Health-care costs of underweight, overweight and obesity: Australian population-based study
Susan A Clifford1,2, Lisa Gold1,3, Fiona K Mensah1,2,4
1Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.
Insights
Excess healthcare costs associated with underweight and obesity in children under 10 become apparent by age 4-5. While individual costs are modest, the population impact on government spending for child health is substantial.
Area of Science:
- Pediatric Health Economics
- Public Health Policy
- Childhood Obesity Research
Background:
- Child health and healthcare costs are influenced by Body Mass Index (BMI).
- The age at which BMI-related healthcare costs emerge and their longitudinal impact remain unclear.
- Understanding these costs is crucial for effective public health interventions.
Purpose of the Study:
- To determine the cross-sectional relationship between BMI and healthcare costs in children up to age 10.
- To analyze if prolonged underweight or obesity status increases healthcare costs over time.
- To quantify the economic burden of BMI variations on government healthcare expenditure.
Main Methods:
- Utilized data from the Longitudinal Study of Australian Children, including Baby (n=4230) and Kindergarten (n=4543) cohorts.
- Assessed biennial Body Mass Index (BMI) measurements from birth to age 10.
- Calculated federal government healthcare costs using Medicare Benefits Scheme data and prescription medication records.
Main Results:
- Prevalence of underweight, overweight, and obesity in Australian children under 10 was established (5-6% underweight, 11-18% overweight, 5-6% obese).
- Excess healthcare costs linked to low (underweight) and high (overweight, obesity) BMI were evident from ages 4-5.
- Obesity incurred the highest costs, followed by underweight and overweight, relative to normal weight; however, individual excess costs were modest (max $94/year).
Conclusions:
- Significant population-level excess costs associated with non-healthy BMIs justify public health initiatives promoting healthy weight.
- While individual excess costs for obese children are low in the short term, effective treatments may increase immediate public health expenditure.
- Long-term economic benefits of healthy weight promotion in children are substantial, despite potential short-term cost increases for interventions.
Aim:
Child health varies with body mass index (BMI), but it is unknown by what age or how much this attracts additional population health-care costs. We aimed to determine the (1) cross-sectional relationships between BMI and costs across the first decade of life and (2) in longitudinal analyses, whether costs increase with duration of underweight or obesity.
Participants:
Baby (n = 4230) and Kindergarten (n = 4543) cohorts in the nationally representative Longitudinal Study of Australian Children.
Outcome:
Medicare Benefits Scheme (including all general practitioner plus a large proportion of paediatrician visits) plus prescription medication costs to federal government from birth to sixth (Baby cohort) and fourth to tenth (Kindergarten cohort) birthdays.
Predictor:
biennial BMI measurements over the same period.
Results:
Among Australian children under 10 years of age, 5-6% were underweight, 11-18% overweight and 5-6% obese. Excess costs with low and high BMI became evident from age 4-5 years, with normal weight accruing the least, obesity the most, and underweight and overweight intermediate costs. Relative to overall between-child variation, these excess costs per child were very modest, with a maximum of $94 per year at age 4-5 years. Nonetheless, this projects to a substantial cost to government of approximately $13 million per annum for all Australian children aged less than 10 years.
Conclusions:
Substantial excess population costs provide further economic justification for promoting healthy body weight. However, obese children's low individual excess health-care costs mean that effective treatments are likely to increase short-term costs to the public health purse during childhood.
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