Application of the UK foresight obesity model in Ireland: the health and economic consequences of projected obesity trends in Ireland

Abstract

Background: Given the scale of the current obesity epidemic and associated health consequences there has been increasing concern about the economic burden placed on society in terms of direct healthcare costs and indirect societal costs. In the Republic of Ireland these costs were estimated at €1.13 billion for 2009. The total direct healthcare costs for six major obesity related conditions (coronary heart disease & stroke, cancer, hypertension, type 2 diabetes and knee osteoarthritis) in the same year were estimated at €2.55 billion. The aim of this research is to project disease burden and direct healthcare costs for these conditions in Ireland to 2030 using the established model developed by the Health Forum (UK) for the Foresight: Tackling Obesities project.

Methodology: Routine data sources were used to derive incidence, prevalence, mortality and survival for six conditions as inputs for the model. The model utilises a two stage modelling process to predict future BMI rates, disease prevalence and costs. Stage 1 employs a non-linear multivariate regression model to project BMI trends; stage 2 employs a microsimulation approach to produce longitudinal projections and test the impact of interventions upon future incidence of obesity-related disease.

Results: Overweight and obesity are projected to reach levels of 89% and 85% in males and females respectively by 2030. This will result in an increase in the obesity related prevalence of CHD & stroke by 97%, cancers by 61% and type 2 diabetes by 21%. The direct healthcare costs associated with these increases will amount to €5.4 billion by 2030. A 5% reduction in population BMI levels by 2030 is projected to result in €495 million less being spent in obesity-related direct healthcare costs over twenty years.

Discussion: These findings have significant implications for policy, highlighting the need for effective strategies to prevent this avoidable health and economic burden.

Figure 1. Projected prevalence of overweight and obesity in the Irish population.

This figure shows the percentage prevalence of overweight and obesity for males and females in Ireland in 2010 and projected prevalence for overweight and obesity for males and females for 2020 and 2030.

Figure 2. Projected prevalence of disease per 100,000 population from 2010-2030.

This figure shows the projected prevalence of disease per 100,000 population for 2010, 2020 and 2030 for six obesity related conditions. These six conditions are: cancer, CHD & stroke, type 2 diabetes, hypertension and knee osteoarthritis.

Figure 3. Cumulative incident cases avoided per 100,000 population relative to scenario 0 (when scenario 1 and scenario 2 are applied).

This figure shows cumulative incident cases avoided per 100,000 population relative to scenario 0 when a 1% decrease in BMI is applied to the Irish population (scenario 1) and a 5% decrease in BMI is applied to the Irish population (scenario 2).