Steven L Gortmaker1, Michael W Long2, Stephen C Resch3, Zachary J Ward3, Angie L Cradock2, Jessica L Barrett2, Davene R Wright4, Kendrin R Sonneville5, Catherine M Giles2, Rob C Carter6, Marj L Moodie6, Gary Sacks6, Boyd A Swinburn7, Amber Hsiao8, Seanna Vine8, Jan Barendregt9, Theo Vos9, Y Claire Wang8. 1. Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts. Electronic address: sgortmak@hsph.harvard.edu. 2. Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts. 3. Center for Health Decision Science, Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, Massachusetts. 4. Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington. 5. Division of Adolescent Medicine, Boston Children's Hospital, Boston, Massachusetts. 6. Deakin Health Economics, Faculty of Health, Deakin University, Melbourne, Victoria, Australia. 7. WHO Collaborating Centre for Obesity Prevention, Deakin University, Melbourne, Victoria, Australia; School of Population Health, University of Auckland, Auckland, New Zealand. 8. Department of Health Policy and Management, Mailman School of Public Health, Columbia University, New York, New York. 9. School of Population Health, University of Queensland, Brisbane, Queensland, Australia.
Abstract
INTRODUCTION: The childhood obesity epidemic continues in the U.S., and fiscal crises are leading policymakers to ask not only whether an intervention works but also whether it offers value for money. However, cost-effectiveness analyses have been limited. This paper discusses methods and outcomes of four childhood obesity interventions: (1) sugar-sweetened beverage excise tax (SSB); (2) eliminating tax subsidy of TV advertising to children (TV AD); (3) early care and education policy change (ECE); and (4) active physical education (Active PE). METHODS: Cost-effectiveness models of nationwide implementation of interventions were estimated for a simulated cohort representative of the 2015 U.S. population over 10 years (2015-2025). A societal perspective was used; future outcomes were discounted at 3%. Data were analyzed in 2014. Effectiveness, implementation, and equity issues were reviewed. RESULTS: Population reach varied widely, and cost per BMI change ranged from $1.16 (TV AD) to $401 (Active PE). At 10 years, assuming maintenance of the intervention effect, three interventions would save net costs, with SSB and TV AD saving $55 and $38 for every dollar spent. The SSB intervention would avert disability-adjusted life years, and both SSB and TV AD would increase quality-adjusted life years. Both SSB ($12.5 billion) and TV AD ($80 million) would produce yearly tax revenue. CONCLUSIONS: The cost effectiveness of these preventive interventions is greater than that seen for published clinical interventions to treat obesity. Cost-effectiveness evaluations of childhood obesity interventions can provide decision makers with information demonstrating best value for the money.
INTRODUCTION: The childhood obesity epidemic continues in the U.S., and fiscal crises are leading policymakers to ask not only whether an intervention works but also whether it offers value for money. However, cost-effectiveness analyses have been limited. This paper discusses methods and outcomes of four childhood obesity interventions: (1) sugar-sweetened beverage excise tax (SSB); (2) eliminating tax subsidy of TV advertising to children (TV AD); (3) early care and education policy change (ECE); and (4) active physical education (Active PE). METHODS: Cost-effectiveness models of nationwide implementation of interventions were estimated for a simulated cohort representative of the 2015 U.S. population over 10 years (2015-2025). A societal perspective was used; future outcomes were discounted at 3%. Data were analyzed in 2014. Effectiveness, implementation, and equity issues were reviewed. RESULTS: Population reach varied widely, and cost per BMI change ranged from $1.16 (TV AD) to $401 (Active PE). At 10 years, assuming maintenance of the intervention effect, three interventions would save net costs, with SSB and TV AD saving $55 and $38 for every dollar spent. The SSB intervention would avert disability-adjusted life years, and both SSB and TV AD would increase quality-adjusted life years. Both SSB ($12.5 billion) and TV AD ($80 million) would produce yearly tax revenue. CONCLUSIONS: The cost effectiveness of these preventive interventions is greater than that seen for published clinical interventions to treat obesity. Cost-effectiveness evaluations of childhood obesity interventions can provide decision makers with information demonstrating best value for the money.
Authors: Kevin D Hall; Gary Sacks; Dhruva Chandramohan; Carson C Chow; Y Claire Wang; Steven L Gortmaker; Boyd A Swinburn Journal: Lancet Date: 2011-08-27 Impact factor: 79.321
Authors: Steven L Gortmaker; Boyd A Swinburn; David Levy; Rob Carter; Patricia L Mabry; Diane T Finegood; Terry Huang; Tim Marsh; Marjory L Moodie Journal: Lancet Date: 2011-08-27 Impact factor: 79.321
Authors: Rob Carter; Marj Moodie; Alison Markwick; Anne Magnus; Theo Vos; Boyd Swinburn; Michele M Haby Journal: BMC Public Health Date: 2009-11-18 Impact factor: 3.295
Authors: Melinda M Davis; Margaret Spurlock; Katrina Ramsey; Jamie Smith; Beth Ann Beamer; Susan Aromaa; Paul B McGinnis Journal: J Sch Nurs Date: 2017-04-13 Impact factor: 2.835
Authors: Jennifer Falbe; Hannah R Thompson; Christina M Becker; Nadia Rojas; Charles E McCulloch; Kristine A Madsen Journal: Am J Public Health Date: 2016-08-23 Impact factor: 9.308
Authors: Brent A Langellier; Usama Bilal; Felipe Montes; Jose D Meisel; Letícia de Oliveira Cardoso; Ross A Hammond Journal: Am J Prev Med Date: 2019-08 Impact factor: 5.043
Authors: Emily Schulz; R Curtis Bay; Beverly Rosa Williams; Eddie M Clark; Jin Huang; Cheryl L Holt Journal: J Fam Med Community Health Date: 2017-07-03
Authors: Michael W Long; Steven L Gortmaker; Zachary J Ward; Stephen C Resch; Marj L Moodie; Gary Sacks; Boyd A Swinburn; Rob C Carter; Y Claire Wang Journal: Am J Prev Med Date: 2015-07 Impact factor: 5.043