost-effective way to improve population health
• Prevention can decrease health expenditure and improve inequalities, but not to a major degree
• Comprehensive strategies combining population and individual approaches provide best results
• Involvement of relevant stakeholders is key to the success of prevention
OECD work on preventionOECD work on prevention
• Obesity and the economics of prevention: fit not fat
• OECD health working papers HWP 32, 45, 46, 48
• Paper in Lancet series on chronic diseases
www.oecd.org/health/prevention www.oecd.org/health/fitnotfat [email protected]