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Evaluation of the association between health state utilities and obesity in sub-Saharan Africa: evidence from World Health Organization Study on Global AGEing and Adult Health Wave 2


Lartey, ST and Si, L and de Graaff, B and Magnussen, CG and Ahmad, H and Campbell, J and Berko Biritwum, R and Minicuci, N and Kowal, P and Palmer, AJ, Evaluation of the association between health state utilities and obesity in sub-Saharan Africa: evidence from World Health Organization Study on Global AGEing and Adult Health Wave 2, Value in Health, 22, (9) pp. 1042-1049. ISSN 1098-3015 (2019) [Refereed Article]

Copyright Statement

Copyright 2019, ISPOR–The Professional Society for Health Economics and Outcomes Research. Published by Elsevier Inc.

DOI: doi:10.1016/j.jval.2019.04.1925


Background: Obesity is a major public health challenge and its prevalence has increased across the age spectrum from 1980 to date in most parts of the world including sub-Saharan Africa. Studies that derive health state utilities (HSUs) stratified by weight status to support the conduct of economic evaluations and prioritization of cost-effective weight management interventions are lacking in sub-Saharan Africa.

Objectives: To estimate age- and sex-specific HSUs for Ghana, along with HSUs by weight status. Associations between HSUs and overweight and obesity will be examined.

Study Design: Cross-sectional survey of the Ghanaian population.

Methods: Data were sourced from the World Health Organization Study of Global AGEing and Adult Health (WHO SAGE), 2014 to 2015. Using a "judgment-based mapping" method, responses to items from the World Health Organization Quality-of-Life (WHOQOL-100) used in the WHO SAGE were mapped to EQ-5D-5L profiles, and the Zimbabwe value set was applied to calculate HSUs. Poststratified sampling weights were applied to estimate mean HSUs, and a multivariable linear regression model was used to examine associations between HSUs and overweight or obesity.

Results: Responses from 3966 adults aged 18 to 110 years were analyzed. The mean (95% confidence interval) HSU was 0.856 (95% CI: 0.850, 0.863) for the population, 0.866 (95% CI: 0.857, 0.875) for men, and 0.849 (95% CI: 0.841, 0.856) for women. Lower mean HSUs were observed for obese individuals and with older ages. Multivariable regression analysis showed that HSUs were negatively associated with obesity (-0.024; 95% CI: -0.037, -0.011), female sex (-0.011; 95% CI: -0.020, -0.003), and older age groups in the population.

Conclusions: The study provides HSUs by sex, age, and body mass index (BMI) categories for the Ghanaian population and examines associations between HSU and high BMI. Obesity was negatively associated with health state utility in the population. These data can be used in future economic evaluations for Ghana and sub-Saharan African populations.

Item Details

Item Type:Refereed Article
Keywords:WHO SAGE Wave 2, health economic evaluations, health state utilities, obesity, sub-Saharan Africa
Research Division:Economics
Research Group:Applied economics
Research Field:Health economics
Objective Division:Health
Objective Group:Public health (excl. specific population health)
Objective Field:Public health (excl. specific population health) not elsewhere classified
UTAS Author:Lartey, ST (Mrs Stella Lartey)
UTAS Author:Si, L (Mr Lei Si)
UTAS Author:de Graaff, B (Dr Barbara de Graaff)
UTAS Author:Magnussen, CG (Associate Professor Costan Magnussen)
UTAS Author:Ahmad, H (Dr Hasnat Ahmad)
UTAS Author:Campbell, J (Dr Julie Campbell)
UTAS Author:Palmer, AJ (Professor Andrew Palmer)
ID Code:132859
Year Published:2019
Web of Science® Times Cited:2
Deposited By:Menzies Institute for Medical Research
Deposited On:2019-05-23
Last Modified:2020-04-09

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