Socioeconomic Costs of obesity for Korean Adults

한국인 성인 비만의 사회경제적 비용

  • Moon, Ok-Ryun (Department of Preventive Medicine, Graduate School of Public Health, Seoul National University) ;
  • Kim, Nam-Soon (Department of Preventive Medicine, Graduate School of Public Health, Seoul National University) ;
  • Kang, Jae-Heon (Department of Family Medicine, Inje university, Sanggye Paik Hospital) ;
  • Yoon, Tae-Ho (Department of Preventive Medicine, Graduate School of Public Health, Seoul National University) ;
  • Lee, Sang-Yi (Department of Preventive Medicine, College of Medicine, Cheju National University) ;
  • Lee, Sin-Jae (Department of Preventive Medicine, Graduate School of Public Health, Seoul National University) ;
  • Jeong, Baek-Geun (Department of Preventive Medicine, Graduate School of Public Health, Seoul National University)
  • 문옥륜 (서울대학교 보건대학원 예방의학교실) ;
  • 김남순 (서울대학교 보건대학원 예방의학교실) ;
  • 강재헌 (인제대학교 상계백병원 가정의학과) ;
  • 윤태호 (서울대학교 보건대학원 예방의학교실) ;
  • 이상이 (제주대학교 의과대학 예방의학교실) ;
  • 이신재 (서울대학교 보건대학원 예방의학교실) ;
  • 정백근 (서울대학교 보건대학원 예방의학교실)
  • Published : 2002.03.01

Abstract

Objective : To estimate the socioeconomic costs of obesity in Korea,1998. Methods : The 1998 National Health and Nutrition Examination Survey(1998 NHNES) data was used and 10,880 persons who had taken health examinations were selected for study. Essential hypertension, NIDDM(non insulin-dependent diabetes mellitus), dyslipidemia, osteoarthritis, coronary heart disease, stroke were included as obesity related disease. The data of direct costs of obesity was obtained from the National Federation of Medical Insurance. The category of indirect costs was the loss of productivity caused by premature death and admission, time costs, traffic costs, nursing fees due to obesity. Multiple logistic regression model was developed to estimate prevalence odds ratio by obesity class adjusted demographic and socio-ecnomic factors and calculate PAF(Population Attributable Fraction) of obesity on obesity related disease. And we finally calculated the socioeconomic costs of obesity in relation to BMI with PAF. Results : The direct costs of obesity were 2,126 billion${\sim}965$ billion Won in considering out of pocket payment to uninsured services, and the indirect costs of obesity were 2,099 billion${\sim}1,086$ billion Won. Consequently, in considering out of pocket payment to uninsured services, the socioeconomic costs of obesity were 4.225 billion${\sim}2,050$ billion Won, which corresponded to about $0.094%{\sim}0.046%$ of GDP and $1.88%{\sim}0.91$ of total health care costs in Korea. Conclusions : Obesity represents a major health problem with significant economic implications for the society. This results are conservative estimates as far as all obesity related disease and all health care and indirect costs were not included due to missing information. further studies are needed to caculate socioeconomic costs of obesity more exactly.

Keywords

References

  1. 대한일차의료학회 비만연구회. 대한일차의료의를 위한 비만학의 이론과 실제. 한국의 학; 1996, (35-54쪽)
  2. WHO. Obesity - Preventing and Mana-ging the Global Epidemic: Report of a WHO Consultation on Obesity, WHO Geneva; 1997. p. 1-69
  3. Chan JM et al. Overweight, underweight, and mortality. A prospective study of 48,287 men and women. Arch Int Med 1996; 156(9): 958-963 https://doi.org/10.1001/archinte.156.9.958
  4. Rissanen A et al. Risk of disability and mortality due to overweight in a Finnish population. BM 1990; 301: 835-837 https://doi.org/10.1136/bmj.301.6756.835
  5. Shaper AG. Obesity and cardiovascular disease. In: Chardwich DJ, Cardew GC, editors. The origins and consequences of obesity. Chichester, Wiley; 1996. p. 90-107(Ciba Foundation Symposium 201)
  6. Schapira DV et al. Visceral obesity and breast cancer risk. Cancer1994; 74: 632-639 https://doi.org/10.1002/1097-0142(19940715)74:2<632::AID-CNCR2820740215>3.0.CO;2-T
  7. MacMahon S et al. Blood pressure, stro-ke and coronary heart disease. Part 1, prolonged differences in blood pressure: prospective observational studies corre-cted for the regression dilution bias. Lancet 1990; 335: 765-774 https://doi.org/10.1016/0140-6736(90)90878-9
  8. Davies HTO, Crombie K, Tavakoli M. When can odds ratios mislead? BMJ 1998; 316:989-991 https://doi.org/10.1136/bmj.316.7136.989
  9. Spector TD, Hart DJ, Doyle DV. Inci-dence and progression of osteoarthritis in women with unilateral knee disease in the general population: the effect of obesity. Ann Rheumatic Dis 1994; 53:565-568 https://doi.org/10.1136/ard.53.9.565
  10. Garrow JS. Obesity 'and Related Disease1998
  11. La Vecchia C et al. Risk factors for gall-stone disease requiring surgery. Int J Epidemiol 1991; 20: 209-215 https://doi.org/10.1093/ije/20.1.209
  12. Zhang S et al. Better breast cancer survival for post menopausal women who are less overweight and eat less fat. The Iowa Women' s Health Study. Cancer 1995; 76: 275-283 https://doi.org/10.1002/1097-0142(19950715)76:2<275::AID-CNCR2820760218>3.0.CO;2-6
  13. Giovannucci E et al. Physical activity, obesity and risk for colon cancer and adenoma in men. Ann Int Med 1995; 122: 327-334 https://doi.org/10.7326/0003-4819-122-5-199503010-00002
  14. 통계청. 1999 경제활동인구연보; 2000, (41-345쪽)
  15. 보건복지부. ‘98 국민건강 . 영양조사 총괄보고서; 1999, (1-144쪽)
  16. 의료보험연합회. ‘98 의료보험통계연보;1999, (300-323쪽)
  17. Kim CY, Lee JS, Kang GW, Kim Y. Magnitude of Patient s Cost-sharing for Hospital Services in the national Health Insurance in Korea. Korean J Health Policy & Administration 1999; 9(4):10(Korean)
  18. 통계청. 1998년 사망원인통계연보; 1999, (74- 109쪽)
  19. Drummond M. F. Priciples of economic appraisal in health care, Oxford Univer-sity; 1980.p. 10-12
  20. Moon OR, Kim NS, Jang SM et al. Relationship between BMI and preval-ence of hypertension & diabetes mellitus based on national health interview survey. J Korean Acad Fam Med 1999; 20(6): 771-786(Korean)
  21. 문옥륜 등. 한국인 비만의 역학적 특성에 따른 비만관리 전략 개발 연구. 1999년 건강 증진기금연구사업 보고서; 2000, (83쪽)