WORK PACKAGE 4: LIFETIME COST OF CHILDHOOD OBESITY

Transcription

1 JOINT ACTION ON NUTRITION AND PHYSICAL ACTIVITY - JANPA KICK-OFF MEETING LUXEMBOURG, SEPTEMBER 2015 WORK PACKAGE 4: LIFETIME COST OF CHILDHOOD OBESITY Lead: Prof. Kevin Balanda Institute of Public Health in Ireland

2 1. Introductions (15 minutes)

3 2. Workshop programme (5 minutes)

4 Workshop objectives The objectives of the workshop are to: Explain the work package and its work plan Ensure all participating countries understand their roles Meet colleagues and build contacts

5 Workshop agenda 15:30 Introductions All 15 minutes 15:45 Workshop programme & materials Kevin Balanda 5 minutes 15:50 Overview of WP 4 Kevin Balanda 15 minutes 16:05 Irish adult obesity costing study Ivan Perry 15 minutes 16:20 Foresight obesity modelling & associated studies Laura Webber 15 minutes 16:35 Steps in the work programme Kevin Balanda 15 minutes 16:50 Coffee break 15 minutes 17:05 Discussion of the steps including: Evidence paper and study protocols BMI trends Data gathering Modelling Benefits of reducing childhood obesity All 1 hour & 15 minutes 18:20 Some administrative matters Kevin Balanda 10 minutes 18:30 Close

6 3. Overview of WP 4 (15 minutes)

7 Contribution of WP 4 Technical objectives Deliverables ISAG Participating Member States Methodological approach

8 Contribution of WP 4 Considerable work has been done on the healthcare costs of adult obesity. Much less has been done on childhood obesity and nonhealthcare (societal) costs. Work Package 4 will start to fill this gap by developing the evidence-based economic rationale for action on childhood obesity

9 Technical objectives 1. To describe the lifetime impact & cost of (present-day) childhood obesity 2. Give a breakdown of these impacts and costs according to the year of occurrence 3. Assess the benefits of reducing childhood obesity by 1% and 5%

10 Deliverables D4.1 Evidence paper & study protocols (M6) D4.2 Prevalence & impacts report (M18) D4.3 Cost report (M18) D4.4 Report on benefits of reduced childhood obesity (M23) D4.5 Briefing for EU Ministers (M24)

11 ISAG An expert International Scientific Advisory Group (ISAG) will be established to guide scientific aspects of WP4.

12 Participating Member States

13 Collaborating partners & stakeholders Collaborating partners: DoH (Ireland) safefood (Ireland) Joint Research Centre (JRC-EU) Stakeholders Sub-contractors (modelling): - UK Health Forum

14 Methodological approach We will expand : Irish adult obesity costing study 2012 (& other adult obesity studies) Associated Burden of Disease forecasting study (part of WHO (Europe ) study) To include children and societal (non-health) impacts Using an adaptation of the Foresight obesity model

15 4. Irish adult obesity costing study (15 minutes) Prof Ivan Perry

16 5. Modelling & associated studies (15 minutes) Dr Laura Webber

17 6. Steps in the work programme (15 minutes)

18 Challenges Big challenges arise from: Incorporating both children and adult data and research Impacts in childhood as well as in adulthood Societal impacts as well as health impacts Forecasts of population BMI distributions (part of modelling) Costings Inequalities Data imputation and extrapolation to EU

19 Steps 1. Review of literature and data systems: a. Produce evidence paper b. Produce study protocols 2. Identify potential impacts : a. Health b. Societal 3. Collect data: a. BMI b. population/ morbidity /mortality c. healthcare and societal cost data

20 Steps (continued) 4. Calculate model inputs 5. Undertake modelling: a. Forecasts of population BMI distributions b. Individual BMI trajectories c. Individual health trajectories 6. Calculate lifetime impacts, costs and DALYs /QALYs 7. Assess benefits of reducing childhood obesity 8. Ministerial Briefing

21 Current approach to modelling Historical BMI data Historical BMI inputs Stage 1: Multiple regression Forecasts of (age, sex) population BMI Distributions Current BMI data Current BMI inputs Stage 2.1: Calculation of BMI trajectories of virtual individuals BMI trajectories for virtual individuals Mortality / morbidity data Mortality / morbidity inputs Stage 2.2: Simulations Stage 2.3: Simulations Societal impact inputs Societal impact data Health impact trajectories of virtual individuals Societal impact trajectories of virtual individuals

22 Current approach to modelling (continued) Health impact Trajectories Societal impact trajectories Health care cost data Health care cost inputs Calculation of healthcare costs Calculation of societal costs Societal cost inputs Societal cost data Calculation of PYLL, DALY, QALYs Utility weights Calculation of DALYs, QALYs Estimates of total impacts & costs, broken down by age, sex and year of occurrence

23 Basic and advanced levels Basic studies Advanced studies Health impacts only Also include other societal impacts Major clinical conditions only Wider range of clinical conditions Focus on core standardised / intercountry comparable data Also include country-specific data Focus on Top down approaches using international inputs (and possibly) local inputs Focus on Bottom up approaches using local inputs Inputting of (adjusted) data from proxy countries More complex data imputation methods involving country-specific data Greater involvement in validation studies

24 7. Discussion of the steps (1 hour and 15 minutes)

25 1. Any general questions? 2. Propose that we focus on a more detailed discussion of : Evidence paper and study protocols (5 minutes) Modelling methods (10 minutes) Data collection (15 minutes) Presentation of findings (15 minutes)

26 Evidence paper & study protocols Prevalence of obesity and overweight forecast of population BMI distributions Potential health and societal impacts and costs (in childhood and adulthood) Existing lifetime costing studies (children & adults) Methods costing and modelling International academic literature and grey literature (English) Other academic and grey literature from participating MSs in other languages (particularly in advanced studies)

27 Modelling methods Review other methods for possible improvements covering: Stage 1 (forecasting population BMI distributions): Include childhood data and use existing approach Include childhood data but explore other ways of forecasting such as exponential models, age-period-cohort analyses, etc Stage 2 (individual BMI trajectories): Using Markov processes: Estimate transition probabilities describing transitions between BMI categories and simulate lifetime BMI trajectories Develop latent BMI trajectories across the lifecourse (latent growth curve analyses)

28 Collect data: process 1. Complete Data Sources Tables for each MS (all) 2. Develop Data Collection Templates (IPH-IRL) 3. Collect pan-european data (IPH-IRL) 4. Circulate for review (all) 5. Collect additional country-specific data (primarily for advanced studies)

29 Collect data: Data domains population profiles and projections BMI data health impacts mortality/morbidity healthcare costs societal impacts societal costs utility weights

30 Data Sources Table (Ireland) sample Domains Sub-domain Source Breakdowns Years Notes Population Profile (including projections) Population counts Eurostat Broken down by: Sex Age (single years) Children & adults 1960 to 2014 BMI data Projected counts Body mass index and level of overweight among children Eurostat Childhood Obesity Surveillance Initiative (COSI) Health Behaviours of School-aged Children (HBSC) surveys Broken down by: Sex Age (single years) Children & adults Broken down by: Sex Age (single years) Children & adults 2013 to / /2010 Measured or selfreported BMI

31 Data Sources Table (Ireland) sample Domains Data items Source Breakdowns Years Notes Health e.g. Hospital European Broken down by: 2000 to data impacts discharge data Hospital Sex 2014 availability morbidity Morbidity Age varies between data Database indicators (HMDB) and countries Societal cost data e.g. Absenteeism from work due to illness

32 Key European Data Sources Eurostat WHO (Europe) Childhood Obesity Surveillance Initiative (COSI) WHO (Europe) Health Behaviours of School-aged Children (HBSC) surveys WHO Global Health Observatory (GHO) Data Repository WHO (Europe) BoD study WHO European Database on Nutrition Obesity and Physical Activity (NOPA) European Hospital Morbidity Database (HMDB) European Health for All database (HFA-DB) European mortality database (HFA-MDB) World Obesity data portal EConDA Project

33 Presentation of findings Many model outputs (broken down by sex-age-yea Prevalence-based approach Incidence-based approach Per capita / total costs Impacts and costs 2012 Irish adult obesity costs Marginal costs difference between the costs associated with overweight/obese child and those for a child who is not Attributable impacts and attributable costs Sonntag et al, Finkelstein et al Lifetime excess costs / Incremental lifetime costs

34 8. Any outstanding administrative matters?

35 9. Close

36 Thank you for your attention!