ORCID Profile
0000-0002-3206-8232
Current Organisation
Griffith University
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Research Topics
In Research Link Australia (RLA), "Research Topics" refer to ANZSRC FOR and SEO codes. These topics are either sourced from ANZSRC FOR and SEO codes listed in researchers' related grants or generated by a large language model (LLM) based on their publications.
Top 5 Research Topics
ANZSRC Field of Research (FoR)
Applied Economics not elsewhere classified | Health Policy | Public Health and Health Services not elsewhere classified | Public Health and Health Services | Social Policy | Policy and Administration
ANZSRC Socio-Economic Objective (SEO)
Public Health (excl. Specific Population Health) not elsewhere classified | Economic Framework not elsewhere classified | Human Capital Issues | Health Policy Economic Outcomes | Health Policy Evaluation |
Related Links
Publications
Active transport and obesity prevention – A transportation sector obesity impact scoping review and assessment for Melbourne, Australia
Publisher: Elsevier BV
Date: 03-2017
DOI: 10.1016/J.YPMED.2016.12.020
Abstract: Given the alarming prevalence of obesity worldwide and the need for interventions to halt the growing epidemic, more evidence on the role and impact of transport interventions for obesity prevention is required. This study conducts a scoping review of the current evidence of association between modes of transport (motor vehicle, walking, cycling and public transport) and obesity-related outcomes. Eleven reviews and thirty-three primary studies exploring associations between transport behaviours and obesity were identified. Cohort simulation Markov modelling was used to estimate the effects of body mass index (BMI) change on health outcomes and health care costs of diseases causally related to obesity in the Melbourne, Australia population. Results suggest that evidence for an obesity effect of transport behaviours is inconclusive (29% of published studies reported expected associations, 33% mixed associations), and any potential BMI effect is likely to be relatively small. Hypothetical scenario analyses suggest that active transport interventions may contribute small but significant obesity-related health benefits across populations (approximately 65 health adjusted life years gained per year). Therefore active transport interventions that are low cost and targeted to those most amenable to modal switch are the most likely to be effective and cost-effective from an obesity prevention perspective. The uncertain but potentially significant opportunity for health benefits warrants the collection of more and better quality evidence to fully understand the potential relationships between transport behaviours and obesity. Such evidence would contribute to the obesity prevention dialogue and inform policy across the transportation, health and environmental sectors.
Policy options for endgame planning in tobacco control: A simulation modelling study
Publisher: BMJ
Date: 19-12-2019
DOI: 10.1136/TOBACCOCONTROL-2019-055126
Abstract: To investigate the potential impacts of several tobacco control interventions on adult daily smoking prevalence in the Australian state of Queensland, using a system dynamics model codeveloped with local and national stakeholders. Eight intervention scenarios were simulated and compared with a reference scenario (business as usual), in which all tobacco control measures currently in place are maintained unchanged until the end of the simulation period (31 December 2037). Under the business as usual scenario, adult daily smoking prevalence is projected to decline from 11.8% in 2017 to 5.58% in 2037. A sustained 50% increase in antismoking advertising exposure from 2018 reduces projected prevalence in 2037 by 0.80 percentage points. Similar reductions are projected with the introduction of tobacco wholesaler and retailer licensing schemes that either permit or prohibit tobacco sales by alcohol-licensed venues (0.65 and 1.73 percentage points, respectively). Increasing the minimum age of legal supply of tobacco products substantially reduces adolescent initiation, but has minimal impact on smoking prevalence in the adult population over the simulation period. Sustained reductions in antismoking advertising exposure of 50% and 100% from 2018 increase projected adult daily smoking prevalence in 2037 by 0.88 and 1.98 percentage points, respectively. These results suggest that any prudent approach to endgame planning should seek to build on rather than replace existing tobacco control measures that have proved effective to date. Additional interventions that can promote cessation are expected to be more successful in reducing smoking prevalence than interventions focussing exclusively on preventing initiation.
Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: a systematic analysis for the Global Burden of Disease Study 2013
Publisher: Elsevier BV
Date: 08-2014
Exercise and life expectancy
Publisher: Elsevier BV
Date: 03-2012
Generalized Cost-Effectiveness Analysis of Pharmaceutical Interventions for Primary Prevention of Cardiovascular Disease in Thailand
Publisher: Elsevier BV
Date: 05-2012
DOI: 10.1016/J.VHRI.2012.03.019
Abstract: To assess the cost-effectiveness of blood pressure (BP)-lowering and cholesterol-lowering drugs for cardiovascular disease (CVD) prevention. We constructed a Markov model in which the Thai population was classified by 10-year absolute CVD risk and modeled the use of BP- and cholesterol-lowering drugs, including a "polypill" (three BP-lowering drugs and a statin). We applied "do-nothing" as the comparator, a health sector perspective on lifetime cost-effectiveness, 3% discounting of costs and effects, and used probabilistic sensitivity analysis. Outcomes are expressed as average and incremental cost-effectiveness in Thai baht per disability-adjusted life-year averted. The polypill would be a very cost-effective option for CVD prevention even in people at modest risk (10-year risk of 5%-9.9%). Use of the three most cost-effective BP drugs is also associated with a net cost saving and large health gain at risk levels greater than 5%. Adding a generic statin gives a price per disability-adjusted life-year of 0.5 (10-year risk at 20%+) to 1.5 (10-year risk at 5%-9.9%) times Thai per-capita gross domestic product using lowest available annual costs. However, at current average drug prices, adding a statin would be considered cost-effective only for those with a 10-year absolute CVD risk of 20% and more. Primary CVD prevention with the polypill or a combination of three generic BP-lowering drugs is very cost-effective in the Thai population.
Corrigendum to “A systematic review of economic analyses of active transport interventions that include physical activity benefits”: (Transport Policy (2016) 45 (190–208) (S0967070X15300639) (10.1016/j.tranpol.2015.10.003))
Publisher: Elsevier BV
Date: 07-2017
Indirect costs of depression and other mental and behavioural disorders for Australia from 2015 to 2030
Publisher: Royal College of Psychiatrists
Date: 05-2019
DOI: 10.1192/BJO.2019.26
Abstract: The impact of mental disorders has been assessed in relation to longevity and quality of life however, mental disorders also have an impact on productive life-years (PLYs). To quantify the long-term costs of Australians aged 45–64 having lost PLYs because of mental disorders. The Survey of Disability, Ageing and Carers 2003, 2009 formed the base population of Health& WealthMOD2030 – a microsimulation model integrating output from the Static Incomes Model, the Australian Population and Policy Simulation Model, the Treasury and the Australian Burden of Disease Study. For depression, in iduals incurred a loss of AU$1062 million in income in 2015, projected to increase to AU$1539 million in 2030 (45% increase). The government is projected to incur costs comprising a 22% increase in social security payments and a 45% increase in lost taxes as a result of depression through its impact on PLYs. Effectiveness of mental health programmes should be judged not only in terms of healthcare use but also quality of life and economic well-being. None.
Estimated health benefits, costs and cost-effectiveness of eliminating dietary industrial trans fatty acids in Kenya: cost-effectiveness analysis
Publisher: BMJ
Date: 10-2023
Processes of care in surgical patients who died with hospital-acquired infections in Australian hospitals
Publisher: Elsevier BV
Date: 05-2018
DOI: 10.1016/J.JHIN.2017.09.001
Abstract: Infection may complicate surgical patients' hospital admission. The effect of hospital-acquired infections (HAIs) on processes of care among surgical patients who died is unknown. To investigate the effect of HAIs on processes of care in surgical patients who died in hospital. Surgeon-recorded infection data extracted from a national Australian surgical mortality audit (2012-2016) were grouped into HAIs and no infection. The audit included all-age surgical patients, who died in hospital. Not all patients had surgery. Excluded from analysis were patients with community-acquired infection and those with missing timing of infection. Multivariate logistic regression was used to determine the adjusted effects of HAIs on the processes of care in these patients. Costs associated with HAIs were estimated. One-fifth of surgical patients who died did so with an HAI (2242 out of 11,681 19.2%). HAI patients had increased processes of care compared to those who died without infection: postoperative complications [51.0% vs 30.3% adjusted odds ratio (aOR): 2.20 95% confidence interval (CI): 1.98-2.45 P < 0.001] unplanned reoperations (22.6% vs 10.9% aOR: 2.38 95% CI: 2.09-2.71 P < 0.001) and unplanned intensive care unit admission (29.3% vs 14.8% aOR: 2.18 95% CI: 1.94-2.45 P < 0.001). HAI patients had longer hospital admissions and greater hospital costs than those without infection. HAIs were associated with increased processes of care and costs in surgical patients who died these outcomes need to be investigated in surgical patients who survive.
The costs of diabetes among Australians aged 45-64 years from 2015 to 2030
Publisher: BMJ
Date: 2017
Physical activity and risk of breast cancer, colon cancer, diabetes, ischemic heart disease, and ischemic stroke events: Systematic review and dose-response meta-analysis for the Global Burden of Disease Study 2013
Publisher: BMJ
Date: 09-08-2016
DOI: 10.1136/BMJ.I3857
Abstract: To quantify the dose-response associations between total physical activity and risk of breast cancer, colon cancer, diabetes, ischemic heart disease, and ischemic stroke events. Systematic review and Bayesian dose-response meta-analysis. PubMed and Embase from 1980 to 27 February 2016, and references from relevant systematic reviews. Data from the Study on Global AGEing and Adult Health conducted in China, Ghana, India, Mexico, Russia, and South Africa from 2007 to 2010 and the US National Health and Nutrition Examination Surveys from 1999 to 2011 were used to map domain specific physical activity (reported in included studies) to total activity. Prospective cohort studies examining the associations between physical activity (any domain) and at least one of the five diseases studied. 174 articles were identified: 35 for breast cancer, 19 for colon cancer, 55 for diabetes, 43 for ischemic heart disease, and 26 for ischemic stroke (some articles included multiple outcomes). Although higher levels of total physical activity were significantly associated with lower risk for all outcomes, major gains occurred at lower levels of activity (up to 3000-4000 metabolic equivalent (MET) minutes/week). For ex le, in iduals with a total activity level of 600 MET minutes/week (the minimum recommended level) had a 2% lower risk of diabetes compared with those reporting no physical activity. An increase from 600 to 3600 MET minutes/week reduced the risk by an additional 19%. The same amount of increase yielded much smaller returns at higher levels of activity: an increase of total activity from 9000 to 12 000 MET minutes/week reduced the risk of diabetes by only 0.6%. Compared with insufficiently active in iduals (total activity <600 MET minutes/week), the risk reduction for those in the highly active category (≥8000 MET minutes/week) was 14% (relative risk 0.863, 95% uncertainty interval 0.829 to 0.900) for breast cancer 21% (0.789, 0.735 to 0.850) for colon cancer 28% (0.722, 0.678 to 0.768) for diabetes 25% (0.754, 0.704 to 0.809) for ischemic heart disease and 26% (0.736, 0.659 to 0.811) for ischemic stroke. People who achieve total physical activity levels several times higher than the current recommended minimum level have a significant reduction in the risk of the five diseases studied. More studies with detailed quantification of total physical activity will help to find more precise relative risk estimates for different levels of activity.
Pharmacy workforce to prevent and manage non-communicable diseases in developing nations: The case of Nepal
Publisher: Elsevier BV
Date: 07-2016
DOI: 10.1016/J.SAPHARM.2015.09.005
Abstract: Non-communicable diseases (NCDs, e.g. cardiovascular diseases, cancer, chronic respiratory diseases and diabetes mellitus) are the main causes of mortality and morbidity in developing countries, including Nepal. Nearly half of the deaths in Nepal are caused by NCDs. Nepal lacks adequate human resources to prevent and manage NCDs, but the skills and expertise of pharmacists in Nepal are underused. There is evidence from many countries that pharmacists can contribute substantially to the prevention and management NCD. We aim to describe the opportunities and challenges for pharmacists to prevent and manage NCDs in Nepal. Pharmacists can contribute by screening and monitoring NCDs counseling on lifestyle providing medication therapy management services promoting public health and providing other pharmaceutical services. Challenges to the implementation of some of these activities in the current context include inadequate training of pharmacists in NCD prevention and management, the cost of pharmaceutical services to patients and government, and the existing health care service delivery model. There is a need for health services research to determine how pharmacists can be best used to prevent and manage NCDs in Nepal.
Health promotion at the workplace setting: A protocol for a systematic review of effectiveness and sustainability of current practice in low-income and middle-income countries
Publisher: BMJ
Date: 05-2019
DOI: 10.1136/BMJOPEN-2018-027050
Abstract: Low-income and middle-income countries (LMICs) are experiencing a growing disease burden due to non-communicable diseases (NCDs). Changing behavioural practices, such as diets high in saturated fat, salt and sugar and sedentary lifestyles, have been associated with the increase in NCDs. Health promotion at the workplace setting is considered effective in the fight against NCDs and has been reported to yield numerous benefits. However, there is a need to generate evidence on the effectiveness and sustainability of workplace health promotion practice specific to LMICs. We aim to synthesise the current literature on workplace health promotion in LMICs focusing on interventions effectiveness and sustainability. We will conduct a systematic review of published studies from LMICs up to 31 March 2019. We will search the following databases: EMBASE, MEDLINE, PubMed, Web of Science, Scopus, ProQuest and CINAHL. Two reviewers will independently screen potential articles for inclusion and disagreements will be resolved by consensus. We will appraise the quality and risk of bias of included studies using two tools from the Cochrane handbook for systematic reviews of interventions. We will present a narrative overview and assessment of the body of evidence derived from the comprehensive review of the studies. The reported outcomes will be summarised by study design, duration, intensity/frequency of intervention delivery and by the six-priority health promotion action areas set out in the Ottawa Charter. We will conduct a thematic analysis to identify the focus areas of current interventions. This systematic review protocol has been prepared according to the Preferred Reporting Items for Systematic reviews and Meta- analyses for Protocols 2015 statement. This study does not require ethics approval. We will disseminate the results of this review through peer-reviewed publications and conference presentations. CRD42018110853.
The indirect costs of ischemic heart disease through lost productive life years for Australia from 2015 to 2030
Publisher: Springer Science and Business Media LLC
Date: 21-06-2019
Let's act on the best available evidence on obesity
Publisher: BMJ
Date: 22-05-2013
DOI: 10.1136/BMJ.F3015
Cost-effectiveness of pharmacotherapy to reduce obesity
Publisher: Public Library of Science (PLoS)
Date: 27-10-2011
Cost-effectiveness of a telephone-delivered intervention for physical activity and diet
Publisher: Public Library of Science (PLoS)
Date: 25-09-2009
Impact of Nonoptimal Intakes of Saturated, Polyunsaturated, and Trans Fat on Global Burdens of Coronary Heart Disease
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 13-01-2016
Abstract: Saturated fat ( SFA ), ω‐6 (n‐6) polyunsaturated fat ( PUFA ), and trans fat ( TFA ) influence risk of coronary heart disease ( CHD ), but attributable CHD mortalities by country, age, sex, and time are unclear. National intakes of SFA , n‐6 PUFA , and TFA were estimated using a Bayesian hierarchical model based on country‐specific dietary surveys food availability data and, for TFA , industry reports on fats/oils and packaged foods. Etiologic effects of dietary fats on CHD mortality were derived from meta‐analyses of prospective cohorts and CHD mortality rates from the 2010 Global Burden of Diseases study. Absolute and proportional attributable CHD mortality were computed using a comparative risk assessment framework. In 2010, nonoptimal intakes of n‐6 PUFA , SFA , and TFA were estimated to result in 711 800 (95% uncertainty interval [UI] 680 700–745 000), 250 900 (95% UI 236 900–265 800), and 537 200 (95% UI 517 600–557 000) CHD deaths per year worldwide, accounting for 10.3% (95% UI 9.9%–10.6%), 3.6%, (95% UI 3.5%–3.6%) and 7.7% (95% UI 7.6%–7.9%) of global CHD mortality. Tropical oil–consuming countries were estimated to have the highest proportional n‐6 PUFA – and SFA ‐attributable CHD mortality, whereas Egypt, Pakistan, and Canada were estimated to have the highest proportional TFA ‐attributable CHD mortality. From 1990 to 2010 globally, the estimated proportional CHD mortality decreased by 9% for insufficient n‐6 PUFA and by 21% for higher SFA, whereas it increased by 4% for higher TFA , with the latter driven by increases in low‐ and middle‐income countries. Nonoptimal intakes of n‐6 PUFA , TFA , and SFA each contribute to significant estimated CHD mortality, with important heterogeneity across countries that informs nation‐specific clinical, public health, and policy priorities.
The potential cost-effectiveness and equity impacts of restricting television advertising of unhealthy food and beverages to Australian children
Publisher: MDPI AG
Date: 15-05-2018
DOI: 10.3390/NU10050622
Improving diet and physical activity to reduce population prevalence of overweight and obesity: An overview of current evidence
Publisher: Elsevier BV
Date: 05-2014
DOI: 10.1016/J.YPMED.2014.02.008
Abstract: The aim of this study is to provide an overview of interventions to reduce or prevent overweight or obesity and improve diet or physical activity. A review of meta-analyses and/or systematic reviews of these interventions in any setting or age group were conducted. Narrative systematic reviews were included for intervention categories with limited meta-analyses available. Summary measures including weighted mean difference, standardised mean difference, and I-squared, were examined. A total of 60 meta-analyses and 23 systematic reviews met the inclusion criteria. Dietary interventions and multi-component interventions targeting overweight and obesity appeared to have the greatest effects, particularly in comparison with workplace or technology or internet-based interventions. Pharmaceutical and surgical interventions produced favourable results for specific population sub-groups (i.e. morbidly obese). Population-wide strategies such as policy interventions have not been widely analysed. The effectiveness of the interventions to assist in maintaining behaviour or weight change remains unclear. Various in idually targeted interventions were shown to reduce body weight, although effect sizes were typically modest, and the durability of effects has been questioned. New approaches to evaluating population-based interventions, such as taxes and regulation, are recommended. Future research modelling the long-term effects of interventions across the lifespan would also be beneficial.
Removing the GST exemption for fresh fruits and vegetables could cost lives
Publisher: AMPCo
Date: 10-2013
DOI: 10.5694/MJA13.11064
Traffic-light nutrition labelling and junk-food tax: A modelled comparison of cost-effectiveness for obesity prevention
Publisher: Springer Science and Business Media LLC
Date: 16-11-2011
DOI: 10.1038/IJO.2010.228
Abstract: Cost-effectiveness analyses are important tools in efforts to prioritise interventions for obesity prevention. Modelling facilitates evaluation of multiple scenarios with varying assumptions. This study compares the cost-effectiveness of conservative scenarios for two commonly proposed policy-based interventions: front-of-pack 'traffic-light' nutrition labelling (traffic-light labelling) and a tax on unhealthy foods ('junk-food' tax). For traffic-light labelling, estimates of changes in energy intake were based on an assumed 10% shift in consumption towards healthier options in four food categories (breakfast cereals, pastries, sausages and preprepared meals) in 10% of adults. For the 'junk-food' tax, price elasticities were used to estimate a change in energy intake in response to a 10% price increase in seven food categories (including soft drinks, confectionery and snack foods). Changes in population weight and body mass index by sex were then estimated based on these changes in population energy intake, along with subsequent impacts on disability-adjusted life years (DALYs). Associated resource use was measured and costed using pathway analysis, based on a health sector perspective (with some industry costs included). Costs and health outcomes were discounted at 3%. The cost-effectiveness of each intervention was modelled for the 2003 Australian adult population. Both interventions resulted in reduced mean weight (traffic-light labelling: 1.3 kg (95% uncertainty interval (UI): 1.2 1.4) 'junk-food' tax: 1.6 kg (95% UI: 1.5 1.7)) and DALYs averted (traffic-light labelling: 45,100 (95% UI: 37,700 60,100) 'junk-food' tax: 559,000 (95% UI: 459,500 676,000)). Cost outlays were AUD81 million (95% UI: 44.7 108.0) for traffic-light labelling and AUD18 million (95% UI: 14.4 21.6) for 'junk-food' tax. Cost-effectiveness analysis showed both interventions were 'dominant' (effective and cost-saving). Policy-based population-wide interventions such as traffic-light nutrition labelling and taxes on unhealthy foods are likely to offer excellent 'value for money' as obesity prevention measures.
Does physical activity prevent cognitive decline and dementia?: A systematic review and meta-analysis of longitudinal studies
Publisher: Springer Science and Business Media LLC
Date: 27-05-2014
Global, Regional, and National Consumption of Sugar-Sweetened Beverages, Fruit Juices, and Milk: A Systematic Assessment of Beverage Intake in 187 Countries
Publisher: Public Library of Science (PLoS)
Date: 05-08-2015
Correction: Modelled health benefits of a sugar-sweetened beverage tax across different socioeconomic groups in Australia: A cost-effectiveness and equity analysis (PLOS Medicine (2017) 14:6 (e1002326) DOI: 10.1371/journal.pmed.1002326)
Publisher: Public Library of Science (PLoS)
Date: 29-07-2020
Annual Research Review: Shifting from ‘normal science’ to neurodiversity in autism science
Publisher: Wiley
Date: 03-11-2021
DOI: 10.1111/JCPP.13534
Abstract: Since its initial description, the concept of autism has been firmly rooted within the conventional medical paradigm of child psychiatry. Increasingly, there have been calls from the autistic community and, more recently, nonautistic researchers, to rethink the way in which autism science is framed and conducted. Neuro ersity, where autism is seen as one form of variation within a ersity of minds, has been proposed as a potential alternative paradigm. In this review, we concentrate on three major challenges to the conventional medical paradigm – an overfocus on deficits, an emphasis on the in idual as opposed to their broader context and a narrowness of perspective – each of which necessarily constrains what we can know about autism and how we are able to know it. We then outline the ways in which fundamental elements of the neuro ersity paradigm can potentially help researchers respond to the medical model’s limitations. We conclude by considering the implications of a shift towards the neuro ersity paradigm for autism science.
Informal caring for back pain
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 24-12-2020
DOI: 10.1097/J.PAIN.0000000000001788
Abstract: This study models the economic costs of informal caring for people with back pain, using a microsimulation model, Care& WorkMOD, from 2015 to 2030. Care& WorkMOD was based on 3 national Australian Surveys of Disability, Ageing and Carers (2003, 2009, 2012) data sets for in iduals aged 15 to 64 years. Estimated national income loss due to caring for people with back pain was AU$258 million in 2015, increasing to $398 million in 2030 (54% increase). Lost income tax revenue to the Australian government due to informal care of people with back pain was estimated to be AU$78 million in 2015, increasing to AU$118 million in 2030 (50% increase), and additional welfare payments were estimated to rise from $132 million in 2015 to AU$180 in 2030 (36% increase). Larger growth in lost income, compared with the increase in welfare payments, means that there would be an increasing income gap between those out of the labour force providing informal care and noncarers who are in the labour force, leading to increased inequality. Informal carers are defined as providers of informal, unpaid assistance to someone with a health condition, for at least 6 months. Informal carers of people with back pain who are out of the labour force incur substantial economic costs. Furthermore, back pain is a large economic burden on national governments. Policies addressing back pain prevention and treatment, and supporting carers, may offset government welfare expenditure, while improving the socioeconomic well-being of carers and patients.
Too early to ditch the campaign
Publisher: BMJ
Date: 25-10-2007
The impact of diabetes on the labour force participation and income poverty of workers aged 45-64 years in Australia
Publisher: Public Library of Science (PLoS)
Date: 20-02-2014
The association between medical students’ lifestyles and their attitudes towards preventive counseling in different countries
Publisher: Springer Science and Business Media LLC
Date: 14-11-2015
Population attributable fraction: Names, types and issues with incorrect interpretation of relative risks
Publisher: BMJ
Date: 08-03-2018
Intellectual disability and autism
Publisher: Royal College of Psychiatrists
Date: 16-09-2019
DOI: 10.1192/BJP.2019.204
Abstract: Intellectual disability and autism spectrum disorder (ASD) influence the interactions of a person with their environment and generate economic and socioeconomic costs for the person, their family and society. To estimate costs of lost workforce participation due to informal caring for people with intellectual disability or autism spectrum disorders by estimating lost income to in iduals, lost taxation payments to federal government and increased welfare payments. We used a microsimulation model based on the Australian Bureau of Statistics' Surveys of Disability, Ageing and Carers (population surveys of people aged 15–64), and projected costs of caring from 2015 in 5-year intervals to 2030. The model estimated that informal carers of people with intellectual disability and/or ASD in Australia had aggregated lost income of AU$310 million, lost taxation of AU$100 million and increased welfare payments of AU$204 million in 2015. These are projected to increase to AU$432 million, AU$129 million and AU$254 million for income, taxation, and welfare respectively by 2030. The income gap of carers for people with intellectual disability and/or ASD is estimated to increase by 2030, meaning more financial stress for carers. Informal carers of people with intellectual disability and/or ASD experience significant loss of income, leading to increased welfare payments and reduced taxation revenue for governments these are all projected to increase. Strategic policies supporting informal carers wishing to return to work could improve the financial and psychological impact of having a family member with intellectual disability and/or ASD. None.
Health services costs for cancer care in Australia: Estimates from the 45 and Up Study
Publisher: Public Library of Science (PLoS)
Date: 30-07-2018
Cost-effectiveness of interventions for reducing road traffic injuries related to driving under the influence of alcohol
Publisher: Elsevier BV
Date: 2013
DOI: 10.1016/J.JVAL.2012.08.2209
Abstract: To determine the cost-effectiveness of interventions to reduce road traffic injuries caused by driving under the influence of alcohol in Thailand. We used generalized cost-effectiveness analysis and included costs from a health sector perspective. The model considered road traffic crash victims who were injured, disabled, or died. We obtained proportions of alcohol-related crashes from the Thai Injury Surveillance system. Intervention effectiveness was derived from published reviews and a study in one province of Thailand. Random breath testing, selective breath testing, and mass media c aigns, both current and intervention scenarios, were compared with a "do-nothing" scenario. We calculated intervention costs and cost offsets of prevented treatment costs in 2004 Thai baht (US $1 = 41 baht) and measured benefits in terms of disability-adjusted life-years averted. Interventions with incremental cost-effectiveness ratios below 110,000 Thai baht (1×gross domestic product per capita) per disability-adjusted life-year (US $2,680) were considered very cost-effective. Compared with doing nothing, mass media c aigns, random breath testing, and selective breath testing are all cost saving. When averted treatment costs are ignored and only intervention costs are included, all three interventions are very cost-effective, with incremental cost-effectiveness ratios of 10,300, 14,300 and 13,000 baht/disability-adjusted life-year, respectively. The current mix of mass media c aigns and sobriety checkpoints is therefore also cost-effective, but underinvestment in checkpoints limits its overall effect. A greater intensity of conducting sobriety checkpoints in Thailand is recommended to complement the investment in mass media c aigns. Together these interventions have the potential to reduce the burden of alcohol-related road traffic injuries by 24%.
Obesity related illness: Beware swallowing whole
Publisher: BMJ
Date: 23-11-2010
DOI: 10.1136/BMJ.C6660
Priority-setting for obesity prevention—The Assessing Cost-Effectiveness of obesity prevention policies in Australia (ACE-Obesity Policy) study
Publisher: Public Library of Science (PLoS)
Date: 19-06-2020
Joint prevalence and control of hypercholesterolemia and hypertension in Thailand: Third national health examination survey
Publisher: SAGE Publications
Date: 03-08-2012
Abstract: The prevalence, diagnosis, treatment, and control of hypercholesterolemia and/or hypertension were estimated for Thailand using data from a recent, nationally representative health examination survey. Multivariate logistic regression was used to assess factors associated with diagnosis, treatment, and control. In all, 14% of men and 17% of women had hypercholesterolemia, 23% and 21% had hypertension, and 5% and 6%, respectively, had both. A large proportion of in iduals with these risk factors is neither diagnosed nor treated, let alone adequately controlled 30% of people with hypertension had been diagnosed and 24% treated, and 9% had their blood pressure controlled. The figures for hypercholesterolemia were 13%, 9%, and 6%, respectively. Those for both risk factors combined were below 15% and did not differ by sex, urbanicity, age, or marital status. Among men, education correlated with diagnosis and treatment odds. There is great scope for improved prevention of cardiovascular disease in Thailand.
Interventions for the prevention of cardiovascular diseases: A protocol for a systematic review of economic evaluations in low-income and middle-income countries
Publisher: BMJ
Date: 12-2016
The Cost-Effectiveness of Laparoscopic Adjustable Gastric Banding in the Morbidly Obese Adult Population of Australia
Publisher: Public Library of Science (PLoS)
Date: 22-05-2013
The national burden of road traffic injuries in Thailand
Publisher: Springer Science and Business Media LLC
Date: 18-01-2011
Exploring the association between BMI and mortality in Australian women and men with and without diabetes: the AusDiab study
Publisher: Springer Science and Business Media LLC
Date: 26-02-2019
Living well after breast cancer randomized controlled trial protocol: evaluating a telephone-delivered weight loss intervention versus usual care in women following treatment for breast cancer
Publisher: Springer Science and Business Media LLC
Date: 28-10-2016
Economic costs of informal care for people with chronic diseases in the community: Lost income, extra welfare payments, and reduced taxes in Australia in 2015-2030
Publisher: Hindawi Limited
Date: 30-10-2019
DOI: 10.1111/HSC.12670
Abstract: We estimated the economic costs of informal care in the community from 2015 to 2030, using an Australian microsimulation model, Care&WorkMOD. The model was based on data from three Surveys of Disability, Ageing, and Carers (SDACs) for the Australian population aged 15-64 years old. Estimated national income lost was AU$3.58 billion in 2015, increasing to $5.33 billion in 2030 (49% increase). Lost tax payments were estimated at AU$0.99 billion in 2015, increasing to AU$1.44 billion in 2030 (45% increase), and additional welfare payments were expected to rise from $1.45 billion in 2015 to AU$1.94 in 2030 (34% increase). There are substantial economic costs both to informal carers and the government due to carers being out of the labour-force to provide informal care for people with chronic diseases. Health and social policies supporting carers to remain in the labour force may allow governments to make substantial savings, while improving the economic situation of carers.
Impact of Nonoptimal Intakes of Saturated, Polyunsaturated, and Trans Fat on Global Burdens of Coronary Heart Disease
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 13-01-2016
Estimation and determinants of direct medical costs of ischaemic heart disease, stroke and hypertensive heart disease: evidence from two major hospitals in Cameroon
Publisher: Springer Science and Business Media LLC
Date: 12-02-2021
DOI: 10.1186/S12913-021-06146-4
Abstract: Cardiovascular disease (CVD) is the largest contributor to the non-communicable diseases (NCD) burden in Cameroon, but data on its economic burden is lacking. A prevalence-based cost-of-illness study was conducted from a healthcare provider perspective and enrolled patients with ischaemic heart disease (IHD), ischaemic stroke, haemorrhagic stroke and hypertensive heart disease (HHD) from two major hospitals between 2013 and 2017. Determinants of cost were explored using multivariate generalized linear models. Overall, data from 850 patients: IHD ( n = 92, 10.8%), ischaemic stroke ( n = 317, 37.3%), haemorrhagic stroke ( n = 193, 22.7%) and HHD ( n = 248, 29.2%) were analysed. The total cost for these CVDs was XAF 676,694,000 (~US$ 1,224,918). The average annual direct medical costs of care per patient were XAF 1,395,200 (US$ 2400) for IHD, XAF 932,700 (US$ 1600) for ischaemic stroke, XAF 815,400 (US$ 1400) for haemorrhagic stroke, and XAF 384,300 (US$ 700) for HHD. In the fully adjusted models, apart from history of CVD event (β = − 0.429 95% confidence interval − 0.705, − 0.153) that predicted lower costs in patients with IHD, having of diabetes mellitus predicted higher costs in patients with IHD (β = 0.435 0.098, 0.772), ischaemic stroke (β = 0.188 0.052, 0.324) and HHD (β = 0.229 0.080, 0.378). This study reveals substantial economic burden due to CVD in Cameroon. Diabetes mellitus was a consistent driver of elevated costs across the CVDs. There is urgent need to invest in cost-effective primary prevention strategies in order to reduce the incidence of CVD and consequent economic burden on a health system already laden with the impact of communicable diseases.
By how much would limiting TV food advertising reduce childhood obesity
Publisher: Oxford University Press (OUP)
Date: 26-03-2009
The long-term economic impacts of arthritis through lost productive life years
Publisher: Springer Science and Business Media LLC
Date: 24-05-2018
African Programme for Onchocerciasis Control 1995–2015: Updated Health Impact Estimates Based on New Disability Weights
Publisher: Public Library of Science (PLoS)
Date: 05-06-2014
The Population Mean Mood Predicts The Prevalence of Depression in an Australian Context
Publisher: SAGE Publications
Date: 16-11-2018
Abstract: The mean population mood has been demonstrated to strongly correlate with the prevalence of depression in European populations. Mean population mood has, therefore, been proposed as both a metric to measure the impact of population-level interventions to prevent depression and a target for public health policy. To demonstrate the relationship between mean population mood and the prevalence of depression using Australian data in order to broaden the applicability of this finding to the Australian population. We used data from the Geelong Osteoporosis Study to assess the relationship between population mean mood and depression. Participants reported mood symptoms via questionnaire (the Hospital Anxiety and Depression Scale or General Health Questionnaire-12). Depression was diagnosed by semi-structured clinical interview ( Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Non-patient Edition). Stratification by age and socio-economic status was used to create subpopulation groups. Socio-economic status was measured using Index of Relative Socio-economic Advantage and Disadvantage quintiles, an area-based measure based on Australian census data and published by the Australian Bureau of Statistics. The mean subpopulation questionnaire scores and subpopulation prevalence of depression were then analysed using regression and predictive models. Mean subpopulation questionnaire scores correlated well with the prevalence of depression across socio-economic status groups in women but not age groups. Questionnaire scores tended to underestimate the prevalence of depression in the young and overestimate it in the elderly. The mean population mood was demonstrated to correlate with the population prevalence of depression in Australia for women, but not for men. Due to the issues of questionnaire validity and s le size in the oldest age groups, the age analysis is unlikely to be a representative of population characteristics. Further work to identify population determinants of mean mood could potentially create policy targets to reduce the prevalence of depression.
Mercury Sorption and Desorption on Gold: A Comparative Analysis of Surface Acoustic Wave and Quartz Crystal Microbalance-Based Sensors
Publisher: American Chemical Society (ACS)
Date: 23-07-2015
DOI: 10.1021/ACS.LANGMUIR.5B01858
Abstract: Microelectromechanical sensors based on surface acoustic wave (SAW) and quartz crystal microbalance (QCM) transducers possess substantial potential as online elemental mercury (Hg(0)) vapor detectors in industrial stack effluents. In this study, a comparison of SAW- and QCM-based sensors is performed for the detection of low concentrations of Hg(0) vapor (ranging from 24 to 365 ppbv). Experimental measurements and finite element method (FEM) simulations allow the comparison of these sensors with regard to their sensitivity, sorption and desorption characteristics, and response time following Hg(0) vapor exposure at various operating temperatures ranging from 35 to 75 °C. Both of the sensors were fabricated on quartz substrates (ST and AT cut quartz for SAW and QCM devices, respectively) and employed thin gold (Au) layers as the electrodes. The SAW-based sensor exhibited up to ∼111 and ∼39 times higher response magnitudes than did the QCM-based sensor at 35 and 55 °C, respectively, when exposed to Hg(0) vapor concentrations ranging from 24 to 365 ppbv. The Hg(0) sorption and desorption calibration curves of both sensors were found to fit well with the Langmuir extension isotherm at different operating temperatures. Furthermore, the Hg(0) sorption and desorption rate demonstrated by the SAW-based sensor was found to decrease as the operating temperature increased, while the opposite trend was observed for the QCM-based sensor. However, the SAW-based sensor reached the maximum Hg(0) sorption rate faster than the QCM-based sensor regardless of operating temperature, whereas both sensors showed similar response times (t90) at various temperatures. Additionally, the sorption rate data was utilized in this study in order to obtain a faster response time from the sensor upon exposure to Hg(0) vapor. Furthermore, comparative analysis of the developed sensors' selectivity showed that the SAW-based sensor had a higher overall selectivity (90%) than did the QCM counterpart (84%) while Hg(0) vapor was measured in the presence of ammonia (NH3), humidity, and a number of volatile organic compounds at the chosen operating temperature of 55 °C.
The impact on productivity of a hypothetical tax on sugar-sweetened beverages
Publisher: Elsevier BV
Date: 06-2017
DOI: 10.1016/J.HEALTHPOL.2017.04.001
Abstract: To quantify the potential impact of an additional 20% tax on sugar-sweetened beverages (SSBs) on productivity in Australia. We used a multi-state lifetable Markov model to examine the potential impact of an additional 20% tax on SSBs on total lifetime productivity in the paid and unpaid sectors of the economy. The study population consisted of Australians aged 20 years or older in 2010, whose health and other relevant outcomes were modelled over their remaining lifetime. The SSBs tax was estimated to reduce the number of people with obesity by 1.96% of the entire population (437,000 fewer persons with obesity), and reduce the number of employees with obesity by 317,000 persons. These effects translated into productivity gains in the paid sector of AU$751 million for the working-age population (95% confidence interval: AU$565 million to AU$954 million), using the human capital approach. In the unpaid sector, the potential productivity gains amounted to AU$1172 million (AU$929 million to AU$1435 million) using the replacement cost method. These productivity benefits are in addition to the health benefits of 35,000 life years gained and a reduction in healthcare costs of AU$425 million. An additional 20% tax on SSBs not only improves health outcomes and reduces healthcare costs, but provides productivity gains in both the paid and unpaid sectors of the economy.
The role of cost-effectiveness analysis in developing nutrition policy
Publisher: Annual Reviews
Date: 17-07-2013
DOI: 10.1146/ANNUREV-NUTR-071812-161133
Abstract: Concern about the overconsumption of unhealthy foods is growing worldwide. With high global rates of noncommunicable diseases related to poor nutrition and projections of more rapid increases of rates in low- and middle-income countries, it is vital to identify effective but low-cost interventions. Cost-effectiveness studies show that in idually targeted dietary interventions can be effective and cost-effective, but a growing number of modeling studies suggest that population-wide approaches may bring larger and more sustained benefits for population health at a lower cost to society. Mandatory regulation of salt in processed foods, in particular, is highly recommended. Future research should focus on lacunae in the current evidence base: effectiveness of interventions addressing the marketing, availability, and price of healthy and unhealthy foods modeling health impacts of complex dietary changes and multi-intervention strategies and modeling health implications in erse subpopulations to identify interventions that will most efficiently and effectively reduce health inequalities.
The health and economic impact and cost effectiveness of interventions for the prevention and control of overweight and obesity in Kenya: a stakeholder engaged modelling study
Publisher: Springer Science and Business Media LLC
Date: 21-09-2023
Does active transport displace other physical activity? A systematic review of the evidence
Publisher: Elsevier BV
Date: 07-2023
Contribution of Trans-Fatty Acid Intake to Coronary Heart Disease Burden in Australia: A Modelling Study
Publisher: MDPI AG
Date: 18-01-2017
DOI: 10.3390/NU9010077
Stakeholder-engaged research: strategies for the prevention and control of overweight and obesity in Kenya
Publisher: Springer Science and Business Media LLC
Date: 06-09-2021
DOI: 10.1186/S12889-021-11649-0
Abstract: This study was done as part of a larger study that aims to identify the most impactful and cost-effective strategies for the prevention and control of overweight and obesity in Kenya. Our objective was to involve stakeholders in the identification of the strategies that would be included in our larger study. The results from the stakeholder engagement are analyzed and reported in this paper. This was a qualitative study. A one-day stakeholder workshop that followed a deliberative dialogue process was conducted. A s le of stakeholders who participate in the national level policymaking process for health in Kenya. Strategies for the prevention and control of overweight and obesity in Kenya. Out of the twenty-three stakeholders who confirmed attendance, fifteen participants attended the one-day workshop. The stakeholders identified a total of 24 strategies for the prevention and control of overweight and obesity in Kenya. From the ranking process carried out the top six strategies identified were: a research-based strategy for the identification of the nutritional value of indigenous foods, implementation of health promotion strategies that focus on the creation of healthy environments, physical activity behavior such as gym attendance, jogging, walking, and running at the in idual level, implementation of school curricula on nutrition and health promotion, integration of physical education into the new Competency-Based Education policy, and policies that increase use of public transport. The stakeholders identified and ranked strategies for the prevention and control of overweight and obesity in Kenya. This informs future overweight and obesity prevention research and policy in Kenya and similar settings.
Feasibility, effectiveness and cost-effectiveness of a telephone-based weight loss program delivered via a hospital outpatient setting
Publisher: Oxford University Press (OUP)
Date: 14-08-2016
On the futility of screening for genes that make you fat
Publisher: Public Library of Science (PLoS)
Date: 11-2011
Modelled health benefits of a sugar-sweetened beverage tax across different socioeconomic groups in Australia: A cost-effectiveness and equity analysis
Publisher: Public Library of Science (PLoS)
Date: 27-06-2017
Physical activity-related health and economic benefits of building walkable neighbourhoods: A modelled comparison between brownfield and greenfield developments
Publisher: Springer Science and Business Media LLC
Date: 20-02-2019
The impact of sugared drink taxation and industry response
Publisher: Elsevier BV
Date: 2017
The indirect costs of back problems (dorsopathies) in Australians aged 45 to 64 years from 2015 to 2030
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 15-09-2016
DOI: 10.1097/J.PAIN.0000000000000715
Abstract: This study projected the indirect costs of back problems through lost productive life years (PLYs) from the in idual's perspective (lost disposable income), the governmental perspective (reduced taxation revenue, greater welfare spending), and the societal perspective (lost gross domestic product, GDP) from 2015 to 2030, using Health& WealthMOD2030—Australia's first microsimulation model on the long-term impacts of ill-health. Quantile regression analysis was used to examine differences in median weekly income, welfare payments, and taxes of people unable to work due to back problems with working full-time without back problems as comparator. National costs and lost GDP resulting from missing workers due to back problems were also projected. We projected that 90,000 people have lost PLYs due to back problems in 2015, increasing to 104,600 in 2030 (16.2% increase). People with lost PLYs due to back problems are projected to receive AU$340.91 less in total income and AU$339.77 more in welfare payments per week than full-time workers without back problems in 2030 and pay no income tax on average. National costs consisted of a loss of AU$2931 million in annual income in 2015, increasing to AU$4660 million in 2030 (60% increase). For government, extra annual welfare payments are projected to increase from AU$1462 million in 2015 to AU$1709 million in 2030 (16.9% increase), and lost annual taxation revenue to increase from AU$671 million in 2015 to $961 million in 2030 (43.2% increase). We projected losses in GDP of AU$10,543 million in 2015, increasing to AU$14,522 million in 2030 due to back problems.
Health-related quality of life (HRQL) among methamphetamine users in treatment
Publisher: Informa UK Limited
Date: 08-2013
Forecasting the quantity and cost of medicines to treat non-communicable diseases in low- and middle-income countries: Applying knowledge on medicine use from developed countries
Publisher: Elsevier BV
Date: 2017
Effectiveness of school-based nutrition interventions in sub-Saharan Africa: a systematic review
Publisher: Cambridge University Press (CUP)
Date: 10-07-2020
DOI: 10.1017/S1368980020000506
Abstract: To evaluate the effect of school-based nutrition interventions (SBNI) involving schoolchildren and adolescents in sub-Saharan Africa (SSA) on child nutrition status and nutrition-related knowledge, attitudes and behaviour. A systematic review on published school nutrition intervention studies of randomised controlled trials, controlled clinical trials, controlled before-and-after studies or quasi-experimental designs with control. Nine electronic bibliographic databases were searched. To be included, interventions had to involve changes to the school’s physical and social environments, to the school’s nutrition policies, to teaching curriculum to incorporate nutrition education and/or to partnership with parents/community. Schools in SSA. School-aged children and adolescents, aged 5–19 years. Fourteen studies met our inclusion criteria. While there are few existing studies of SBNI in SSA, the evidence shows that food supplementation/fortification is very effective in reducing micronutrient deficiencies and can improve nutrition status. Secondly, school nutrition education can improve nutrition knowledge, but this may not necessarily translate into healthy nutrition behaviour, indicating that nutrition knowledge may have little impact without a facilitating environment. Results regarding anthropometry were inconclusive however, there is evidence for the effectiveness of SBNI in improving cognitive abilities. There is enough evidence to warrant further trials of SBNI in SSA. Future research should consider investigating the impact of SBNI on anthropometry and nutrition behaviour, focusing on the role of programme intensity and/or duration. To address the high incidence of micronutrient deficiencies in low- and middle-income countries, food supplementation strategies currently available to schoolchildren should be expanded.
Modelling the potential impact of a sugar-sweetened beverage tax on stroke mortality, costs and health-adjusted life years in South Africa
Publisher: Springer Science and Business Media LLC
Date: 31-05-2016
Stemming the obesity epidemic: A tantalizing prospect
Publisher: Wiley
Date: 09-2007
DOI: 10.1038/OBY.2007.280
Abstract: Obesity is a growing problem worldwide, but there are no good methods to assess the future course of the epidemic and the potential influence of interventions. We explore the behavior change needed to stop the obesity epidemic in the U.S. We modeled the population distribution of BMI as a log-normal curve of which the mean shifts upward with time due to a positive population energy balance. Interventions that decrease food intake or increase physical activity result in more favorable trends in BMI. The recently observed trend in average BMI implies that the average U.S. adult over-consumes by approximately 10 kcal/d. If this trend continues unaltered, obesity prevalence will exceed 40% for men and 45% for women in 2015. To stop the epidemic, it suffices to decrease caloric consumption by approximately 10 kcal or walk an extra 2 to 3 minutes per day, on average. This leads to a paradox: little behavior change seems sufficient to halt the epidemic, but in practice this proves hard to achieve. The obesogenic environment is the likely culprit. In iduals trying to maintain a healthy weight need to be supported by environments that stimulate physical activity and do not encourage over-consumption. Research should show what measures are effective.
Environmental Contributions to the Leading Causes of Disease Burden Among Australian Children
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 05-2013
Individual and national financial impacts of informal caring for people with mental illness in Australia, projected to 2030
Publisher: Royal College of Psychiatrists
Date: 07-2022
DOI: 10.1192/BJO.2022.540
Abstract: Mental illness has a significant impact not only on patients, but also on their carers’ capacity to work. To estimate the costs associated with lost labour force participation due to the provision of informal care for people with mental illness in Australia, such as income loss for carers and lost tax revenue and increased welfare payments for government, from 2015 to 2030. The output data of a microsimulation model Care& WorkMOD were analysed to project the financial costs of informal care for people with mental illness, from 2015 to 2030. Care& WorkMOD is a population-representative microsimulation model of the Australian population aged between 15 and 64 years, built using the Australian Bureau of Statistics Surveys of Disability, Ageing and Carers data and the data from other population-representative microsimulation models. The total annual national loss of income for all carers due to caring for someone with mental illness was projected to rise from AU$451 million (£219.6 million) in 2015 to AU$645 million (£314 million) in 2030 in real terms. For the government, the total annual lost tax revenue was projected to rise from AU$121 million (£58.9 million) in 2015 to AU$170 million (£82.8 million) in 2030 and welfare payments to increase from AU$170 million (£82.8 million) to AU$220 million (£107 million) in 2030. The costs associated with lost labour force participation due to the provision of informal care for people with mental illness are projected to increase for both carers and government, with a widening income gap between informal carers and employed non-carers, putting carers at risk of increased inequality.
Estimated health benefits, costs, and cost-effectiveness of eliminating industrial trans-fatty acids in Australia: A modelling study
Publisher: Public Library of Science (PLoS)
Date: 02-11-2020
Cost-effectiveness of Weight Watchers and the Lighten Up to a Healthy Lifestyle program
Publisher: Elsevier BV
Date: 06-2010
DOI: 10.1111/J.1753-6405.2010.00520.X
Abstract: Intensive weight loss programs that incorporate dietary counselling and exercise advice are popular and are supported by evidence of immediate weight loss benefits. We evaluate the cost-effectiveness of two weight loss programs, Lighten Up to a Healthy Lifestyle and Weight Watchers. Health gains from prevention of chronic disease are modelled over the lifetime of the Australian population. These results are combined with estimates of intervention costs and cost offsets (due to reduced rates of lifestyle-related diseases) to determine the dollars per disability-adjusted life year (DALY) averted by each intervention program, from an Australian health sector perspective. Both weight loss programs produced small improvements in population health compared to current practice. The time and travel associated with attending group-counselling sessions, however, was costly for patients, and overall the cost-effectiveness ratios for Lighten Up ($130,000/DALY) and Weight Watchers ($140,000/DALY) were high. Based on current evidence, these intensive behavioural counselling interventions are not very cost-effective strategies for reducing obesity, and the potential benefits for population health are small. It will be critical to consider other strategies (e.g. changing the 'obesogenic' environment) or explore alternative methods of intervention delivery (e.g. Internet) to see if they offer a more cost-effective approach by effectively reaching a high number of people at a low cost.
Dietary Salt Reduction, Prevalence of Hypertension and Avoidable Burden of Stroke in Vietnam: Modelling the Health and Economic Impacts
Publisher: Frontiers Media SA
Date: 04-06-2021
DOI: 10.3389/FPUBH.2021.682975
Abstract: Dietary salt reduction has been recommended as a cost-effective population-wide strategy to prevent cardiovascular disease. The health and economic impact of salt consumption on the future burden of stroke in Vietnam is not known. Objective: To estimate the avoidable incidence of and deaths from stroke, as well as the healthy life years and healthcare costs that could be gained from reducing salt consumption in Vietnam. Methods: This was a macrosimulation health and economic impact assessment study. Data on blood pressure, salt consumption and stroke epidemiology were obtained from the Vietnam 2015 STEPS survey and the Global Burden of Disease study. A proportional multi-cohort multistate lifetable Markov model was used to estimate the impact of achieving the Vietnam national salt targets of 8 g/day by 2025 and 7 g/day by 2030, and to the 5 g/day WHO recommendation by 2030. Probabilistic sensitivity analysis was conducted to quantify the uncertainty in our projections. Results: If the 8 g/day, 7 g/day, and 5 g/day targets were achieved, the prevalence of hypertension could reduce by 1.2% (95% uncertainty interval [UI]: 0.5 to 2.3), 2.0% (95% UI: 0.8 to 3.6), and 3.5% (95% UI: 1.5 to 6.3), respectively. This would translate, respectively, to over 80,000, 180,000, and 257,000 incident strokes and over 18,000, 55,000, and 73,000 stroke deaths averted. By 2025, over 56,554 stroke-related health-adjusted life years (HALYs) could be gained while saving over US$ 42.6 million in stroke healthcare costs. By 2030, about 206,030 HALYs (for 7 g/day target) and 262,170 HALYs (for 5 g/day target) could be gained while saving over US$ 88.1 million and US$ 122.3 million in stroke healthcare costs respectively. Conclusion: Achieving the national salt reduction targets could result in substantial population health and economic benefits. Estimated gains were larger if the WHO salt targets were attained and if changes can be sustained over the longer term. Future work should consider the equity impacts of specific salt reduction programs.
The productivity gains associated with a junk food tax and their impact on cost-effectiveness
Publisher: Public Library of Science (PLoS)
Date: 22-07-2019
The impact of a tax on sugar-sweetened beverages on health and health care costs: A modelling study
Publisher: Public Library of Science (PLoS)
Date: 13-04-2016
The Potential Impact of a 20% Tax on Sugar-Sweetened Beverages on Obesity in South African Adults: A Mathematical Model
Publisher: Public Library of Science (PLoS)
Date: 19-08-2014
What is the best practice method for quantifying the health and economic benefits of active transport?
Publisher: MDPI AG
Date: 26-08-2020
Abstract: The aim of this study was to identify a best practice method to cost the health benefits of active transport for use in infrastructure planning in New South Wales, Australia. We systematically reviewed the international literature covering the concept areas of active transport and cost and health benefits. Original publications describing a method to cost the health benefits of active transport, published in 2000–2019 were included. Studies meeting the inclusion criteria were assessed against criteria identified in interviews with key government stakeholders. A total of 2993 studies were identified, 53 were assessed for eligibility, and 19 were included in the review. The most commonly studied active transport modes were cycling (n = 8) and walking and cycling (n = 6). Exposures considered were physical activity, road transport related injuries and air pollution. The most often applied economic evaluation method was cost benefit analysis (n = 8), and costs were commonly calculated by monetising health outcomes. Based on evaluation of models against the criteria, a Multistate Life Table model was recommended as the best method currently available. There is strong and increasing interest in quantifying and costing the health benefits of active transport internationally. Incorporating health-related economic benefits into existing regulatory processes such as cost benefit analyses could provide an effective way to encourage the non-health sector to include health impacts in infrastructure measures.
Population awareness of cardiovascular disease and its risk factors in Buea, Cameroon
Publisher: Springer Science and Business Media LLC
Date: 05-06-2017
The Potential Impact of Physical Activity on the Burden of Osteoarthritis and Low Back Pain in Australia: A Systematic Review of Reviews and Life Table Analysis
Publisher: Human Kinetics
Date: 08-2023
Abstract: Objective : The objectives were (1) to establish the strength of the association between incident cases of osteoarthritis (OA) and low back pain (LBP), and physical activity (PA) and to assess the likelihood of the associations being causal and (2) to quantify the impact of PA on the burden of OA and LBP in Australia. Methods : We conducted a systematic literature review in EMBASE and PubMed databases from January 01, 2000, to April 28, 2020. We used the Bradford Hill viewpoints to assess causality. We used a proportional multistate life table model to estimate the impact of changes in the PA levels on OA and LBP burdens for the 2019 Australian population (aged ≥ 20 y) over their remaining lifetime. Results : We found that both OA and LBP are possibly causally related to physical inactivity. Assuming causality, our model projected that if the 2025 World Health Organization global target for PA was met, the burden in 25 years’ time could be reduced by 70,000 prevalent cases of OA and over 11,000 cases of LBP. Over the lifetime of the current adult population of Australia, the gains could add up to approximately 672,814 health-adjusted life years (HALYs) for OA (ie, 27 HALYs per 1000 persons) and 114,042 HALYs for LBP (ie, 5 HALYs per 1000 persons). The HALY gains would be 1.4 times bigger if the 2030 World Health Organization global target for PA was achieved and 11 times bigger if all Australians adhered to the Australian PA guidelines. Conclusion : This study provides empirical support for the adoption of PA in strategies for the prevention of OA and back pain.
Use of Healthcare Services by Patients with Non-Communicable Diseases in Nepal: A Qualitative Study with Healthcare Providers.
Publisher: JCDR Research and Publications
Date: 2017
The global burden attributable to low bone mineral density
Publisher: BMJ
Date: 04-2014
DOI: 10.1136/ANNRHEUMDIS-2013-204320
Abstract: The Global Burden of Disease Study 2010 estimated the worldwide health burden of 291 diseases and injuries and 67 risk factors by calculating disability-adjusted life years (DALYs). Osteoporosis was not considered as a disease, and bone mineral density (BMD) was analysed as a risk factor for fractures, which formed part of the health burden due to falls. To calculate (1) the global distribution of BMD, (2) its population attributable fraction (PAF) for fractures and subsequently for falls, and (3) the number of DALYs due to BMD. A systematic review was performed seeking population-based studies in which BMD was measured by dual-energy X-ray absorptiometry at the femoral neck in people aged 50 years and over. Age- and sex-specific mean ± SD BMD values (g/cm(2)) were extracted from eligible studies. Comparative risk assessment methodology was used to calculate PAFs of BMD for fractures. The theoretical minimum risk exposure distribution was estimated as the age- and sex-specific 90th centile from the Third National Health and Nutrition Examination Survey (NHANES III). Relative risks of fractures were obtained from a previous meta-analysis. Hospital data were used to calculate the fraction of the health burden of falls that was due to fractures. Global deaths and DALYs attributable to low BMD increased from 103 000 and 3 125 000 in 1990 to 188 000 and 5 216 000 in 2010, respectively. The percentage of low BMD in the total global burden almost doubled from 1990 (0.12%) to 2010 (0.21%). Around one-third of falls-related deaths were attributable to low BMD. Low BMD is responsible for a growing global health burden, only partially representative of the real burden of osteoporosis.
Cost-effectiveness of investing in sidewalks as a means of increasing physical activity: a RESIDE modelling study
Publisher: BMJ
Date: 09-2016
Prevalence and characteristics of energy intake under-reporting among Australian adults in 1995 and 2011 to 2012
Publisher: Wiley
Date: 30-06-2019
Abstract: Misreporting of energy intake is a common source of measurement error found in dietary surveys, resulting in biased estimates and a reduction in statistical power. The present study aims to refine the conventional cut-off methods and to examine the extent to which Australian adults misreport their energy intake, and the characteristics of under-reporters between two time points. A revised Goldberg cut-off approach was used to identify those who reported implausible intake amounts in a secondary analysis of two large cross-sectional surveys. Identified low energy reporters were then used as the outcome variable in Poisson regressions to examine association with sex, age, body mass index (BMI), weight perceptions, education, relative household income, geographic remoteness and relative socioeconomic disadvantage. The prevalence of under-reporting increased from 32% in 1995 to 41% in 2012, most of which can be attributed to an increase in men. Under-reporting has a positive association with BMI and relative socioeconomic disadvantage, but an inverse association with age, education, relative household income and residence in inner regional areas. Under-reporting of energy intake is high in Australian adults, and appears have worsened over time in men, which could be partly explained by the upward trend in obesity. The use of conventional Goldberg method to identify under-reporters can greatly underestimate the prevalence of under-reporting, future studies should consider selecting a lower critical value to improve accuracy.
Availability, Price, and Affordability of Essential Medicines to Manage Noncommunicable Diseases: A National Survey From Nepal
Publisher: SAGE Publications
Date: 2019
Abstract: The aim of this study was to evaluate the availability, price, and affordability of essential noncommunicable disease (NCD) medicines in Nepal. A cross-sectional survey was conducted in Nepal in 2015 using World Health Organization/Health Action International (WHO/HAI) methodology. We collected data on the availability and price of 60 essential NCD medicines from medicine distribution outlets in both the public and private health care sectors in 6 regions. Essential NCD medicines were more available in the private sector (78%) than the public sector (60%). Furosemide tablets were the cheapest (NPR 0.6/10 tablets) and streptokinase injections were the most expensive (NPR 2200/vial) drugs. There was no significant difference ( P .05) in availability and affordability of essential NCD medicines across the 6 survey areas. Treating selected NCD conditions with medicines was generally affordable, with 1 month of treatment costing no more than a day’s wage of the lowest paid unskilled government worker. The lower availability of NCD medicines in the public sector limits the effectiveness of the government’s policy of providing free health services at public facilities. Although NCD medicines were generally affordable, future health policy should aim to ensure improved equitable access to NCD medicines, particularly in public facilities.
Categorical versus continuous risk factors and the calculation of potential impact fractions
Publisher: BMJ
Date: 19-08-2010
Abstract: The potential impact fraction is a measure of effect that calculates the proportional change in disease risk after a change in the exposure of a related risk factor. Potential impact fractions are increasingly used to calculate attributable fractions when the lowest exposure is non-zero. Risk-factor exposure can be expressed as a categorical or a continuous variable. For a categorical risk factor, a change in risk-factor exposure can be expressed as a change in the proportion of the population in each category ('proportions shift'). For a continuous risk factor, the change is expressed as a change in its parameters ('distribution shift'). A third method ('RR shift') takes elements of both the categorical and the continuous approach. We compare the three calculation methods using hypothetical data on BMI and an intervention that affects the obese category. The 'proportion shift' calculation produces non-linear artefacts and is best avoided. The 'RR shift' and 'distribution shift' calculation require the estimation of an RR function to describe excess risk, but perform much better. The 'proportion shift' calculation is best avoided. The 'RR shift' and 'distribution shift' calculation produce virtually the same results. For evaluating high-risk strategies, the 'RR shift' calculation is the simplest and therefore preferred. The 'distribution shift' is best suited for evaluating population strategies.
The Impact of Dietary and Metabolic Risk Factors on Cardiovascular Diseases and Type 2 Diabetes Mortality in Brazil
Publisher: Public Library of Science (PLoS)
Date: 18-03-2016
Dietary fats, health, and inequalities: There's nothing good about trans fats; a total ban would be best for public health
Publisher: BMJ
Date: 15-09-2015
DOI: 10.1136/BMJ.H4671
Dietary fats: A new look at old data challenges established wisdom
Publisher: BMJ
Date: 12-04-2016
DOI: 10.1136/BMJ.I1512
The potential impact of taxing sugar drinks on health inequality in Indonesia
Publisher: BMJ
Date: 11-2018
DOI: 10.1136/BMJGH-2018-000923
Abstract: Evidence suggests reducing consumption of sugar-sweetened beverages is important to reducing weight gain and chronic disease risk. Indonesia’s large population is a growing market for sugar-sweetened beverages. Taxation to reduce consumption is of interest, but considered fiscally regressive. Little is known about differential effects between income groups in low-income countries. This modelling study uses a proportional multistate life table to model reduced daily energy intake following a $0.30 per litre tax on sugar-sweetened beverages and subsequent shifts in Body Mass Index (BMI) distribution for income groups in Indonesia. Energy balance equations calculate reduced BMI. Reduced incidence of type 2 diabetes mellitus, ischaemic heart disease and stroke is determined from the relative risk of the BMI shift and subsequent health-adjusted life years gained calculated. The tax’s effect was greater for higher income quintiles than lower. Energy intake reduced most in higher income quintiles. Cases of overweight and obesity for women decreased by approximately 15 000 in the lowest income quintile, but 417 000 for the highest. For men, this was 12 000 and 415 000. Over 25 years, 63 000 cases of diabetes were averted in the lowest quintile and 1 487 000 in the highest. Similar magnitudes were observed for stroke and ischaemic heart disease. Tax paid over 25 years was $0.5 billion for the lowest income quintile and $15.1 billion for the highest. Sugar-sweetened beverage taxation can help to reduce the number of overweight and obese, and prevent over a million cases of diabetes in Indonesia. Higher income groups would benefit more than lower income groups. The tax would raise $920 million in the first year and $27.3 billion over 25 years.
Health services costs for lung cancer care in Australia: Estimates from the 45 and Up Study
Publisher: Public Library of Science (PLoS)
Date: 31-08-2020
Population interventions for obesity
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 03-2010
Validity of predictions in health impact assessment
Publisher: BMJ
Date: 04-2007
Orlistat reduces weight but its cost-effectiveness remains unclear
Publisher: BMJ
Date: 24-11-2013
Abstract: Implications for practise and research: Ara and colleagues studied the effectiveness and cost-effectiveness of weight-reducing drugs and found that they provide statistically significant weight loss and are worth the investment. The analysis contains several unwarranted assumptions, notably around the amount of weight lost, subsequent weight regained and the permanency of weight loss. Definitive conclusions cannot be drawn from this study.
Correction: The cost-effectiveness of laparoscopic adjustable gastric banding in the morbidly obese adult population of Australia (PLoS ONE (2013) 8, 5 (e64965) DOI: 10.1371/journal.pone.0064965)
Publisher: Public Library of Science (PLoS)
Date: 15-08-2014
Television viewing time and reduced life expectancy: a life table analysis
Publisher: BMJ
Date: 24-09-2012
DOI: 10.1136/BJSPORTS-2011-085662
Abstract: Prolonged television (TV) viewing time is unfavourably associated with mortality outcomes, particularly for cardiovascular disease, but the impact on life expectancy has not been quantified. The authors estimate the extent to which TV viewing time reduces life expectancy in Australia, 2008. The authors constructed a life table model that incorporates a previously reported mortality risk associated with TV time. Data were from the Australian Bureau of Statistics and the Australian Diabetes, Obesity and Lifestyle Study, a national population-based observational survey that started in 1999-2000. The authors modelled impacts of changes in population average TV viewing time on life expectancy at birth. The amount of TV viewed in Australia in 2008 reduced life expectancy at birth by 1.8 years (95% uncertainty interval (UI): 8.4 days to 3.7 years) for men and 1.5 years (95% UI: 6.8 days to 3.1 years) for women. Compared with persons who watch no TV, those who spend a lifetime average of 6 h/day watching TV can expect to live 4.8 years (95% UI: 11 days to 10.4 years) less. On average, every single hour of TV viewed after the age of 25 reduces the viewer's life expectancy by 21.8 (95% UI: 0.3-44.7) min. This study is limited by the low precision with which the relationship between TV viewing time and mortality is currently known. TV viewing time may be associated with a loss of life that is comparable to other major chronic disease risk factors such as physical inactivity and obesity.
Decreasing the Burden of Type 2 Diabetes in South Africa: The Impact of Taxing Sugar-Sweetened Beverages
Publisher: Public Library of Science (PLoS)
Date: 17-11-2015
The effects of built environment attributes on physical activity-related health and health care costs outcomes in Australia
Publisher: Elsevier BV
Date: 11-2016
DOI: 10.1016/J.HEALTHPLACE.2016.08.010
Abstract: Attributes of the built environment can positively influence physical activity of urban populations, which results in health and economic benefits. In this study, we derived scenarios from the literature for the association built environment-physical activity and used a mathematical model to translate improvements in physical activity to health-adjusted life years and health care costs. We modelled 28 scenarios representing a erse range of built environment attributes including density, ersity of land use, availability of destinations, distance to transit, design and neighbourhood walkability. Our results indicated potential health gains in 24 of the 28 modelled built environment attributes. Health care cost savings due to prevented physical activity-related diseases ranged between A$1300 to A$105,355 per 100,000 adults per year. On the other hand, additional health care costs of prolonged life years attributable to improvements in physical activity were nearly 50% higher than the estimated health care costs savings. Our results give an indication of the potential health benefits of investing in physical activity-friendly built environments.
Population prevalence of depression and mean Beck Depression Inventory score
Publisher: Royal College of Psychiatrists
Date: 12-2009
DOI: 10.1192/BJP.BP.109.066191
Abstract: For some phenomena the mean of population distributions predicts the proportion of people exceeding a threshold value. To investigate whether in depression, too, the population mean predicts the number of in iduals at the extreme end of the distribution. We used data from the European Outcome in Depression International Network (ODIN) study from populations in Finland, Norway and the UK to create models that predicted the prevalence of depression based on the mean Beck Depression Inventory (BDI) score. The models were tested on data from Ireland and Spain. Mean BDI score correlated well with the prevalence of depression determined by clinical interviews. A model based on the beta distribution best fitted the BDI distribution. Both models predicted the depression prevalence in Ireland and Spain fairly well. The mean of a continuous population distribution of mood predicts the prevalence of depression. Characteristics of both in iduals and populations determine depression rates.
Erratum to: Feasibility, effectiveness and cost-effectiveness of a telephone-based weight loss program delivered via a hospital outpatient setting (Translational Behavioral Medicine, (2016), 6, 3, (386-395), 10.1007/s13142-015-0337-9)
Publisher: Oxford University Press (OUP)
Date: 23-03-2017
Cost-effectiveness of interventions to promote fruit and vegetable consumption
Publisher: Public Library of Science (PLoS)
Date: 30-11-2010
A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease
Publisher: Elsevier BV
Date: 12-2012
Primary and secondary prevention interventions for cardiovascular disease in low-income and middle-income countries: A systematic review of economic evaluations
Publisher: Springer Science and Business Media LLC
Date: 14-06-2018
The impact of diabetes on the labour force participation, savings and retirement income of workers aged 45-64 years in Australia
Publisher: Public Library of Science (PLoS)
Date: 23-02-2015
Shift in disease burden from communicable to non-communicable diseases: Aiming to achieve Universal Health Coverage in Nepal
Publisher: SAGE Publications
Date: 07-2015
Corrigendum to “The effects of built environment attributes on physical activity-related health and health care costs outcomes in Australia” [Health Place 42 (2016) 19–29](S1353829216301368)(10.1016/j.healthplace.2016.08.010)
Publisher: Elsevier BV
Date: 11-2018
Physical Activity and Depression and Anxiety Disorders: A Systematic Review of Reviews and Assessment of Causality
Publisher: Elsevier BV
Date: 06-2023
A cost-benefit analysis framework for preventive health interventions to aid decision-making in Australian governments
Publisher: Springer Science and Business Media LLC
Date: 12-2021
DOI: 10.1186/S12961-021-00796-W
Abstract: Australian governments are increasingly mandating the use of cost–benefit analysis (CBA) to inform the efficient allocation of government resources. CBA is likely to be useful when evaluating preventive health interventions that are often cross-sectoral in nature and require Cabinet approval prior to implementation. This study outlines a CBA framework for the evaluation of preventive health interventions that balances the need for consistency with other agency guidelines whilst adhering to guidelines and conventions for health economic evaluations. We analysed CBA and other evaluation guidance documents published by Australian federal and New South Wales (NSW) government departments. Data extraction compared the recommendations made by different agencies and the impact on the analysis of preventive health interventions. The framework specifies a reference case and sensitivity analyses based on the following considerations: (1) applied economic evaluation theory (2) consistency between CBA across different government departments (3) the ease of moving from a CBA to a more conventional cost-effectiveness/cost-utility analysis framework often used for health interventions (4) the practicalities of application and (5) the needs of end users being both Cabinet decision-makers and health policy-makers. Nine documents provided CBA or relevant economic evaluation guidance. There were differences in terminology and areas of agreement and disagreement between the guidelines. Disagreement between guidelines involved (1) the community included in the societal perspective (2) the number of options that should be appraised in ex ante analyses (3) the appropriate time horizon for interventions with longer economic lives (4) the theoretical basis and value of the discount rate (5) parameter values for variables such as the value of a statistical life and (6) the summary measure for decision-making. This paper addresses some of the methodological challenges that have hindered the use of CBA in prevention by outlining a framework that is consistent with treasury department guidelines whilst considering the unique features of prevention policies. The effective use and implementation of a preventive health CBA framework is likely to require considerable investment of time and resources from state and federal government departments of health and treasury but has the potential to improve decision-making related to preventive health policies and programmes.
Quantitative health impact assessment: Current practice and future directions
Publisher: BMJ
Date: 05-2005
Depression prevention, labour force participation and income of older working aged Australians
Publisher: SAGE Publications
Date: 25-11-2015
Abstract: Depression has economic consequences not only for the health system, but also for in iduals and society. This study aims to quantify the potential economic impact of five-yearly screening for sub-syndromal depression in general practice among Australians aged 45-64 years, followed by a group-based psychological intervention to prevent progression to depression. We used an epidemiological simulation model to estimate reductions in prevalence of depression, and a microsimulation model, Health& WealthMOD2030, to estimate the impact on labour force participation, personal income, savings, taxation revenue and welfare expenditure. Group therapy is estimated to prevent around 5,200 prevalent cases of depression (2.2%) and add about 520 people to the labour force. Private incomes are projected to increase by $19 million per year, tax revenues by $2.4 million, and transfer payments are reduced by $2.6 million. Group-based psychological intervention to prevent depression could result in considerable economic benefits in addition to its clinical effects.
The impact of chronic conditions of care recipients on the labour force participation of informal carers in Australia: Which conditions are associated with higher rates of non-participation in the labour force?
Publisher: Springer Science and Business Media LLC
Date: 05-06-2014
Taxes and Subsidies for Improving Diet and Population Health in Australia: A Cost-Effectiveness Modelling Study
Publisher: Public Library of Science (PLoS)
Date: 14-02-2017
The association between built environment features and physical activity in the Australian context: A synthesis of the literature
Publisher: Springer Science and Business Media LLC
Date: 08-06-2016
The association between sidewalk length and walking for different purposes in established neighborhoods
Publisher: Springer Science and Business Media LLC
Date: 2012
Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990–2013: a systematic analysis for the Global
Publisher: Elsevier BV
Date: 08-2015
Health Impact Assessment and advocacy: A challenging combination
Publisher: Springer Science and Business Media LLC
Date: 06-2006
Cost-Effectiveness Study of HPV Vaccination as a Primary Prevention Strategy for Anal Cancer in HIV-Positive Men in Chile
Publisher: Elsevier BV
Date: 12-2016
DOI: 10.1016/J.VHRI.2015.12.002
Abstract: Most anal cancers are caused by the human papilloma virus (HPV) infection. The incidence is increasing, especially in high-risk in iduals such as HIV-positive men. Evidence shows that the new quadrivalent HPV vaccine reduces the rates of anal intraepithelial neoplasia among men who have sex with men. To determine whether vaccinating against HPV-related anal cancer is cost-effective in HIV-positive men in Chile. A cost-effectiveness analysis was conducted by constructing a cohort multistate life-table-based Markov model in MS Excel in which the prevention of HPV infection was expected to influence the incidence of anal cancer in HIV-positive men. The comparator was the current practice of no systematic HPV prevention. Estimates of the efficacy of the vaccine were obtained from a substudy of a larger randomized controlled trial, incidence rates from the Chilean Population Cancer Registries, mortality rates from the National Institute of Statistics, and disease costs from a cost-effectiveness report. A public health care sector perspective was applied. The outcome was measured in averted disability-adjusted life-years. The incremental cost-effectiveness ratio was calculated considering a lifetime horizon for costs and health outcomes. The estimated incremental cost-effectiveness ratio was US $138,269/ disability-adjusted life-year (95% confidence interval $95,936-$221,862). Assuming a threshold of 3 times the gross domestic product per capita, the intervention was not cost-effective. The outcome was sensitive to the vaccine price and vaccine efficacy. HPV vaccination in HIV-positive men from a Chilean public health care sector perspective is not cost-effective.
African Programme for Onchocerciasis Control 1995–2015: Model-Estimated Health Impact and Cost
Publisher: Public Library of Science (PLoS)
Date: 31-01-2013
Lost productive life years caused by chronic conditions in Australians aged 45–64 years, 2010–2030
Publisher: AMPCo
Date: 09-2015
DOI: 10.5694/MJA15.00132
Abstract: To estimate (1) productive life years (PLYs) lost because of chronic conditions in Australians aged 45-64 years from 2010 to 2030, and (2) the impact of this loss on gross domestic product (GDP) over the same period. A microsimulation model, Health&WealthMOD2030, was used to project lost PLYs caused by chronic conditions from 2010 to 2030. The base population consisted of respondents aged 45-64 years to the Australian Bureau of Statistics Survey of Disability, Ageing and Carers 2003 and 2009. The national impact of lost PLYs was assessed with Treasury's GDP equation. Lost PLYs due to chronic disease at 2010, 2015, 2020, 2025 and 2030 (ie, whole life years lost because of chronic disease) the national impact of lost PLYs at the same time points (GDP loss caused by PLYs) the effects of population growth, labour force trends and chronic disease trends on lost PLYs and GDP at each time point. Using Health&WealthMOD2030, we estimated a loss of 347,000 PLYs in 2010 this was projected to increase to 459,000 in 2030 (32.28% increase over 20 years). The leading chronic conditions associated with premature exits from the labour force were back problems, arthritis and mental and behavioural problems. The percentage increase in the number of PLYs lost by those aged 45-64 years was greater than that of population growth for this age group (32.28% v 27.80%). The strongest driver of the increase in lost PLYs was population growth (accounting for 89.18% of the increase), followed by chronic condition trends (8.28%). Our study estimates an increase of 112 000 lost PLYs caused by chronic illness in older workers in Australia between 2010 and 2030, with the most rapid growth projected to occur in men aged 55-59 years and in women aged 60-64 years. The national impact of this lost labour force participation on GDP was estimated to be $37.79 billion in 2010, increasing to $63.73 billion in 2030.
The European Common Agricultural Policy on fruits and vegetables: Exploring potential health gain from reform
Publisher: Oxford University Press (OUP)
Date: 09-2006
Abstract: Consumption of fruits and vegetables is associated with a reduced risk of cardiovascular disease and cancer. The European Union Common Agricultural Policy keeps prices high by limiting the availability of fruits and vegetables. This policy is at odds with public health interests. We assess the potential health gain for the Dutch population of discontinuing EU withdrawal support for fruits and vegetables. The maximum effect of the reform was estimated by assuming that a quantity equivalent to the amount of produce withdrawn in recent years would be brought onto the market. For the calculation of the effect of consumption change on health we constructed a multi-state life table model in which consumption of fruits and vegetables is linked to ischaemic heart disease, stroke, and cancer of the oesophagus, stomach, colorectum, lung and breast. Uncertainty is quantified using Monte Carlo simulation. The reform would maximally increase the average consumption of fruits and vegetables by 1.80% (95% uncertainty interval 1.12-2.73), with an ensuing increase in life expectancy of 3.8 (2.2-5.9) days for men and 2.6 (1.5-4.2) days for women. The reform is also likely to decrease socio-economic inequalities in health. Ending EU withdrawal support for fruits and vegetables could result in a modest health gain for the Dutch population, though uncertainty in the estimates is high. A more comprehensive examination of the health effects of the EU agricultural policy could help to ensure health is duly considered in decision-making.
Forecasting the amount and cost of medicine to treat type 2 diabetes mellitus in Nepal using knowledge on medicine usage from a developed country
Publisher: Oxford University Press (OUP)
Date: 30-08-2200
DOI: 10.1111/JPHS.12265
Abstract: This research was aimed to forecast the amount and cost of medicines required to treat people with type 2 diabetes mellitus (T2DM) in Nepal over 30 years. We modelled the financial burden of T2DM medicines by estimating the cost of medicines to treat all cases of T2DM in Nepal over three decades based on the prevalence of T2DM in Nepal, the Nepalese costs of medicine and the T2DM medicine use profile of Australia. With the current T2DM prevalence trend, it would cost US$63–95 million in 2013 to purchase T2DM medicines for Nepal, if Nepalese receive the same mix of T2DM medicines as used in Australia. This cost is almost one-quarter of the total health budget of Nepal (US$308 million). The cost of medicines to treat T2DM is projected to triple between 2013 and 2043. With the medicines for only T2DM projected to cost about 25% of the entire health budget, the planned health insurance seems unaffordable if patients are treated with the same medicines as those in one of the best healthcare systems in the world. The government needs to stimulate rational prescribing and secure additional funding through taxation, health insurance or health levy to provide such medicines and services.
A systematic review of economic analyses of active transport interventions that include physical activity benefits
Publisher: Elsevier BV
Date: 2016
Global, regional, and national consumption of animal-source foods between 1990 and 2018: findings from the Global Dietary Database
Publisher: Elsevier BV
Date: 03-2022
Improved and standardized method for assessing years lived with disability after injury
Publisher: WHO Press
Date: 13-03-2012
Estimated Impact of Achieving the Australian National Sodium Reduction Targets on Blood Pressure, Chronic Kidney Disease Burden and Healthcare Costs: A Modelling Study
Publisher: MDPI AG
Date: 09-01-2023
DOI: 10.3390/NU15020318
Abstract: Excess sodium intake raises blood pressure which increases the risk of chronic kidney disease (CKD). We aimed to estimate the impact of reduced sodium intake on future CKD burden in Australia. A multi-cohort proportional multistate lifetable model was developed to estimate the potential impact on CKD burden and health expenditure if the Australian Suggested Dietary Target (SDT) and the National Preventive Health Strategy 2021–2030 (NPHS) sodium target were achieved. Outcomes were projected to 2030 and over the lifetime of adults alive in 2019. Achieving the SDT and NPHS targets could lower population mean systolic blood pressure by 2.1 mmHg and 1.7 mmHg, respectively. Compared to normal routines, attaining the SDT and NPHS target by 2030 could prevent 59,220 (95% UI, 53,140–65,500) and 49,890 (44,377–55,569) incident CKD events, respectively, while postponing 568 (479–652) and 511 (426–590) CKD deaths, respectively. Over the lifetime, this generated 199,488 health-adjusted life years (HALYs) and AUD 644 million in CKD healthcare savings for the SDT and 170,425 HALYs and AUD 514 million for the NPHS. CKD due to hypertension and CKD due to other/unspecified causes were the principal contributors to the HALY gains. Lowering sodium consumption in Australia could deliver substantial CKD health and economic benefits.
Cost of inaction on sugar-sweetened beverage consumption: implications for obesity in South Africa
Publisher: Cambridge University Press (CUP)
Date: 23-10-2015
DOI: 10.1017/S1368980015003006
Abstract: To estimate the effect of increased sugar-sweetened beverage (SSB) consumption on future adult obesity prevalence in South Africa in the absence of preventive measures. A model was constructed to simulate the effect of a 2·4 % annual increase in SSB consumption on obesity prevalence. The model computed the change in energy intake assuming a compounding increase in SSB consumption. The population distribution of BMI by age and sex was modelled by fitting measured data from the 2012 South African National Income Dynamics Survey to the log-normal distribution and shifting the mean values. Over the past decade the prevalence of obesity and related non-communicable diseases has increased in South Africa, as have the sales and availability of SSB. Soft drink sales in South Africa are projected to grow between 2012 and 2017 at an annual compounded growth rate of 2·4 % in the absence of preventive measures to curb consumption. A 2·4 % annual growth in SSB sales alongside population growth and ageing will result in an additional 1 287 000 obese adults in South Africa by 2017, 22 % of which will be due to increased SSB consumption. In order to meet the South African target of reducing the number of people who are obese and/or overweight by 10 % by 2020, the country cannot afford to delay implementing effective population-wide interventions. In the face of plans to increase growth of SSB, the country will soon face even greater challenges in overcoming obesity and related non-communicable diseases.
The impact of policies to reduce trans fat consumption: A systematic review of the evidence
Publisher: Elsevier BV
Date: 12-2018
Potential impact of a modest reduction in salt intake on blood pressure, cardiovascular disease burden and premature mortality: A modelling study
Publisher: BMJ
Date: 02-2019
DOI: 10.1136/OPENHRT-2018-000943
Abstract: To assess the potential impact of reduction in salt intake on the burden of cardiovascular disease (CVD) and premature mortality in Cameroon. Using a multicohort proportional multistate life table model with Markov process, we modelled the impact of WHO’s recommended 30% relative reduction in population-wide sodium intake on the CVD burden for Cameroonian adults alive in 2016. Deterministic and probabilistic sensitivity analyses were conducted and used to quantify uncertainty. Over the lifetime, incidence is predicted to decrease by 5.2% (95% uncertainty interval (UI) 4.6 to 5.7) for ischaemic heart disease (IHD), 6.6% (95% UI 5.9 to 7.4) for haemorrhagic strokes, 4.8% (95% UI 4.2 to 5.4) for ischaemic strokes and 12.9% (95% UI 12.4 to 13.5) for hypertensive heart disease (HHD). Mortality over the lifetime is projected to reduce by 5.1% (95% UI 4.5 to 5.6) for IHD, by 6.9% (95% UI 6.1 to 7.7) for haemorrhagic stroke, by 4.5% (95% UI 4.0 to 5.1) for ischaemic stroke and by 13.3% (95% UI 12.9 to 13.7) for HHD. About 776 400 (95% UI 712 600 to 841 200) health-adjusted life years could be gained, and life expectancy might increase by 0.23 years and 0.20 years for men and women, respectively. A projected 16.8% change (reduction) between 2016 and 2030 in probability of premature mortality due to CVD would occur if population salt reduction recommended by WHO is attained. Achieving the 30% reduction in sodium intake recommended by WHO could considerably decrease the burden of CVD. Targeting blood pressure via decreasing population salt intake could translate in significant reductions in premature CVD mortality in Cameroon by 2030.
A method for the inclusion of physical activity-related health benefits in cost-benefit analysis of built environment initiatives
Publisher: Elsevier BV
Date: 2018
DOI: 10.1016/J.YPMED.2017.11.009
Abstract: The built environment has a significant influence on population levels of physical activity (PA) and therefore health. However, PA-related health benefits are seldom considered in transport and urban planning (i.e. built environment interventions) cost-benefit analysis. Cost-benefit analysis implies that the benefits of any initiative are valued in monetary terms to make them commensurable with costs. This leads to the need for monetised values of the health benefits of PA. The aim of this study was to explore a method for the incorporation of monetised PA-related health benefits in cost-benefit analysis of built environment interventions. Firstly, we estimated the change in population level of PA attributable to a change in the built environment due to the intervention. Then, changes in population levels of PA were translated into monetary values. For the first step we used estimates from the literature for the association of built environment features with physical activity outcomes. For the second step we used the multi-cohort proportional multi-state life table model to predict changes in health-adjusted life years and health care costs as a function of changes in PA. Finally, we monetised health-adjusted life years using the value of a statistical life year. Future research could adapt these methods to assess the health and economic impacts of specific urban development scenarios by working in collaboration with urban planners.
Cost-effectiveness of interventions to reduce dietary salt intake
Publisher: BMJ
Date: 11-2010
Abstract: To evaluate population health benefits and cost-effectiveness of interventions for reducing salt in the diet. Proportional multistate life-table modelling of cardiovascular disease and health sector cost outcomes over the lifetime of the Australian population in 2003. The current Australian programme of incentives to the food industry for moderate reduction of salt in processed foods a government mandate of moderate salt limits in processed foods dietary advice for everyone at increased risk of cardiovascular disease and dietary advice for those at high risk. Costs measured in Australian dollars for the year 2003. Health outcomes measured in disability-adjusted life years (DALY) averted over the lifetime. Mandatory and voluntary reductions in the salt content of processed food are cost-saving interventions under all modelled scenarios of discounting, costing and cardiovascular disease risk reversal (dominant cost-effectiveness ratios). Dietary advice targeting in iduals is not cost-effective under any of the modelled scenarios, even if directed at those with highest blood pressure risk only (best case median cost-effectiveness A$100 000/DALY 95% uncertainty interval A$64 000/DALY to A$180 000/DALY). Although the current programme that relies on voluntary action by the food industry is cost-effective, the population health benefits could be 20 times greater with government legislation on moderate salt limits in processed foods. Programmes to encourage the food industry to reduce salt in processed foods are highly recommended for improving population health and reducing health sector spending in the long term, but regulatory action from government may be needed to achieve the potential of significant improvements in population health.
Sobriety checkpoints in Thailand: A review of effectiveness and developments over time
Publisher: SAGE Publications
Date: 20-12-2015
Abstract: This review describes the legal basis for and implementation of sobriety checkpoints in Thailand and identifies factors that influenced their historical development and effectiveness. The first alcohol and traffic injury control law in Thailand was implemented in 1934. The 0.05 g/100 mL blood alcohol concentration limit was set in 1994. Currently, 3 types of sobriety checkpoints are used: general police checkpoints, selective breath testing, and special event sobriety checkpoints. The authors found few reports on the strategies, frequencies, and outcomes for any of these types of checkpoints, despite Thailand having devoted many resources to their implementation. In Thailand and other low-middle income countries, it is necessary to address the country-specific barriers to successful enforcement (including political and logistical issues, lack of equipment, and absence of other supportive alcohol harm reduction measures) before sobriety checkpoints can be expected to be as effective as reported in high-income countries.
Economic costs of chronic disease through lost productive life years (PLYs) among Australians aged 45–64 years from 2015 to 2030
Publisher: BMJ
Date: 09-2016
Unexpected survival of people with sleep apnoea: Parallels in obesity research
Publisher: Wiley
Date: 03-2010
Cost-effectiveness of diet and exercise interventions to reduce overweight and obesity
Publisher: Springer Science and Business Media LLC
Date: 11-01-2011
DOI: 10.1038/IJO.2010.246
Abstract: To analyze whether two dietary weight loss interventions--the dietary approaches to stop hypertension (DASH) program and a low-fat diet program--would be cost-effective in Australia, and to assess their potential to reduce the disease burden related to excess body weight. We constructed a multi-state life-table-based Markov model in which the distribution of body weight influences the incidence of stroke, ischemic heart disease, hypertensive heart disease, diabetes mellitus, osteoarthritis, post-menopausal breast cancer, colon cancer, endometrial cancer and kidney cancer. The target population was the overweight and obese adult population in Australia in 2003. We used a lifetime horizon for health effects and costs, and a health sector perspective for costs. We populated the model with data identified from Medline and Cochrane searches, Australian Bureau of Statistics published catalogues, Australian Institute of Health and Welfare, and Department of Health and Ageing. Disability adjusted life years (DALYs) averted, incremental cost-effectiveness ratios (ICERs) and proportions of disease burden avoided. ICERs under AUS$50,000 per DALY are considered cost-effective. The DASH and low-fat diet programs have ICERs of AUS$12,000 per DALY (95% uncertainty range: Cost-saving- 68,000) and AUS$13,000 per DALY (Cost-saving--130,000), respectively. Neither intervention reduced the body weight-related disease burden at population level by more than 0.1%. The sensitivity analysis showed that when participants' costs for time and travel are included, the ICERs increase to AUS$75,000 per DALY for DASH and AUS$49,000 per DALY for the low-fat diet. Modest weight loss during the interventions, post-intervention weight regain and low participation limit the health benefits. Diet and exercise interventions to reduce obesity are potentially cost-effective but have a negligible impact on the total body weight-related disease burden.
Television food advertising and the prevalence of childhood overweight and obesity: A multicountry comparison
Publisher: Cambridge University Press (CUP)
Date: 17-12-2010
DOI: 10.1017/S1368980009992850
Abstract: To estimate the contribution of television (TV) food advertising to the prevalence of obesity among 6–11-year-old children in Australia, Great Britain (England and Scotland only), Italy, The Netherlands, Sweden and the United States. Data from contemporary representative studies on the prevalence of childhood obesity and on TV food advertising exposure in the above countries were entered into a mathematical simulation model. Two different effect estimators were used to calculate the reduction in prevalence of overweight and obesity in the absence of TV food advertising in each country one based on literature and one based on experts’ estimates. Six- to eleven-year-old children in six Western countries. Estimates of the average exposure of children to TV food advertising range from 1·8 min/d in The Netherlands to 11·5 min/d in the United States. Its contribution to the prevalence of childhood obesity is estimated at 16 %–40 % in the United States, 10 %–28 % in Australia and Italy and 4 %–18 % in Great Britain, Sweden and The Netherlands. The contribution of TV advertising of foods and drinks to the prevalence of childhood obesity differs distinctly by country and is likely to be significant in some countries.
Evidence that a tax on sugar sweetened beverages reduces the obesity rate: a meta-analysis
Publisher: Springer Science and Business Media LLC
Date: 13-11-2013
DOI: 10.1186/1471-2458-13-1072
Abstract: Excess intake of sugar sweetened beverages (SSBs) has been shown to result in weight gain. To address the growing epidemic of obesity, one option is to combine programmes that target in idual behaviour change with a fiscal policy such as excise tax on SSBs. This study evaluates the literature on SSB taxes or price increases, and their potential impact on consumption levels, obesity, overweight and body mass index (BMI). The possibility of switching to alternative drinks is also considered. The following databases were used: Pubmed/Medline, The Cochrane Database of Systematic Reviews, Google Scholar, Econlit, National Bureau of Economics Research (NBER), Research Papers in Economics (RePEc). Articles published between January 2000 and January 2013, which reported changes in diet or BMI, overweight and/or obesity due to a tax on, or price change of, SSBs were included. Nine articles met the criteria for the meta-analysis. Six were from the USA and one each from Mexico, Brazil and France. All showed negative own-price elasticity, which means that higher prices are associated with a lower demand for SSBs. Pooled own price-elasticity was -1.299 (95% CI: -1.089 - -1.509). Four articles reported cross-price elasticities, three from the USA and one from Mexico higher prices for SSBs were associated with an increased demand for alternative beverages such as fruit juice (0.388, 95% CI: 0.009 – 0.767) and milk (0.129, 95% CI: -0.085 – 0.342), and a reduced demand for diet drinks (-0.423, 95% CI: -0.628 - -1.219). Six articles from the USA showed that a higher price could also lead to a decrease in BMI, and decrease the prevalence of overweight and obesity. Taxing SSBs may reduce obesity. Future research should estimate price elasticities in low- and middle-income countries and identify potential health gains and the wider impact on jobs, monetary savings to the health sector, implementation costs and government revenue. Context-specific cost-effectiveness studies would allow policy makers to weigh these factors.
A shift from motorised travel to active transport: What are the potential health gains for an Australian city?
Publisher: Public Library of Science (PLoS)
Date: 11-10-2017
Determinants of Obesity and Associated Population Attributability, South Africa: Empirical Evidence from a National Panel Survey, 2008-2012
Publisher: Public Library of Science (PLoS)
Date: 10-06-2022
Stakeholder perceptions of current practices and challenges in priority setting for non-communicable disease control in Kenya: a qualitative study
Publisher: BMJ
Date: 04-2021
DOI: 10.1136/BMJOPEN-2020-043641
Abstract: To explore the stakeholders’ perceptions of current practices and challenges in priority setting for non-communicable disease (NCD) control in Kenya. A qualitative study approach conducted within a 1-day stakeholder workshop that followed a deliberative dialogue process. Study was conducted within a 1-day stakeholder workshop that was held in October 2019 in Nairobi, Kenya. Stakeholders who currently participate in the national level policymaking process for health in Kenya. Priority setting process for NCD control in Kenya. Donor funding was identified as a key factor that informed the priority setting process for NCD control. Misalignment between donors’ priorities and the country’s priorities for NCD control was seen as a hindrance to the process. It was identified that there was minimal utilisation of context-specific evidence from locally conducted research. Additional factors seen to inform the priority setting process included political leadership, government policies and budget allocation for NCDs, stakeholder engagement, media, people’s cultural and religious beliefs. There is an urgent need for development aid partners to align their priorities to the specific NCD control priority areas that exist in the countries that they extend aid to. Additionally, context-specific scientific evidence on effective local interventions for NCD control is required to inform areas of priority in Kenya and other low-income and middle-income countries. Further research is needed to develop best practice guidelines and tools for the creation of national-level priority setting frameworks that are responsive to the identified factors that inform the priority setting process for NCD control.
Physical Activity and Depression and Anxiety Disorders in Australia: A Lifetable Analysis
Publisher: Elsevier BV
Date: 06-2023
Cost-effectiveness analysis of population salt reduction interventions to prevent cardiovascular disease in Cameroon: mathematical modelling study
Publisher: BMJ
Date: 11-2020
DOI: 10.1136/BMJOPEN-2020-041346
Abstract: Reducing dietary sodium (salt) intake has been proposed as a population-wide strategy to reduce blood pressure and cardiovascular disease (CVD). The cost-effectiveness of such strategies has hitherto not been investigated in Cameroon. A multicohort multistate life table Markov model was used to evaluate the cost-effectiveness of three population salt reduction strategies: mass media c aign, school-based salt education programme and low-sodium salt substitute. A healthcare system perspective was considered and adults alive in 2016 were simulated over the life course. Outcomes were changes in disease incidence, mortality, health-adjusted life years (HALYs), healthcare costs and incremental cost-effectiveness ratios (ICERs) over the lifetime. Probabilistic sensitivity analysis was used to quantify uncertainty. Over the life span of the cohort of adults alive in Cameroon in 2016, substantial numbers of new CVD events could be prevented, with over 10 000, 79 000 and 84 000 CVD deaths that could be averted from mass media, school education programme and salt substitute interventions, respectively. Population health gains over the lifetime were 46 700 HALYs, 348 800 HALYs and 368 400 HALYs for the mass media, school education programme and salt substitute interventions, respectively. ICERs showed that all interventions were dominant, with probabilities of being cost-saving of 84% for the school education programme, 89% for the mass media c aign and 99% for the low sodium salt substitute. Results were largely robust in sensitivity analysis. All the salt reduction strategies evaluated were highly cost-effective with very high probabilities of being cost-saving. Salt reduction in Cameroon has the potential to save many lives and offers good value for money.
The economic impact of diabetes through lost labour force participation on individuals and government: Evidence from a microsimulation model
Publisher: Springer Science and Business Media LLC
Date: 04-03-2014
The macroeconomic impacts of diet-related fiscal policy for NCD prevention: A systematic review
Publisher: Elsevier BV
Date: 05-2020
Body mass index-measured adiposity and population attributability of associated factors: A population-based study from Buea, Cameroon
Publisher: Springer Science and Business Media LLC
Date: 07-01-2017
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Nihes - Netherlands Institute For Health Sciences
Location: Netherlands
Netherlands School Of Public And Occupational Health
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