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标题：Forecasting the Future Economic Burden of Current Adolescent Overweight: An Estimate of the Coronary Heart Disease Policy Model
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作者：James Lightwood ; Kirsten Bibbins-Domingo ; Pamela Coxson 等
期刊名称：American journal of public health
印刷版ISSN：0090-0036
出版年度：2009
卷号：99
期号：12
页码：2230-2237
DOI：10.2105/AJPH.2008.152595
语种：English
出版社：American Public Health Association
摘要：Objectives. We predicted the future economic burden attributable to high rates of current adolescent overweight. Methods. We constructed models to simulate the costs of excess obesity and associated diabetes and coronary heart disease (CHD) among adults aged 35–64 years in the US population in 2020 to 2050. Results. Current adolescent overweight is projected to result in 161 million life-years complicated by obesity, diabetes, or CHD and 1.5 million life-years lost. The cumulative excess attributable total costs are estimated at $254 billion: $208 billion because of lost productivity from earlier death or morbidity and $46 billion from direct medical costs. Currently available therapies for hypertension, hyperlipidemia, and diabetes, used according to guidelines, if applied in the future, would result in modest reductions in excess mortality (decreased to 1.1 million life-years lost) but increase total excess costs by another $7 billion (increased to $261 billion total). Conclusions. Current adolescent overweight will likely lead to large future economic and health burdens, especially lost productivity from premature death and disability. Application of currently available medical treatments will not greatly reduce these future burdens of increased adult obesity. Excessive weight gain in childhood and adolescence has risen over the past several decades. The prevalence of overweight adolescents tripled between the 1970s and 2000 and reached 17% as of 2000 to 2004.¹ Overweight adolescents are likely to become obese adults,^{2 – 4} thereby producing a substantial, long-lasting future health burden. The prevalence of adult obesity was reported to be 34% in 2007.⁵ A recent study forecast that current adolescent overweight will increase future adult obesity by 5% to 15% by 2035, resulting in more than 100 000 excess prevalent cases of coronary heart disease (CHD) by 2035.¹ The economic burden attributable to this future excess obesity has not been estimated. In addition to the costs of medical treatment of the higher rates of obesity, CHD, and other obesity-related illness such as diabetes, the costs of lost productivity resulting from premature morbidity and mortality in the working-age population may also be high. We used the CHD Policy Model^{6 – 8} to estimate the increase from 2020 to 2050 in adult obesity, obesity-associated CHD, and obesity-related diabetes attributable to increases in prevalence of adolescent overweight between the late 1970s and 2000. We then estimated the attributable increases in direct medical costs and indirect productivity costs. We also estimated the economic costs associated with medical treatment protocols (or standards of care or policies) that might mitigate the projected rise of modifiable, obesity-related cardiovascular risk factors.