Rate of overweight OBESITY AND THE ECONOMICS OF PREVENTION: FIT NOT FAT KEY FACTS MEXICO, UPDATE 14 A. ADULTS 1. More than 70% of adults are overweight in Mexico, a higher proportion than in any other OECD country. About 32% of adults are obese, the second highest rate in the OECD, after the United States (36.5%). Overweight and obesity rates increased steadily since 00 in both men and women. Figure 1. Trends in the prevalence of overweight (including obesity) in adults, selected OECD countries 75% 70% 65% 60% - - - Past projection New data points Mexico Australia 55% 50% 45% 40% 35% USA Spain England Italy Canada France 30% Switzerland Korea 25% 72 76 80 84 88 92 96 00 04 08 12 Year Source: OECD estimates based on national health surveys. Note: Measured height and weight in Australia, England, Korea, Mexico and USA; self-reported data in other countries. 1
Obesity rate 2. Overweight and obesity have different social patterns in men and women in Mexico. Men with lower levels of education are less likely to be obese than more educated men. In contrast, women with less education are more likely to be obese than more educated women (Figure 2). However, this gradient is observed in women living in urban, but not in rural, areas (Smith and Goldman, 07; Perez et al., 14). Figure 2. Rates of obesity by education level in 06 and 12, men and women, Mexico 50% 45% 40% 35% 30% 25% % % 10% 5% 0% Low education Medium High education 06 12 06 12 Men Women Source: OECD estimates based on the Mexican survey Encuesta Nacional de Salud y Nutrición Note: Adjusted probabilities of obesity for men and women aged 40 (controlling for marital status, indigenous minority status, tobacco smoking, and working status). 3. Individual prevention programmes could avoid up to 47 000 deaths from chronic diseases every year. Deaths avoided could increase to 55 000 if different interventions were combined in a comprehensive prevention strategy. An organised programme of counselling of obese people by their family doctors would also lead to an annual gain of over 0 000 years of life in good health. Figure 3. Health outcomes of prevention, average effect per year, Mexico school-based interventions adverting self-regulation mass media campaigns labelling worksite interventions advertising regulation Life years in good health (DALYs) Life years fiscal measures physician counselling physician-dietician counselling 3 0,000 40,000 60,000 2
Cost (MXN) per life year gained in good health (DALY) Cost (million MXN) 4. How much does prevention cost? How much does it save? Most prevention programmes would cost less than MXN 3.5 bn every year, with individual counselling by family doctors costing up to MXN bn. Most prevention programmes will cut health expenditures for chronic diseases, but only by a relatively small margin (up to MXN 3.9 bn per year). Figure 4. Economic effects of prevention, average effect per year, Mexico,000,000 10,000 5,000 0-5,000 fiscal meas label mass media camp adv reg adv slfrg schoolbased int worksit e int phys couns physdiet couns intervention costs 37 443 8 864 3 95 3362 9071 256 health expenditure -82-831 93-7 1-6 -972-601 -3890 net cost -45-388 101 130 9 972 89 8470 366 5. Is prevention cost-effective? Prevention can improve health at a lower cost than many treatments offered today by OECD health systems. In Mexico, all of the prevention programmes examined will be cost-effective in the long run relative to internationally accepted standards corresponding to around MXN 640 000 per year of life gained in good health. However, some programmes will take a longer time to produce their health effects and therefore will be less cost-effective in the short run. 1,600,000 Figure 5. Cost-effectiveness of prevention, Mexico more than 2,000,000 MXN/DALY 1,280,000 960,000 640,000 640,000 MXN / DALY 50,000 USD / DALY 3,000 0 Cost-effectiveness after 10 years Cost-effectiveness after 100 years 3
B. CHILDREN 6. Child overweight rates in Mexico are among the highest in the OECD area. International data collated by the International Association for the Study of Obesity show that almost 1 in 3 children is overweight in Mexico, compared with % of boys and % of girls, on average, in OECD countries (Figure 3). Figure 6. Measured overweight (including obesity) among children at different ages, 10 or nearest year Greece Italy New Zealand Slovenia United States Mexico Hungary Portugal Chile Spain Canada Korea Israel Finland China OECD33 Japan Luxembourg UK (England) Australia Ireland India Iceland Germany Switzerland Austria Russian Federation Netherlands Belgium Poland Denmark Sweden Estonia Czech Republic France Slovak Republic Brazil Norway Turkey South Africa Indonesia 8 Boys 13 14 38 36 32 30 30 28 28 27 27 25 25 14 13 0 10 30 40 50 % of children Source: International Association for the Study of Obesity, 13; Bös et al. (04) for Luxembourg; and KNHANES for Korea. Girls 44 4
References: Smith K, Goldman N (07). Socioeconomic differences in health among older adults in Mexico. Social, Science & Medicine 65 (7): 1372 1385. Perez Ferrer C, McMunn A, Rivera Dommarco JA, Brunner EJ (14). Educational Inequalities in Obesity among Mexican Women: Time-Trends from 88 to 12. PLoS ONE 9(3): e905. doi:10.1371/journal.pone.00905 Release: 27 May 14. http://www.oecd.org/health/obesity-update.htm. For more information, please contact: Franco.Sassi@oecd.org, Marion.Devaux@oecd.org or Michele.Cecchini@oecd.org. 5