Approaches to tackling childhood obesity can vary widely in their costs of implementation as well as their effects on children’s weight. So far, there hasn’t been much guidance as to which strategies may have the biggest impact at the lowest cost. However, a recent analysis examining the cost-effectiveness of four specific childhood obesity interventions has revealed which strategies might just be the most effective.
The initial results of a five-year collaborative research project looking at the costs, effectiveness and benefits of possible approaches to curbing childhood obesity were recently published in the American Journal of Preventive Medicine. The Childhood Obesity Cost-Effectiveness Study, or CHOICES, is the first project to examine the cost effectiveness of four particular strategies implemented nationally. The strategies include placing an excise tax of a penny per ounce on sugary drinks; ending tax write-offs for TV advertising of unhealthy foods and beverages to children; increasing physical activity in schools; and improving nutrition, increasing physical activity and reducing screen time in early childcare settings. These interventions were chosen because they represent a wide range of nationally scalable strategies to reduce childhood obesity, using a mix policy and program-based changes.
The research showed that several strategies can help children reach and maintain a healthy weight while also reducing the future risk of adult obesity. The strategies could also save the country significant healthcare costs and even generate revenue to support further weight control efforts. The researchers discovered that the most effective strategies were typically policy interventions because of their low cost, ability to reach a wide population, and potential for sustainability.
The results showed that after 10 years, the sugary drinks and TV ad-focused interventions would be America’s best bet, saving the country $55 and $38 for every dollar spent and producing $12.5 billion and $80 million in yearly tax revenue, respectively. While the emphasis of the project was specifically on child and adolescent interventions, the sugary drinks intervention would target the whole population. In fact, the largest estimated savings, a total of $23.2 billion over 10 years, was associated with this intervention since it would impact every age group, including adults who already suffer from obesity-related diseases and the associated healthcare costs. Additionally, the TV ad intervention would result in an estimated $343 million saved over a decade.
The research team, led by Dr. Steven Gortmaker, the director of the Harvard Prevention Research Center and professor of the Practice of Health Sociology at the Harvard T.H. Chan School of Public Health, modeled nationwide implementation using a simulation of the 2015 American population over 10 years. Population reach varied widely, and the cost per change in BMI ranged from $1.16 for the TV ad intervention to $401 for physical activity. The results also revealed that the cost effectiveness of these preventative interventions would be greater than that seen for commonly reimbursed medical treatments to treat obesity.
It’s clear that reversing the obesity epidemic will require a multi-pronged approach involving a broad range of intervention strategies. Identifying the best strategies will require careful consideration of a variety of factors, including the costs, impact and healthcare cost savings. This recent analysis is an important first step in providing the tools needed to pinpoint which strategies would have the biggest impact on efforts to defeat childhood obesity.
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