Impact of overweight and obesity on life expectancy, quality-adjusted life years and lifetime costs in the adult population of Ghana

Stella Lartey; Lei Si; Thomas Lung; Costan G Magnussen; Godfred O Boateng; Nadia Minicuci; Paul Kowal; Alison Hayes; Barbara de Graaff; Leigh Blizzard; Andrew J Palmer

doi:10.1136/bmjgh-2020-003332

Impact of overweight and obesity on life expectancy, quality-adjusted life years and lifetime costs in the adult population of Ghana

BMJ Glob Health. 2020 Sep;5(9):e003332. doi: 10.1136/bmjgh-2020-003332.

Authors

Stella Lartey^{1

2

3}, Lei Si⁴, Thomas Lung^{4

5}, Costan G Magnussen^{6

7}, Godfred O Boateng⁸, Nadia Minicuci⁹, Paul Kowal^{10

11}, Alison Hayes⁵, Barbara de Graaff⁶, Leigh Blizzard⁶, Andrew J Palmer^{6

12}

Affiliations

¹ Menzies Institute for Medical Research, University of Tasmania, Menzies Institute for Medical Research, Hobart, Tasmania, Australia stella.lartey@utas.edu.au.
² Department of Economics, University of Calgary, Calgary, AB, Canada.
³ Ministry of Health, Accra, GAR, Ghana.
⁴ The George Institute for Global Health, Sydney, New South Wales, Australia.
⁵ Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.
⁶ Menzies Institute for Medical Research, University of Tasmania, Menzies Institute for Medical Research, Hobart, Tasmania, Australia.
⁷ Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.
⁸ Department of Kinesiology, College of Nursing and Health Innovations, University of Texas at Arlington, Arlington, Texas, USA.
⁹ National Research Council, Neuroscience Institute, Padova, Italy.
¹⁰ World Health Organization, Geneva, Switzerland.
¹¹ Research Centre for Generational Health and Ageing, University of Newcastle, Newcastle, New South Wales, Australia.
¹² Centre for Health Policy, School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia.

Abstract

Introduction: Prior studies have revealed the increasing prevalence of obesity and its associated health effects among ageing adults in resource poor countries. However, no study has examined the long-term and economic impact of overweight and obesity in sub-Saharan Africa. Therefore, we quantified the long-term impact of overweight and obesity on life expectancy (LE), quality-adjusted life years (QALYs) and total direct healthcare costs.

Methods: A Markov simulation model projected health and economic outcomes associated with three categories of body mass index (BMI): healthy weight (18.5≤BMI <25.0); overweight (25.0≤BMI < 30.0) and obese (BMI ≥30.0 kg/m²) in simulated adult cohorts over a 50-year time horizon from age fifty. Costs were estimated from government and patient perspectives, discounted 3% annually and reported in 2017 US$. Mortality rates from Ghanaian lifetables were adjusted by BMI-specific all-cause mortality HRs. Published input data were used from the 2014/2015 Ghana WHO Study on global AGEing and adult health data. Internal and external validity were assessed.

Results: From age 50 years, average (95% CI) remaining LE for females were 25.6 (95% CI: 25.4 to 25.8), 23.5 (95% CI: 23.3 to 23.7) and 21.3 (95% CI: 19.6 to 21.8) for healthy weight, overweight and obesity, respectively. In males, remaining LE were healthy weight (23.0; 95% CI: 22.8 to 23.2), overweight (20.7; 95% CI: 20.5 to 20.9) and obesity (17.6; 95% CI: 17.5 to 17.8). In females, QALYs for healthy weight were 23.0 (95% CI: 22.8 to 23.2), overweight, 21.0 (95% CI: 20.8 to 21.2) and obesity, 19.0 (95% CI: 18.8 to 19.7). The discounted total costs per female were US$619 (95% CI: 616 to 622), US$1298 (95% CI: 1290 to 1306) and US$2057 (95% CI: 2043 to 2071) for healthy weight, overweight and obesity, respectively. QALYs and costs were lower in males.

Conclusion: Overweight and obesity have substantial health and economic impacts, hence the urgent need for cost-effective preventive strategies in the Ghanaian population.

Keywords: health economics; health services research; nutritional and metabolic disorders.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Female
Ghana / epidemiology
Humans
Life Expectancy*
Male
Middle Aged
Obesity / epidemiology
Overweight* / epidemiology
Quality-Adjusted Life Years

Grants and funding

001/WHO_/World Health Organization/International