Childhood Obesity Intervention Health Promotion

¶ … Childhood Obesity Intervention

Health Promotion Financing

Cost-Benefit Analysis of a Childhood Obesity Intervention

Cost-Benefit Analysis of a Childhood Obesity Intervention

Recent estimates suggest that 16.1% of children between the ages of 2 and 19 in the United States are overweight, while another 18.1% are obese (Trasande and Elbel, 2012). The estimated annual health care costs that the families of these children will incur range between $172 and $220, but over a child's lifetime the additional health care costs are predicted to average about $13,745. With an estimated 80 million children within this age group in 2010 (U.S. Census Bureau, 2012), this translates into nearly 13 and 14.5 million overweight and obese children, respectively. Accordingly, the annual extra healthcare costs for treating overweight and obese children would be $4.8 to $6.1 billion, with an average lifetime additional healthcare cost of almost $400 billion. Reducing the prevalence of overweight and obese children would therefore be expected to reduce the public and private healthcare burden significantly.

Australia is facing the same problem, with nearly a quarter of its children overweight or obese (Moodie, Haby, Wake, Gold, and Carter, 2008). With many of its citizen located in remote areas of the country, childhood obesity interventions for these remote areas have necessarily turned to primary care physicians (PCP). The LEAP (Live, Eat, and Play) intervention relies solely on lifestyle changes to tackle childhood obesity and this program is designed to be communicated to patients and their families through their PCPs. The lifestyle changes include diet modification, physical exercise, and brief PCP encounters to provide additional guidance and counseling. This essay will present the predicted costs for implementing a similar intervention (LEAP-U.S.) in the United States.

Table 1

LEAP-U.S. Expenditure Predictions (adapted from Moodie et al., 2008)

Expense

Cost

Type of Expenseb

F

V

C

UR

Project Coordinator for recruiting PCPs/NPs and running the training program

$84,270a annually

X

X

Psychiatrist for PCP/NP training

$840a per training session

X

Psychiatrist Travel

$80a per hour

X

Facility Rental

$15,000 annually

X

X

PCP/NP Attendance Reimbursement

$720

X

X

PCP Travel

$1 per mile

X

X

Actors for Training Sessions

$700 per training

X

Refreshments

$15 per PCP

X

X

Manual for PCPs

$10

X

X

Receptionist

$20a per hour

X

Training Equipment

$100

X

X

Child BMI Evaluation

$7

X

Initial Consult

$55

X

Subsequent Consults

$27

X

Family Instructional Reading Material

$40

X

X

X

Notes: a salary information was obtained from BLS (2012); babbreviations are: F, fixed; V, variable; C, controllable; UR, unrecoverable.

Cost-Benefit Analysis

Moodie and colleagues (2008) estimated that the overall cost of implementing the program on a national level would be AUS $6.3 million, so the cost of implementing an equivalent program would be much higher in the U.S. with its larger population. Converting this estimate for the U.S. population would give an estimate of just under U.S.$200 million annually (Australian Bureau of Statistics, 2012). If the annual additional healthcare costs for overweight and obese children in the U.S. is between $4.8 and $6.1 billion, as is suggested by the analysis presented in the first paragraph of this report, only 3.3% to 4.2% of these children would need to achieve a healthy weight to achieve the break-even point for the cost of the intervention.

There is a significant limitation to this health promotion proposal. A moderate-sized study investigating the efficacy of the LEAP program revealed small, non-significant improvements in BMI at the 9-month assessment, but none at the 15-month follow-up (McCallum et al., 2007). However, family reports of enrolled children engaging in more exercise and eating healthier did reach statistical significance at both time points. The authors of this report argue that these findings are too preliminary to draw hard conclusions. Moodie and colleagues (2008) mention that a much larger LEAP study is underway. The short time-span of the intervention may also be a problem, since a 2-year pilot study in Pittsburgh, Pennsylvania revealed a significant reduction in BMI for elementary school children in an in-school obesity intervention group (Manger et al., 2012).