scholarly journals An Enhanced Approach for Economic Evaluation of Long-Term Benefits of School-Based Health Promotion Programs

Nutrients ◽  
2020 ◽  
Vol 12 (4) ◽  
pp. 1101
Author(s):  
John Paul Ekwaru ◽  
Arto Ohinmaa ◽  
Paul J. Veugelers
Keyword(s):  
Public Health ◽  
Physical Activity ◽  
Risk Factors ◽  
Health Promotion ◽  
Economic Evaluation ◽  
Chronic Diseases ◽  
Weight Status ◽  
Economic Evaluations ◽  
Multiple Risk Factors ◽  
Program Effects

Chronic diseases constitute a tremendous public health burden globally. Poor nutrition, inactive lifestyles, and obesity are established independent risk factors for chronic diseases. Public health decision-makers are in desperate need of effective and cost-effective programs that prevent chronic diseases. To date, most economic evaluations consider the effect of these programs on body weight, without considering their effects on other risk factors (nutrition and physical activity). We propose an economic evaluation approach that considers program effects on multiple risk factors rather than on a single risk factor. For demonstration, we developed an enhanced model that incorporates health promotion program effects on four risk factors (weight status, physical activity, and fruit and vegetable consumption). Relative to this enhanced model, a model that considered only the effect on weight status produced incremental cost-effectiveness ratio (ICER) estimates for quality-adjusted life years that were 1% to 43% higher, and ICER estimates for years with chronic disease prevented that were 1% to 26% higher. The corresponding estimates for return on investment were 1% to 20% lower. To avoid an underestimation of the economic benefits of chronic disease prevention programs, we recommend economic evaluations consider program effects on multiple risk factors.

scholarly journals Urbanization and greenness in HBSC survey: association with overweight and obesity in adolescents

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
V Bellisario ◽  
R Bono ◽  
G Squillacioti ◽  
M Caputo ◽  
I Gintoli ◽  
...  
Keyword(s):  
Public Health ◽  
Physical Activity ◽  
Risk Factors ◽  
Air Pollution ◽  
Population Density ◽  
Weight Status ◽  
Overweight And Obesity ◽  
Green Spaces ◽  
Children Health ◽  
Public Health Strategies

Abstract Background Childhood obesity is an important public health issue worldwide and includes different risk factors, such as environmental pollutants exposure or physical activity. Neighborhood composition and green spaces availability could contrast obesogenic lifestyles and promote healthy habits, whereas, urbanization and traffic volume exposure are inversely associated with physical activity and worsen effects on childhood health. Methods This project analyzed students involved in the HBSC survey from the Piedmont Region. Data were collected in 2018, following the protocol. All the subjects were georeferenced within buffers around schools. Green-spaces availability was measured by Normalised Difference Vegetation Index (NDVI-satellite images) while urbanization was calculated by population density, traffic intensity (satellite measurements) and air pollution concentration (sampling stations). Results Overall, the sample included 3022 subjects, with amount 50% male/female and 30% for each age group (11-13-15 years old). Concerning weight status, above 14% of the all sample is obese or overweight, with, respectively, 20% among boys and 11% among girls. Preliminary analyses showed an association between weight status and population density (rural vs urbanized areas). Currently, we are analyzing the association with greenness and the other measures of urbanization. Conclusions Our preliminary findings suggest that high urbanization levels impact health implementing weight in children. We are testing the hypothesis that greenness positively influences weight status and reduce negative effects of urbanization and air pollution. The managing of these risk factors must be deepened and corroborated by active preventive Public Health strategies for improving children health. Key messages Urbanization and greenness may influence weight status in children. Public Health strategies must be improved for children health.

scholarly journals Pattern and Predicting Risk Factors of Multi-Morbidity in the AzarCohort Population Using Structural Equation Model

2021 ◽  
Author(s):  
Mohammad-Hossein Somi ◽  
Alireza Ostadrahimi ◽  
Neda Gilani ◽  
Arash Haji Kamanaj ◽  
Sina Hassannezhad ◽  
...  
Keyword(s):  
Public Health ◽  
Physical Activity ◽  
Risk Factors ◽  
Chronic Diseases ◽  
Structural Equation Model ◽  
Structural Equation ◽  
Equation Model ◽  
Public Health Issue ◽  
Model Complex ◽  
Wide Range

Background: The co-existence of chronic diseases (CD), a condition defined as multimorbidity (MM), is becoming a major public health issue. Understanding the general framework of MM diseases according to the well-known risk factors can assist in finding direct and indirect relationships among them. Therefore, we aimed to determine pattern and predicting risk factors of multi-morbidity in the Azar Cohort population using Structural Equation Model (SEM). Methods: In this study, the prevalence of MM in 15006 XXX cohort population was evaluated. MM was defined as the co-existence of two or more CDs. The information regarding socio-economic, demographic, sleeping habits, and physical activity were collected by questionnaires. A multi-group SEM was employed to model complex relationships between directly- and indirectly-observed variables. Results: The overall MM was seen in 28.8% of the population. The most prevalent chronic diseases were obesity, hypertension, depression, and diabetes, respectively. Obesity, depression, and diabetes were the most co-occurring CDs in our population. The SEM diagram indicated the overall effect of socio-demographic (predictors) and sleep and physical activity (mediators) on the number of CDs. The number of CDs in the active participants and those who sleep 6.6-7.3 hours/day was lower than the inactive participants and those who sleep ≤6.5 hours/day. Conclusions: According to our results, it seems that the reduction of MM is possible through promoting public health from an early age and for a wide range of socio-economic conditions, provided that the necessary support for general health is offered for the aging population.

scholarly journals Economics of physical activity in low-income and middle- income countries: a systematic review

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e037784
Author(s):  
Priyanga Diloshini Ranasinghe ◽  
Subhash Pokhrel ◽  
Nana Kwame Anokye
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Economic Evaluation ◽  
Drug Treatment ◽  
Chronic Diseases ◽  
Low Income ◽  
Economic Burden ◽  
Eligibility Criteria ◽  
Middle Income ◽  
Middle Income Countries

BackgroundPromotion of physical activity (PA) among populations is a global health investment. However, evidence on economic aspects of PA is sparse and scattered in low-income and middle-income countries (LMICs).ObjectiveThe objective of this study was to summarise the available evidence on economics of PA in LMICs, identify potential target variables for policy and report gaps in the existing economic evidence alongside research recommendations.Data sourcesA systematic review of the electronic databases (Scopus, Web of Science and SPORTDiscus) and grey literature.Study eligibility criteriaCost-of-illness studies, economic evaluations, interventions and descriptive studies on economic factors associated with PA using preset eligibility criteria.Study appraisal and synthesis of methodsScreening, study selection and quality appraisal based on standard checklists performed by two reviewers with consensus of a third reviewer. Descriptive synthesis of data was performed.ResultsThe majority of the studies were from upper-middle-income countries (n=16, 88.8%) and mainly from Brazil (n=9, 50%). Only one economic evaluation study was found. The focus of the reviewed literature spanned the economic burden of physical inactivity (n=4, 22%), relationship between PA and costs (n=6, 46%) and socioeconomic determinants of PA (n=7, 39%). The findings showed a considerable economic burden due to insufficient PA, with LMICs accounting for 75% of disability-adjusted life years (DALYs) globally due to insufficient PA. Socioeconomic correlates of PA were identified, and inverse relationship of PA with the cost of chronic diseases was established. Regular PA along with drug treatment as a treatment scheme for chronic diseases showed advantages with a cost–utility ratio of US$3.21/quality-adjusted life year (QALY) compared with the drug treatment-only group (US$3.92/QALY) by the only economic evaluation conducted in the LMIC, Brazil.LimitationsMeta-analysis was not performed due to heterogeneity of the studies.Conclusions and recommendationsEconomic evaluation studies for PA promotion interventions/strategies and local research from low-income countries are grossly inadequate. Setting economic research agenda in LMICs ought to be prioritised in those areas.PROSPERO registration numberCRD42018099856.

ALZHEIMER’S ASSOCIATION: INITIATIVES & PUBLIC HEALTH PERSPECTIVE

2016 ◽  
pp. 1-3
Author(s):  
H.M. Snyder ◽  
M.C. Carrillo
Keyword(s):  
Public Health ◽  
Physical Activity ◽  
Risk Factors ◽  
Cognitive Decline ◽  
Population Based ◽  
Current Evidence ◽  
Public Health Perspective ◽  
Reduce Risk ◽  
Number Of Individuals ◽  
Do So

An estimated 47 million people worldwide are living with dementia in 2015 and this number is expected to triple by 2050. There is a clear urgency for therapies and / or interventions to slow, stop or prevent dementia. Amounting evidence suggests strategies to reduce risk of development dementia may be of growing import for reducing the number of individuals affected. The Alzheimer’s Association believes, from a population based perspective that: (1) Regular physical activity and management of cardiovascular risk factors (e.g. diabetes, obesity, smoking and hypertension) have been shown to reduce the risk of cognitive decline and may reduce the risk of dementia; (2) A healthy diet and lifelong learning/cognitive training may also reduce the risk of cognitive decline. The current evidence underscores the need to communicate to the broader population what the science indicates and to do so with diverse stakeholders and consistent messaging. There has never been a better time to define and distribute global messaging on public health for dementia.

Exercise and Physical Activity for Older Adults

2014 ◽  
Vol 3 (1) ◽  
pp. 101-106 ◽  
Author(s):  
Wojtek J. Chodzko-Zajko
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Risk Factors ◽  
Older Adults ◽  
Chronic Diseases ◽  
Successful Aging ◽  
Healthy Aging ◽  
Improve Quality ◽  
Reduce Risk

For more than half a century fellows of the National Academy of Kinesiology have enthusiastically advocated for the promotion and adoption of physically active lifestyles as an affordable and effective means to prevent chronic diseases and conditions, and enhance independence and high quality of life for older adults. It is possible to discern distinct evolutionary stages when examining scholarship related to the role of physical activity in the promotion of healthy aging. Research into physical activity and aging began with critical early studies that established the underlying scientific evidence for a relationship between physical activity and healthy aging. More recent work has addressed such topics as building consumer demand, developing policies and legislation to support active aging, and understanding the complex interrelationships between physical activity and other lifestyle factors in the prevention and treatment of chronic diseases and conditions. It is increasingly apparent that strategies to promote active and successful aging must be integrated into an effective public policy. Kinesiologists and other health professionals, working in collaboration with colleagues from other disciplines, can help to reduce risk factors for chronic disease and improve quality of life for older adults by building awareness of the importance of physical activity and by assisting with the development and implementation of appropriate and effective interventions that reduce risk factors and improve quality of life.

The Demise of an Australian Physical Activity Alliance

2018 ◽  
Vol 15 (10) ◽  
pp. 795-798
Author(s):  
Rebecca Reynolds ◽  
David Menzies ◽  
Keyword(s):  
Public Health ◽  
Physical Activity ◽  
Health Promotion ◽  
Online Survey ◽  
Government Funding ◽  
Collective Impact ◽  
Governmental Funding ◽  
Exercise Referral ◽  
Exercise Referral Scheme ◽  
National Physical Activity

Background: Physical activity health promotion coalitions are uncommon but important for beneficial collective impact on public health. The authors sought to obtain the viewpoints of member organizations of an Australian physical activity alliance, the National Physical Activity Alliance. Methods: The authors conducted an online survey regarding member agenda, commitment, and vision for the alliance. Questions were mostly open ended (eg, “What are the 3 areas of priority related to physical activity that you would like The Alliance to focus on?”). A total of 11 Australian organizations involved in physical activity public health (eg, the nongovernment organization Alzheimer’s Australia and the professional fitness association Fitness Australia). Results: 82% of members responded to the survey. Member programs and goals were diverse and overlapping. There was agreement among members that the main priority area for alliance focus was a national exercise referral scheme. Barriers for members achieving their own goals as well as alliance goals focused on governmental issues, including inadequate government funding for physical activity public health. Conclusions: This novel survey highlights the promise and difficulties of a physical activity coalition, with the difficulties, namely lack of governmental funding, resulting in a stagnation of the alliance’s activities since the study was carried out.

Explicit incorporation of equity considerations into economic evaluation of public health interventions

2009 ◽  
Vol 4 (2) ◽  
pp. 231-245 ◽  
Author(s):  
RICHARD COOKSON ◽  
MIKE DRUMMOND ◽  
HELEN WEATHERLY
Keyword(s):  
Public Health ◽  
Economic Evaluation ◽  
Health Outcomes ◽  
Health Equity ◽  
Health Gain ◽  
Background Information ◽  
Economic Evaluations ◽  
Value Judgment ◽  
Health Gains ◽  
Egalitarian Value

AbstractHealth equity is one of the main avowed objectives of public health policy across the world. Yet economic evaluations in public health (like those in health care more generally) continue to focus on maximizing health gain. Health equity considerations are rarely mentioned. Health economists rely on the quasi-egalitarian value judgment that ‘a QALY is a QALY’ – that is QALYs are equally weighted and the same health outcome is worth the same no matter how it is achieved or to whom it accrues. This value judgment is questionable in many important circumstances in public health. For example, policy-makers may place rather little value on health outcomes achieved by infringing individual liberties or by discriminating on the basis of age, sex, or race. Furthermore, there is evidence that a majority of the general public wish to give greater weight to health gains accruing to children, the severely ill, and, to a lesser extent, the socio-economically disadvantaged. This paper outlines four approaches to explicit incorporation of equity considerations into economic evaluation in public health: (i) review of background information on equity, (ii) health inequality impact assessment, (iii) analysis of the opportunity cost of equity, and (iv) equity weighting of health outcomes. The first three approaches can readily be applied using standard methods of health technology assessment, where suitable data are available; whereas approaches for generating equity weights remain experimental. The potential benefits of considering equity are likely to be largest in cases involving: (a) interventions that target disadvantaged individuals or communities and are also relatively cost-ineffective and (b) interventions to encourage lifestyle change, which may be relatively ineffective among ‘hard-to-reach’ disadvantaged groups and hence may require re-design to avoid increasing health inequalities.

scholarly journals Association of Vitamin D Status with Chronic Disease Risk Factors and Cognitive Dysfunction in 50–70 Year Old Adults

Nutrients ◽  
2019 ◽  
Vol 11 (1) ◽  
pp. 141 ◽  
Author(s):  
Japneet Kaur ◽  
Steven Ferguson ◽  
Eduardo Freitas ◽  
Ryan Miller ◽  
Debra Bemben ◽  
...  
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Vitamin D ◽  
Chronic Diseases ◽  
Disease Risk ◽  
Serum Vitamin ◽  
Old Adults ◽  
Serum Vitamin D ◽  
Chronic Disease Risk ◽  
Vitamin D Levels

Vitamin D deficiency/insufficiency has been primarily associated with skeletal disorders, however, since vitamin D receptors are found on multiple types of cells, there is also a link to increased chronic disease risk and all-cause mortality. The aim of this study was to examine whether deficient/insufficient vitamin D levels are associated with risk factors of chronic diseases and cognitive dysfunction in 50 to 70 year old adults. Participants completed the health status, three-day dietary record and vitamin D food frequency, sun exposure, and international physical activity questionnaires. Cognitive function of the participants was assessed using the Automated Neuropsychological Assessment Metrics while body composition (percent body fat, android/gynoid ratio) was assessed using Dual Energy X-ray Absorptiometry. Applanation tonometry was used to obtain pressure wave forms at the radial artery to examine arterial stiffness and central pressures. A fasting blood draw was taken to measure vitamin D, blood lipid and glucose levels. Fifty percent of the participants (36/72) were vitamin D deficient/insufficient. Individuals in the low physical activity (PA) group had lower serum vitamin D concentration compared to those in the high PA group (p = 0.04). Moreover, serum vitamin D levels were negatively related to risk factors of chronic diseases; blood glucose (r = −0.38; p = 0.01), triglycerides (r = −0.27; p = 0.02), and android/gynoid ratio (r = −0.32; p = 0.01). Deficient/insufficient vitamin D levels are linked to the risk factors of chronic diseases in men and women aged 50 to 70 years.

scholarly journals Economic evaluation of ‘Men on the Move’, a ‘real world’ community-based physical activity programme for men

2020 ◽  
Author(s):  
Liam Kelly ◽  
Michael Harrison ◽  
Noel Richardson ◽  
Paula Carroll ◽  
Tom Egan ◽  
...  
Keyword(s):  
Public Health ◽  
Physical Activity ◽  
Economic Evaluation ◽  
Cost Effectiveness ◽  
Health Benefits ◽  
Cost Effective ◽  
Health Improvement ◽  
Community Based ◽  
Life Years ◽  
The Impact

Abstract Background Physical activity (PA) interventions capable of producing health benefits cost effectively are a public health priority across the Western world. ‘Men on the Move’ (MOM), a community-based PA intervention for men, demonstrated significant health benefits up to 52-weeks (W) post-baseline. This article details the economic evaluation of MOM with a view to determining its cost-effectiveness as a public health intervention to be rolled out nationally in Ireland. Methods Cost-effectiveness was determined by comparing the costs (direct and indirect) of the programme to its benefits, which were captured as the impact on quality-adjusted life-years (QALYs). For the benefits, cost–utility analysis was conducted by retrospectively adapting various health-related measures of participants to generate health states using Brazier et al.’s (2002) short form-6D algorithm. This in turn allowed for ‘utility measures’ to be generated, from which QALYs were derived. Results Findings show MOM to be cost-effective in supporting an ‘at risk’ cohort of men achieves significant improvements in aerobic fitness, weight loss and waist reduction. The total cost per participant (€125.82 for each of the 501 intervention participants), the QALYs gained (11.98 post-12-W intervention, or 5.3% health improvement per participant) and estimated QALYs ratio costs of €3723 represents a cost-effective improvement when compared to known QALY guidelines. Conclusions The analysis shows that the cost per QALY achieved by MOM is significantly less than the existing benchmarks of £20 000 and €45 000 in the UK and Ireland respectively, demonstrating MOM to be cost-effective.

scholarly journals Sedentary Death Syndrome

2004 ◽  
Vol 29 (4) ◽  
pp. 447-460 ◽  
Author(s):  
Simon J. Lees ◽  
Frank W. Booth
Keyword(s):  
Public Health ◽  
Physical Activity ◽  
Chronic Diseases ◽  
Physical Inactivity ◽  
Scientific Basis ◽  
Control Group ◽  
Physically Active ◽  
Public Health Burden ◽  
The Impact ◽  
Active Controls

Sedentary death syndrome (SeDS) is a major public health burden due to its causing multiple chronic diseases and millions of premature deaths each year. Despite the impact of physical inactivity, very little is known about the actual causes of physical inactivity-induced chronic diseases. It is important to study the mechanisms underlying molecular changes related to physical inactivity in order to better understand the scientific basis of individualized exercise prescription and the rapies for chronic diseases, and to support improved public health efforts by providing molecular proof that physical inactivity is an actual cause of chronic diseases. Physical activity has a genetic basis. A subpopulation of genes, which have functioned to support physical activity for survival through most of humankind's existence, require daily exercise to maintain long-term health and vitality. Type 2 diabetes (T2D) is an example of a SeDS condition, as it is almost entirely preventable with physical activity. To determine the true role of physical inactivity in the development and progression of T2D, information is presented which indicates that comparisons should be made to physically active controls, rather than sedentary controls, as this population is the healthiest. Use of sedentary subjects as the control group has led to potentially misleading interpretations. If physically active individuals were designated as the control group, a different interpretation would have been drawn. It is thought that there is no difference in GLUT4 concentration between T2D and sedentary groups. However, GLUT4 expression is higher in active controls than in sedentary and T2D groups. Therefore, to obtain causal mechanisms for SeDS in order to allow for scientifically based prevention and therapy strategies, physically active subjects must serve as the control group. Key words: physical inactivity, chronic diseases, diabetes, glucose

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