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Impact of overweight and obesity on life expectancy, quality-adjusted life years and lifetime costs in the adult population of Ghana

Citation

Lartey, S and Si, L and Lung, T and Magnussen, CG and Boateng, GO and Minicuci, N and Kowal, P and Hayes, A and de Graaff, B and Blizzard, L and Palmer, AJ, Impact of overweight and obesity on life expectancy, quality-adjusted life years and lifetime costs in the adult population of Ghana, BMJ Global Health, 5, (9) Article e003332. ISSN 2059-7908 (2020) [Refereed Article]


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Copyright 2020 the authors. Licensed under Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) https://creativecommons.org/licenses/by-nc/4.0/

DOI: doi:10.1136/bmjgh-2020-003332

Abstract

Introduction: Prior studies have revealed the increasing prevalence of obesity and its associated health effects among ageing adults in resource poor countries. However, no study has examined the long-term and economic impact of overweight and obesity in sub-Saharan Africa. Therefore, we quantified the long-term impact of overweight and obesity on life expectancy (LE), quality-adjusted life years (QALYs) and total direct healthcare costs.

Methods: A Markov simulation model projected health and economic outcomes associated with three categories of body mass index (BMI): healthy weight (18.5≤BMI <25.0); overweight (25.0≤BMI < 30.0) and obese (BMI ≥30.0 kg/m2) in simulated adult cohorts over a 50-year time horizon from age fifty. Costs were estimated from government and patient perspectives, discounted 3% annually and reported in 2017 US$. Mortality rates from Ghanaian lifetables were adjusted by BMI-specific all-cause mortality HRs. Published input data were used from the 2014/2015 Ghana WHO Study on global AGEing and adult health data. Internal and external validity were assessed.

Results: From age 50 years, average (95% CI) remaining LE for females were 25.6 (95% CI: 25.4 to 25.8), 23.5 (95% CI: 23.3 to 23.7) and 21.3 (95% CI: 19.6 to 21.8) for healthy weight, overweight and obesity, respectively. In males, remaining LE were healthy weight (23.0; 95% CI: 22.8 to 23.2), overweight (20.7; 95% CI: 20.5 to 20.9) and obesity (17.6; 95% CI: 17.5 to 17.8). In females, QALYs for healthy weight were 23.0 (95% CI: 22.8 to 23.2), overweight, 21.0 (95% CI: 20.8 to 21.2) and obesity, 19.0 (95% CI: 18.8 to 19.7). The discounted total costs per female were US$619 (95% CI: 616 to 622), US$1298 (95% CI: 1290 to 1306) and US$2057 (95% CI: 2043 to 2071) for healthy weight, overweight and obesity, respectively. QALYs and costs were lower in males.

Conclusion: Overweight and obesity have substantial health and economic impacts, hence the urgent need for cost-effective preventive strategies in the Ghanaian population.

Item Details

Item Type:Refereed Article
Keywords:Ghana, obesity, WHO-SAGE Wave 2, life expectancy, QALYs, health economics, health services research, nutritional and metabolic disorders
Research Division:Health Sciences
Research Group:Health services and systems
Research Field:Health services and systems not elsewhere classified
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, S (Mrs Stella Lartey)
UTAS Author:Magnussen, CG (Associate Professor Costan Magnussen)
UTAS Author:de Graaff, B (Dr Barbara de Graaff)
UTAS Author:Blizzard, L (Professor Leigh Blizzard)
UTAS Author:Palmer, AJ (Professor Andrew Palmer)
ID Code:141192
Year Published:2020
Deposited By:Menzies Institute for Medical Research
Deposited On:2020-10-02
Last Modified:2020-11-09
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