A health inequality impact assessment of leveling down overweight and obesity

Abstract Background Social differences in the proportion of overweight and obesity have increased in recent decades. Health impact assessments provide population-level valuations of changes in disease prevalence related to scenarios with different risk factors levels. These scenarios can be focused on reducing overweight and obesity among people with low socioeconomic position. Methods This study included the projected population of Copenhagen, Denmark in year 2040 (n = 742,130). Using the DYNAMO-HIA tool we conducted a health inequality impact assessment. Future prevented disease prevalence (IHD, diabetes, stroke, and multi-morbidity) and change in life expectancy related to an equalized scenario were estimated in a scenario where the prevalence of overweight/obesity (OWOB) in the group of people with short and medium educational attainment was reduced to the levels of people with long education. Results A higher proportion of people with short and medium education were OWOB than among people with long education and they had higher prevalence of cardiometabolic diseases. The diabetes prevalence among people with short education was reduced by 8-10% for men and 12-13% for women and life expectancy with diabetes decreased by one year in the group of women with short education. No notable effect of the equalized OWOB was seen regarding life expectancy with and prevalence of stroke and IHD. Conclusions Reaching the low prevalence of OWOB observed among people with high educational level, will reduce future cardiometabolic disease, increase life expectancy and meanwhile reduce the social inequality in health. These findings can serve as relevant references points for public health planners. Key messages This study is the first to combine advanced mathematical modelling and population data to assess changes in health from reducing socioeconomic inequality in obesity and overweight. These results propose valuable reference values for outcome assessments of interventions on inequalities in health.

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A health inequality impact assessment from reduction in overweight and obesity

BMC Public Health ◽

10.1186/s12889-020-09831-x ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Anne Mette Bender ◽

Jan Sørensen ◽

Finn Diderichsen ◽

Henrik Brønnum-Hansen

Keyword(s):

Life Expectancy ◽

Impact Assessment ◽

Health Inequality ◽

Disease Prevalence ◽

Overweight And Obesity ◽

Reference Points ◽

Cardiometabolic Diseases ◽

Medium Education ◽

The Future ◽

Short Education

Abstract Background In recent years, social differences in overweight and obesity (OWOB) have become more pronounced. Health impact assessments provide population-level scenario evaluations of changes in disease prevalence and risk factors. The objective of this study was to simulate the health effects of reducing the prevalence of overweight and obesity in populations with short and medium education. Methods The DYNAMO-HIA tool was used to conduct a health inequality impact assessment of the future reduced disease prevalence (ischemic heart disease (IHD), diabetes, stroke, and multi-morbidity) and changes in life expectancy for the 2040-population of Copenhagen, Denmark (n = 742,130). We simulated an equalized weight scenario where the prevalence of OWOB in the population with short and medium education was reduced to the levels of the population with long education. Results A higher proportion of the population with short and medium education were OWOB relative to the population with long education. They also had a higher prevalence of cardiometabolic diseases. In the equalized weight scenario, the prevalence of diabetes in the population with short education was reduced by 8–10% for men and 12–13% for women. Life expectancy increased by one year among women with short education. Only small changes in prevalence and life expectancy related to stroke and IHD were observed. Conclusion Reducing the prevalence of OWOB in populations with short and medium education will reduce the future prevalence of cardiometabolic diseases, increase life expectancy, and reduce the social inequality in health. These simulations serve as reference points for public health debates.

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Assessing the health of populations

Oxford Handbook of Public Health Practice ◽

10.1093/med/9780198800125.003.0003 ◽

2020 ◽

pp. 28-41

Author(s):

Julian Flowers ◽

Sian Evans

Keyword(s):

Public Health ◽

Resource Allocation ◽

Impact Assessment ◽

Health Inequality ◽

Burden Of Disease ◽

Health Impact ◽

Service Evaluation ◽

Public Health Activity ◽

Health Assessments ◽

Allocation Planning

Assessing population health is a fundamental element of most public health activity. We cannot improve health and measure success without being able to conduct health assessments. These may be components of, for example: measuring burden of disease; needs assessment; assessing health equity and health inequality; resource allocation; planning; health impact assessment (HIA); service evaluation.

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Introduction of Health Impact Assessment and Healthy Cities as a Tool for Tackling Health Inequality

Journal of Preventive Medicine and Public Health ◽

10.3961/jpmph.2007.40.6.439 ◽

2007 ◽

Vol 40 (6) ◽

pp. 439 ◽

Cited By ~ 3

Author(s):

Weon-Seob Yoo ◽

Keon-Yeop Kim ◽

Kwang-Wook Koh

Keyword(s):

Impact Assessment ◽

Health Inequality ◽

Health Impact Assessment ◽

Health Impact ◽

Healthy Cities

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Health impact assessment to predict the impact of tobacco price increases on COPD burden in Italy, England and Sweden

Scientific Reports ◽

10.1038/s41598-021-81876-3 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Elaine Fuertes ◽

Alessandro Marcon ◽

Laura Potts ◽

Giancarlo Pesce ◽

Stefan K. Lhachimi ◽

...

Keyword(s):

Life Expectancy ◽

Impact Assessment ◽

Smoking Prevalence ◽

Health Impact Assessment ◽

Health Impact ◽

Chronic Obstructive ◽

Cumulative Number ◽

Incident Cases ◽

The Impact ◽

Over 40 Years

AbstractRaising tobacco prices effectively reduces smoking, the main risk factor for chronic obstructive pulmonary disease (COPD). Using the Health Impact Assessment tool “DYNAMO-HIA”, this study quantified the reduction in COPD burden that would occur in Italy, England and Sweden over 40 years if tobacco prices were increased by 5%, 10% and 20% over current local prices, with larger increases considered in secondary analyses. A dynamic Markov-based multi-state simulation modelling approach estimated the effect of changes in smoking prevalence states and probabilities of transitioning between smoking states on future smoking prevalence, COPD burden and life expectancy in each country. Data inputs included demographics, smoking prevalences and behaviour and COPD burden from national data resources, large observational cohorts and datasets within DYNAMO-HIA. In the 20% price increase scenario, the cumulative number of COPD incident cases saved over 40 years was 479,059 and 479,302 in Italy and England (populous countries with higher smoking prevalences) and 83,694 in Sweden (smaller country with lower smoking prevalence). Gains in overall life expectancy ranged from 0.25 to 0.45 years for a 20 year-old. Increasing tobacco prices would reduce COPD burden and increase life expectancy through smoking behavior changes, with modest but important public health benefits observed in all three countries.

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