Thursday, January 25, 2007

Obesity cost more than EUR 260 million last year in Finland

In addition to being a major health issue for thoudands of individual Finns, obesity has considerable economic implications for the whole nation and brings costs of 260 million every year.
With some individuals, the public health system is willing to spend as much as EUR 400 for every kilo of weight that they shed.
This is the average cost incurred by the Social Insurance Institution (KELA) when it pays for rehabilitation courses for obese Finns with high blood pressure or other diseases requiring weigh loss.

KELA calculates that the courses lead to an average weight loss of four kilos for the individual, which can be enough to prevent the outbreak of adult-onset diabetes.
"The price might seem high", says Paula Hakala, head researcher at KELA, "but the costs of rehabilitation cannot be considered high, if the person is thus spared diabetes and the complications linked with it." The rehabilitation makes economic sense, even if it merely delays the onset of a disease by a few years.

The annual EUR 800,000 that is spent on rehabilitation of the overweight is only a fraction of the costs imposed on the whole Finnish economy by obesity.
Research professor Markku Pekurinen of the National Research and Development Centre for Welfare and Health (STAKES) calculates that obesity cost the Finnish economy more than EUR 260 million last year in health care and social spending.
The costs of obesity exceed even those caused by smoking.
Pekurinen calculates that 1,200 hospital beds - the equivalent of a relatively large central hospital - are required for the treatment of illnesses linked with excess weight. Obesity is also the cause of 340,000 days of absenteeism from work.
In health care, EUR 188 million was spent on the treatment of obesity - a total of 1.7 per cent of all spending. In the same year EUR 75 million was spent on sick leave and disability pension benefits for diseases linked with obesity, which is about 1.8 per cent of total costs of social benefits.

Fortunately, the percentages are not very high. However, the amount of excess body fat, and diseases linked with it, are constantly increasing, which means that the costs are also likely to rise.
Attempts have been made to keep the costs in check by changing treatment methods. The number of patients hospitalised for diseases caused by obesity declined by 30 per cent from 1997 to 2004. Increasing numbers of those suffering from obesity are treated as outpatients.

Adult-onset diabetes is the most obvious risk factor for the overweight. The frequency of the disease has risen especially with working-aged men. About 65 per cent of cases of adult diabetes are believed to be linked with obesity. Excess body weight is believed to be a factor in one in four strokes and cases of high blood pressure. It is believed to play a role in 12 per cent of injuries to joints.
In 2004 Finnish hospitals treated nearly 5,000 cases of diabetes attributed to obesity. Visits to hospital outpatient clinics in that same year exceeded 15,000.
A year later KELA paid compensation to 110,000 Finns for medicines used for the treatment of diabetes caused by obesity. The number of people receiving the benefit increased by more than 6,000 in a single year.
About one third of health care costs linked with obesity were for the treatment of diabetes.

Calculation of the costs of obesity involves the use of many assumptions.
Pekurinen’s study classifies as obese those people whose body mass index exceeds 28. The index is calculated by dividing a person's weight in kilos by the square of his or her hight in metres.
People of normal weight have a body mass index between 18.5 and 26. Illnesses increase considerably when the index rises over 30.
In Finland, the index for those in the 45-64 age group exceeds 27. With one third of the age group the index is 30 or more.
Pekurinen says that cautious assumptions are used in calculating the costs of obesity, because the results are used as a basis for decision-making in health care, and it is important that the studies not raise unfounded expectations on the impact of different actions.
Professor Aila Rissanen, who studies diseases linked with obesity, feels that the costs of obesity have been clearly underestimated in the calculations.

In addition to direct costs incurred by health care and social services, obesity imposes "productivity costs" on society, in the form of work that is left undone when a person falls ill or dies prematurely.
In addition to a higher rate of absenteeism, an obese person is often less productive when he or she is at work.
"Sleep disorders have a clear correlation with obesity. They affect alertness during the day, and have a clear impact on productivity", Rissanen says. "Most people feel that they are more alert and function better when they have lost weight, or if they exercise more, or both."

There has been no attempt to calculate the total costs of obesity to the national economy in Finland.
Based on foreign assessments, Markku Pekurinen says that the total costs in absenteeism and disability could be many times higher than those incurred by health care.


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