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Special Issue "Economics of the Prevention and Treatment of Obesity"

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601).

Deadline for manuscript submissions: closed (31 December 2013)

Special Issue Editor

Guest Editor
Prof. Dr. Paul A. Scuffham

Centre for Applied Health Economics, School of Medicine & Population and Social Health Research Program Griffith Health Institute, Griffith University, Logan Campus, Meadowbrook, Queensland 4131, Australia
Website | E-Mail
Fax: +61 7 3382 1338
Interests: economic evaluation of healthcare interventions; cost of illness; cost-effectiveness analysis; valuation of health states; use of multi-attribute utility instruments; medical devices; health services research

Special Issue Information

Dear Colleagues,

Obesity is the fastest growing cause for morbidity and mortality in developed and developing countries. Obesity is a risk factor for chronic diseases, loss of quality of life, incapacity and eventually death. One of the potential consequences of obesity is diabetes mellitus. This in itself requires management with therapeutic agents, and often a change in lifestyle and diet. However, the incidence and prevalence of diabetes mellitus continues to grow and cost the health system more and more due to its consequences and complications which include blindness, neuropathy, foot and leg ulcers and often amputations.

Lifestyle factors are the main cause of obesity and thus obesity (and many of its consequences) is preventable. However, for an individual, the more obese they become, the more difficult it is to reverse that trend. There are now several pharmaceutical and surgical interventions available to manage or reverse obesity, but lifestyle factors are the most difficult to change.

There are a multitude of potential interventions and policy responses to prevent and treat obesity. Some focus on reducing consumption of unhealthy foods by imposing differential taxes on healthy vs junk foods, restrictions on advertising and increased physical activity in school curricula. Other interventions target those who are obese with multidisciplinary teams that include a psychologist, exercise physiologist and nutritionist/dietician to assist in changing lifestyle, pharmaceuticals to reduce intestinal absorption of fats or to increase metabolic rates, and the range of bariatric surgeries including gastric bypass, lap banding and now gastric sleeves. However, in order to use available resources wisely and to be able to prioritise between potential interventions, detailed information is needed on both health outcomes and costs, and the relation between the two. Moreover, the optimal balance of resources allocated to prevention versus treatment of obesity is highly debatable.

The focus of this Special Issue is on the Economics of Prevention and Treatment of Obesity. This includes developing knowledge on the economic consequences of prevention and treatments, on both the cost and the benefit side, in order to reduce societal as well as individual burden caused by obesity.

Empirical, theoretical and review papers are equally welcome, on any topic relevant to Economics of Prevention and Treatment of Obesity. Submissions on the optimal balance of resources allocated to prevention and treatment, articles identifying the optimal patient criteria for surgical interventions, and articles describing public acceptability of policy are especially welcome.

Professor Paul A. Scuffham
Guest Editor

Submission

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. Papers will be published continuously (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are refereed through a peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed Open Access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1600 CHF (Swiss Francs).


Keywords

  • costs
  • public health
  • prevention
  • treatment
  • chronic disease
  • obesity
  • bariatric surgery
  • intervention
  • resource allocation
  • economic evaluation

Published Papers (5 papers)

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Research

Open AccessArticle Economics of Obesity — Learning from the Past to Contribute to a Better Future
Int. J. Environ. Res. Public Health 2014, 11(4), 4007-4025; doi:10.3390/ijerph110404007
Received: 1 February 2014 / Revised: 28 March 2014 / Accepted: 28 March 2014 / Published: 14 April 2014
Cited by 4 | PDF Full-text (253 KB) | HTML Full-text | XML Full-text
Abstract
The discipline of economics plays a varied role in informing the understanding of the problem of obesity and the impact of different interventions aimed at addressing it. This paper discusses the causes of the obesity epidemic from an economics perspective, and outlines various
[...] Read more.
The discipline of economics plays a varied role in informing the understanding of the problem of obesity and the impact of different interventions aimed at addressing it. This paper discusses the causes of the obesity epidemic from an economics perspective, and outlines various justifications for government intervention in this area. The paper then focuses on the potential contribution of health economics in supporting resource allocation decision making for obesity prevention/treatment. Although economic evaluations of single interventions provide useful information, evaluations undertaken as part of a priority setting exercise provide the greatest scope for influencing decision making. A review of several priority setting examples in obesity prevention/treatment indicates that policy (as compared with program-based) interventions, targeted at prevention (as compared with treatment) and focused “upstream” on the food environment, are likely to be the most cost-effective options for change. However, in order to further support decision makers, several methodological advances are required. These include the incorporation of intervention costs/benefits outside the health sector, the addressing of equity impacts, and the increased engagement of decision makers in the priority setting process. Full article
(This article belongs to the Special Issue Economics of the Prevention and Treatment of Obesity)
Open AccessArticle Socioeconomic Inequalities in Adult Obesity Prevalence in South Africa: A Decomposition Analysis
Int. J. Environ. Res. Public Health 2014, 11(3), 3387-3406; doi:10.3390/ijerph110303387
Received: 23 December 2013 / Revised: 10 March 2014 / Accepted: 11 March 2014 / Published: 21 March 2014
Cited by 9 | PDF Full-text (264 KB) | HTML Full-text | XML Full-text
Abstract
In recent years, there has been a dramatic increase in obesity in low and middle income countries. However, there is limited research in these countries showing the prevalence and determinants of obesity. In this study, we examine the socioeconomic inequalities in obesity among
[...] Read more.
In recent years, there has been a dramatic increase in obesity in low and middle income countries. However, there is limited research in these countries showing the prevalence and determinants of obesity. In this study, we examine the socioeconomic inequalities in obesity among South African adults. We use nationally representative data from the South Africa National Income Dynamic Survey of 2008 to: (1) construct an asset index using multiple correspondence analyses (MCA) as a proxy for socioeconomic status; (2) estimate concentration indices (CI) to measure socioeconomic inequalities in obesity; and (3) perform a decomposition analysis to determine the factors that contribute to socioeconomic related inequalities. Consistent with other studies, we find that women are more obese than men. The findings show that obesity inequalities exist in South Africa. Rich men are more likely to be obese than their poorer counterparts with a concentration index of 0.27. Women on the other hand have similar obesity patterns, regardless of socioeconomic status with CI of 0.07. The results of the decomposition analysis suggest that asset index contributes positively and highly to socio-economic inequality in obesity among females; physical exercise contributes negatively to the socio-economic inequality. In the case of males, educational attainment and asset index contributed more to socio-economic inequalities in obesity. Our findings suggest that focusing on economically well-off men and all women across socioeconomic status is one way to address the obesity problem in South Africa. Full article
(This article belongs to the Special Issue Economics of the Prevention and Treatment of Obesity)
Open AccessArticle Yes, The Government Should Tax Soft Drinks: Findings from a Citizens’ Jury in Australia
Int. J. Environ. Res. Public Health 2014, 11(3), 2456-2471; doi:10.3390/ijerph110302456
Received: 31 December 2013 / Revised: 14 February 2014 / Accepted: 17 February 2014 / Published: 27 February 2014
Cited by 10 | PDF Full-text (228 KB) | HTML Full-text | XML Full-text
Abstract
Taxation has been suggested as a possible preventive strategy to address the serious public health concern of childhood obesity. Understanding the public’s viewpoint on the potential role of taxation is vital to inform policy decisions if they are to be acceptable to the
[...] Read more.
Taxation has been suggested as a possible preventive strategy to address the serious public health concern of childhood obesity. Understanding the public’s viewpoint on the potential role of taxation is vital to inform policy decisions if they are to be acceptable to the wider community. A Citizens’ Jury is a deliberative method for engaging the public in decision making and can assist in setting policy agendas. A Citizens’ Jury was conducted in Brisbane, Australia in May 2013 to answer the question: Is taxation on food and drinks an acceptable strategy to the public in order to reduce rates of childhood obesity? Citizens were randomly selected from the electoral roll and invited to participate. Thirteen members were purposively sampled from those expressing interest to broadly reflect the diversity of the Australian public. Over two days, participants were presented with evidence on the topic by experts, were able to question witnesses and deliberate on the evidence. The jurors unanimously supported taxation on sugar-sweetened drinks but generally did not support taxation on processed meats, snack foods and foods eaten/ purchased outside the home. They also supported taxation on snack foods on the condition that traffic light labelling was also introduced. Though they were not specifically asked to deliberate strategies outside of taxation, the jurors strongly recommended more nutritional information on all food packaging using the traffic light and teaspoon labelling systems for sugar, salt and fat content. The Citizens’ Jury suggests that the general public may support taxation on sugar-sweetened drinks to reduce rates of obesity in children. Regulatory reforms of taxation on sugar-sweetened drinks and improved labelling of nutritional information on product packaging were strongly supported by all members of the jury. These reforms should be considered by governments to prevent childhood obesity and the future burden on society from the consequences of obesity. Full article
(This article belongs to the Special Issue Economics of the Prevention and Treatment of Obesity)
Open AccessArticle Adolescent Bariatric Surgery — Thoughts and Perspectives from the UK
Int. J. Environ. Res. Public Health 2014, 11(1), 573-582; doi:10.3390/ijerph110100573
Received: 10 September 2013 / Revised: 2 December 2013 / Accepted: 13 December 2013 / Published: 31 December 2013
Cited by 2 | PDF Full-text (441 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
Opinions of healthcare professionals in the United Kingdom regarding bariatric surgery in adolescents are largely unknown. This study aims to explore the perspectives of medical professionals regarding adolescent bariatric surgery. Members of the British Obesity and Metabolic Surgery Society and groups of primary
[...] Read more.
Opinions of healthcare professionals in the United Kingdom regarding bariatric surgery in adolescents are largely unknown. This study aims to explore the perspectives of medical professionals regarding adolescent bariatric surgery. Members of the British Obesity and Metabolic Surgery Society and groups of primary care practitioners based in London were contacted by electronic mail and invited to complete an anonymous online survey consisting of 21 questions. Ninety-four out of 324 questionnaires were completed. 66% of professionals felt that adolescents with a body mass index (BMI) >40 or BMI >35 with significant co-morbidities can be offered surgery. Amongst pre-requisites, parental psychological counseling was chosen most frequently. 58% stated 12 months as an appropriate period for weight management programs, with 24% regarding 6 months as sufficient. Most participants believed bariatric surgery should only be offered ≥16 years of age. However, 17% of bariatric surgeons marked no minimum age limit. Over 80% of the healthcare professionals surveyed consider bariatric surgery in adolescents to be acceptable practice. Most healthcare professionals surveyed feel that adolescent bariatric surgery is an acceptable therapeutic option for adolescent obesity. These views can guide towards a consensus opinion and further development of selection criteria and care pathways. Full article
(This article belongs to the Special Issue Economics of the Prevention and Treatment of Obesity)
Open AccessArticle Using Small-Area Analysis to Estimate County-Level Racial Disparities in Obesity Demonstrating the Necessity of Targeted Interventions
Int. J. Environ. Res. Public Health 2014, 11(1), 418-428; doi:10.3390/ijerph110100418
Received: 12 November 2013 / Revised: 19 December 2013 / Accepted: 19 December 2013 / Published: 27 December 2013
Cited by 2 | PDF Full-text (457 KB) | HTML Full-text | XML Full-text
Abstract
Data on the national and state levels is often used to inform policy decisions and strategies designed to reduce racial disparities in obesity. Obesity-related health outcomes are realized on the individual level, and policies based on state and national-level data may be inappropriate
[...] Read more.
Data on the national and state levels is often used to inform policy decisions and strategies designed to reduce racial disparities in obesity. Obesity-related health outcomes are realized on the individual level, and policies based on state and national-level data may be inappropriate due to the variations in health outcomes within and between states. To examine county-level variation of obesity within states, we use a small-area analysis technique to fill the void for county-level obesity data by race. Five years of Behavioral Risk Factor Surveillance System data are used to estimate the prevalence of obesity by county, both overall and race-stratified. A modified weighting system is used based on demographics at the county level using 2010 census data. We fit a multilevel reweighted regression model to obtain county-level prevalence estimates by race. We compare the distribution of prevalence estimates of non-Hispanic Blacks to non-Hispanic Whites. For 25 of the 26 states included in our analysis there is a statistically significant difference between within-state county-level average obesity prevalence rates for non-Hispanic Whites and non-Hispanic Blacks. This study provides information needed to target disparities interventions and resources to the local areas with greatest need; it also identifies the necessity of doing so. Full article
(This article belongs to the Special Issue Economics of the Prevention and Treatment of Obesity)

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