The case for action on socioeconomic differences in overweight and obesity among Australian adults: modelling the disease burden and healthcare costs

• Main Authors: Emma Gearon, Kathryn Backholer, Anita Lal, Wilma Nusselder, Anna Peeters
• Format: Article
• Language: English
• Published: Wiley 2020-04-01
• Series: Australian and New Zealand Journal of Public Health
• Subjects: socioeconomic factors; obesity; body mass index; epidemiology; epidemiological monitoring; costs and cost analysis
• Online Access: https://doi.org/10.1111/1753-6405.12970
• ISSN: 1326-0200; 1753-6405

Abstract Objective: We aimed to quantify the extent to which socioeconomic differences in body mass index (BMI) drive avoidable deaths, incident disease cases and healthcare costs. Methods: We used population attributable fractions to quantify the annual burden of disease attributable to socioeconomic differences in BMI for Australian adults aged 20 to <85 years in 2016, stratified by quintiles of an area‐level indicator of socioeconomic disadvantage (SocioEconomic Index For Areas Indicator of Relative Socioeconomic Disadvantage; SEIFA) and BMI (normal weight, overweight, obese). We estimated direct healthcare costs using annual estimates per person per BMI category. Results: We attributed $AU1.06 billion in direct healthcare costs to socioeconomic differences in BMI in 2016. The greatest number (proportion) of cases and deaths attributable to socioeconomic differences in BMI was observed for type 2 diabetes among women (8,602 total cases [16%], with 3,471 cases [22%] in the most disadvantaged quintile [SEIFA 1]) and all‐cause mortality among men (2027 total deaths [4%], with 815 deaths [6%] in SEIFA 1). Conclusions: Socioeconomic differences in BMI substantially contribute to avoidable deaths, disease cases and direct healthcare costs in Australia. Implications for public health: Population‐level policies to reduce socioeconomic differences in overweight and obesity must be identified and implemented.