Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Aug 22;17(1):667.
doi: 10.1186/s12889-017-4665-1.

Estimating the variation in need for community-based social care by body mass index in England and associated cost: population-based cross-sectional study

Vicky R Copley  1 , Nick Cavill  2 , Jane Wolstenholme  3 , Richard Fordham  4 , Harry Rutter  5
Affiliations

Estimating the variation in need for community-based social care by body mass index in England and associated cost: population-based cross-sectional study

Vicky R Copley et al. BMC Public Health. .

Abstract

Background: Adult obesity is linked to a greater need for social care because of its association with the development of long term conditions and because obese adults can have physical and social difficulties which inhibit daily living. Obesity thus has considerable social care cost implications but the magnitude of these costs is currently unknown. This paper outlines an approach to estimating obesity-related social care costs in adults aged over 65 in England.

Methods: We used univariable and multivariable logistic regression models to investigate the relation between the self-reported need for social care and potential determinants, including body mass index (BMI), using data from Health Survey for England. We combined these modelled estimates of need for social care with the mean hours of help received, conditional on receiving any help, to calculate the expected hours of social care received per adult by BMI.

Results: BMI is positively associated with self-reported need for social care. A one unit (ie 1 kg/m2) increase in BMI is on average associated with a 5% increase in the odds of need for help with social care (odds ratio 1.05, 95% CI 1.04 to 1.07) in an unadjusted model. Adjusting for long term illness and sociodemographic characteristics we estimate the annual cost of local authority funded care for those who receive it is £599 at a BMI of 23 but £1086 at a BMI of 40.

Conclusion: BMI is positively associated with self-reported need for social care after adjustment for sociodemographic factors and limiting long term illness. The increase in need for care with BMI gives rise to additional costs in social care provision which should be borne in mind when calculating the cost-effectiveness of interventions aimed at reducing obesity.

Keywords: BMI; Economics; Obesity; Public health; Social care.

PubMed Disclaimer

Conflict of interest statement

Ethics approval and consent to participate

Not required for this secondary data analysis project. The Health Survey for England has been approved by the Oxford A Research Ethics Committee.

Consent for publication

Not applicable.

Competing interests

All authors have completed the Unified Competing Interest form at www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author) and declare that: VRC has support from Public Health England for the submitted work; VRC NC JW RF HR have had no relationships with companies that might have an interest in the submitted work in the previous 3 years; VRC NC JW RF HR have no non-financial interests that may be relevant to the submitted work.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Marginal predicted probabilities of self-reported need for help with Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL), by BMI. Dotted lines represent 95% confidence intervals. Model 2 is adjusted for limiting long term illness, in addition to the sociodemographic characteristics also considered in model 1. Model 3 is the same as model 2 but uses a definition of long term illness which does not include diabetes
See this image and copyright information in PMC

References

    1. World Health Organization. Overweight and obesity; 2015. http://www.who.int/mediacentre/factsheets/fs311/en/. Accessed 15 Aug 2017.
    1. Local Government Association. Social care and obesity; 2013. https://www.local.gov.uk/social-care-and-obesity-discussion-paper. Accessed 15 Aug 2017.
    1. Cawley J, Meyerhoefer C. The medical care costs of obesity: an instrumental variables approach. J Health Econ. 2012;31:219–230. doi: 10.1016/j.jhealeco.2011.10.003. - DOI - PubMed
    1. de Oliveira ML, Santos LM, da Silva EN. Direct healthcare cost of obesity in Brazil: an application of the cost-of-illness method from the perspective of the public health system in 2011. PLoS One. 2015;10 doi: 10.1371/journal.pone.0121160. - DOI - PMC - PubMed
    1. Tigbe WW, Briggs AH, Lean ME. A patient-centred approach to estimate total annual healthcare cost by body mass index in the UK counterweight programme. Int J Obes. 2013;37:1135–1139. doi: 10.1038/ijo.2012.186. - DOI - PubMed