It is widely recognized worldwide that obesity-related diseases and their complications significantly increase health care costs and lost productivity. In turn, this creates a huge burden on people, their families and governments.
One estimate shows that 9% of the continent’s total health care costs go to dealing with overweight and obese people.
We conducted a study to estimate the cost of obesity to the South African health care system. Our aim was to estimate the direct healthcare costs associated with the treatment of weight-related diseases based on public sector rates.
Based on our calculations, overweight and obesity cost the South African health system 33 billion rand (US$1.9 billion) per year. This represents 15.38% of public health spending and is equivalent to 0.67% of GDP. The annual cost of tackling overweight and obesity is 2,769 rand per person.
Among the most expensive diseases to treat were diabetes and cardiovascular disease.
Our analysis shows that overweight and obesity place a huge financial burden on the public health system in South Africa. This indicates an urgent need for preventive interventions at the population level to reduce the level of overweight and obesity. The reduction will reduce the incidence, prevalence, and health care costs of noncommunicable diseases.
Quantifying the financial costs associated with overweight and obesity also provides national policymakers with an understanding of the scale of costs to the state, costs of disease control, and costs to society.
The scale of the problem
Half of all adults in South Africa are overweight (23%) or obese (27%). And the World Obesity Federation predicts an additional 10% increase in obesity among adults (37%) by 2030. Overweight and obesity significantly increase the risk of non-communicable diseases. This burden contributes to the country’s high prevalence of diabetes, or e.g. According to estimates, in 2021, 11% of people over the age of 15 had diabetes. This is much higher than Nigeria which is 4%.
About 12 million people suffer from obesity-related illnesses for which they receive treatment in the public sector. These include diabetes, hypertension, cardiovascular disease, arthritis and some cancers.
This does not include the many undiagnosed people with diabetes and hypertension who are not receiving treatment. It also does not count people who are treated in the private sector.
These non-communicable diseases cause life-changing illness, disability and premature death.
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What we found
Our study calculated the cost of obesity starting at age 15. In making the calculations, we looked at the following: cancer, cardiovascular disease, diabetes, diseases of the musculoskeletal system, diseases of the respiratory tract and digestion.
We estimated the cost of each in detail and used the prevalence of these diseases to measure the cost of the system, taking into account health care utilization patterns.
In South Africa, the largest share of annual expenditure of 33 billion rand (US$1.9 billion) is diabetes care (19.86 billion rand). Cardiovascular diseases accounted for the second largest share (ZAR 8.87 billion). These costs, in turn, are mainly due to the cost of drugs and hospitalization. Diabetes and hypertension-related diseases are among the top ten causes of death in South Africa. Digestive diseases such as gallstones and gall bladder disease contribute less (395 million rand).
Diabetes (95%) and arthritis (58%) are diseases that are mainly caused by overweight and obesity.
Overall, 53% of the total health care expenditure on the treatment and management of these diseases in the public sector was related to the problem of overweight and obesity. South Africa shares this dubious distinction with other high- and middle-income countries such as Brazil, South Korea, Thailand and Colombia. Our results are similar to the World Obesity Federation’s estimate of 36 billion rand.
We also warn that 33 billion rubles is an underestimation of the economic value. We used public sector rates, which we calculated as 60% of private sector costs. We also excluded costs such as clinical examination and treatment of comorbidities such as amputations, as well as potential costs of undiagnosed conditions.
And our findings do not include the indirect costs of lost productivity from absenteeism. We also did not consider premature death from diseases related to overweight and obesity.
Next steps
Describing the health problem in monetary terms can create a sense of urgency to find ways to reduce future out-of-pocket costs for health care, as well as to reduce future losses to the state from the consequences of illness and premature death, including the consequences of worsening poverty.
This is particularly a problem in a setting such as South Africa, which already has a severely under-resourced health system, shockingly high unemployment, and undernutrition and overeating crises exacerbated by obesity and poverty-driven food choices. .
Until now, there has been a lack of detailed information on the economic costs of overweight and obesity in sub-Saharan Africa. Based on our research, South Africa’s burden is even higher than the average for Africa or the world: 15.38% of the total public health budget, which equals 0.67% of GDP.
Unless urgent action is taken to reduce obesity and overweight, the health care system will be burdened and the planned National Health Insurance Scheme will fail to ensure equity in health services.
The opportunity costs of being overweight and obese – and the diseases they often bring with them – are both personal and national. It is difficult to put a monetary value on a personal disability – the benefits of a significant improvement in quality of life are priceless.
Michael Boaci, Senior Research Fellow, University of the Witwatersrand
This article is republished from The Conversation under a Creative Commons license. Read the original article.
