IS A HEALTHY DIET ECONOMICALLY SUSTAINABLE? THE HEALTH EFFECTS OF PREVENTION POLICIES Michele Cecchini OECD – Health Division

The Burden of Obesity on Health Systems In any given moment, obese patients cost more Source:Brunello et al., 2008 Bhattacharia & Sood, 2005

The OECD/WHO CDP Model Physical activity adequate physical act insuff.physical act Body mass index normal weight pre-obesity obesity Blood pressure normal hypertension Cholesterol normal hypercholesterolemia Glycaemia normal diabetes Cancers Stroke Ischemic heart disease Fat low fat intake medium fat intake high fat intake Fibre adequate fibre intake low fibre intake Socio-economic status upper lower

A Comprehensive & Affordable Prevention Package OECD CountriesEmerging Economies Mass media campaigns Compulsory food labelling Industry self-regulation of food advertising to children Government regulation of food advertising to children Physician-dietician counsellingFiscal measures School-based interventions CanadaEuropeBrazilChina $/cap22.45 $/cap0.40 $/cap0.20 $/cap

Expectations Must Be Realistic Does prevention improve health? Does it reduce health expenditure? Does it improve health inequalities? Is it cost-effective?

Prevention Saves Lives Life Years Saved Every Year

Prevention Keeps Healthy Years of Life Free of NCDs Cancers (lung, colorectal, breast) Cardiovascular diseases

Prevention is a Good Investment Impact on Health Expenditure

Cost-Effectiveness of Prevention Brazil China Canada Europe After 20 years After 50 years

Impact on Inequalities Fiscal measures in Europe Different social groups: Different risk profiles: – Larger benefits in those most at risk (~) Different responses to interventions: – Larger benefits with a greater response

Key Policy Implications Obesity and NCDs are global economic issues Prices and regulations work best in emerging economies. Primary care doctors play a role in countries with stronger health systems Comprehensive intersectoral prevention strategies are more efficient and generate larger health gains We can afford to tackle obesity and prevention is good value for money

Health Effects of a Healthy Diet 10% of Energy from Saturated Fats Source: Lock et al., 2010

OECD Work on Health Behaviours OECD health working papers HWP 32, 45, 46, 48 Paper in Lancet series on chronic diseases Lancet paper on priority interventions Best buys paper for the UN Summit on NCDs OECD/Euro Observatory book