Over the past 40 years, industrialized countries have undergone social and economic changes that have increased the risk of developing chronic diseases within the population. The increasingly sedentary nature of work, a decrease in physical activity due to reliance on automobiles and to urban sprawl and more sedentary recreational activities have all contributed to an ongoing reduction in levels of physical activity.
To this can be added the major changes the food system has undergone during the same period. The food system is now characterized by the industrialization of agricultural production, increased caloric availability and lower prices for food with low nutritional value. In addition, food distribution and marketing practices have made food continually available in our environments. In this type of environment, which does little to promote healthy eating and the adoption of a physically active lifestyle, chronic diseases and obesity increased.
This report documents the economic impact of these social changes for Québec. It presents the initial results of an ongoing study at the Institut national de santé publique du Québec aimed at estimating the economic impact of overweight and obesity among adults in Québec. Two types of direct costs tied to the provision of health services are analyzed: medical consultations in outpatient clinics and nights in hospital. An analysis is made of the impact of those classified as overweight or obese, in terms of additional health services use, as compared to those of normal weight in the control group.
The main source of data for this project is the National Population Health Survey (NPHS). This is a longitudinal Canadian survey conducted by Statistics Canada. The survey was conducted from 1994 to 2011, every two years, among households in the ten Canadian provinces. The initial sample set for Québec used for our analysis includes 2,357 adults.
Our data indicates that adults in Québec who were obese in 1994 made greater use of health services between 1994 and 2011 than those of normal weight. The likelihood of use among obese people was 94% higher than for normal weight individuals for the number of nights in hospital and 13% higher for the number of medical consultations.
This excess use translates into an annual economic burden of $1.5 billion for Québec, if the monetary value is based on the expenses incurred for these health services in 2011. This amount represents 10 percent of total costs for medical consultations and hospitalization for adults in Québec in 2011.
To reduce the economic burden associated with obesity, importance should be placed on pursuing and intensifying current measures aimed at promoting healthy lifestyles and preventing weight-related problems by altering the environments in which we live, so that they become more conducive to healthy eating and physical activity. Indeed, international recommendations concerning obesity prevention stress the importance of working to change not only individual behaviour, but also, especially, the physical, economic, political and socio-cultural environments that shape our everyday habits. The social changes that produced an economic burden of this scale developed over the course of decades; long-term efforts will be required for the creation of living environments that make healthy choices the easiest ones.