通过应用公共经济框架评估日本超重和肥胖的财政负担。

IF 2.3 Q2 ECONOMICS Journal of Health Economics and Outcomes Research Pub Date : 2024-11-04 eCollection Date: 2024-01-01 DOI:10.36469/001c.123991

Ataru Igarashi, Cillian Copeland, Nikos Kotsopoulos, Riku Ota, Silvia Capucci, Daisuke Adachi

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A targeted literature review was conducted to identify data estimating the impact of OAO on employment, income, sick leave, retirement, and mortality. These modifiers were applied to Japanese epidemiological and fiscal projections to calculate government tax revenue and spending. The incremental impact of reducing OAO in the general population was subsequently calculated. Results were estimated based on the 2023 Japanese working-age population aged 18 to 70 years. Results: The total fiscal burden of OAO in Japan, defined as BMI of at least 25, is estimated at US <math><mn>13.41</mn> <mi>b</mi> <mi>i</mi> <mi>l</mi> <mi>l</mi> <mi>i</mi> <mi>o</mi> <mi>n</mi> <mo>(</mo> <mrow><mo>¥</mo></mrow> <mn>1925</mn> <mi>b</mi> <mi>i</mi> <mi>l</mi> <mi>l</mi> <mi>i</mi> <mi>o</mi> <mi>n</mi> <mo>)</mo> <mo>,</mo> <mi>r</mi> <mi>e</mi> <mi>p</mi> <mi>r</mi> <mi>e</mi> <mi>s</mi> <mi>e</mi> <mi>n</mi> <mi>t</mi> <mi>i</mi> <mi>n</mi> <mi>g</mi> <mn>0.4</mn></math> 6.3 billion (¥901 billion) and <math><mn>1.2</mn> <mi>b</mi> <mi>i</mi> <mi>l</mi> <mi>l</mi> <mi>i</mi> <mi>o</mi> <mi>n</mi> <mo>(</mo> <mrow><mo>¥</mo></mrow> <mn>179</mn> <mi>b</mi> <mi>i</mi> <mi>l</mi> <mi>l</mi> <mi>i</mi> <mi>o</mi> <mi>n</mi> <mo>)</mo> <mi>i</mi> <mi>n</mi> <mi>d</mi> <mi>i</mi> <mi>r</mi> <mi>e</mi> <mi>c</mi> <mi>t</mi> <mi>a</mi> <mi>n</mi> <mi>d</mi> <mi>i</mi> <mi>n</mi> <mi>d</mi> <mi>i</mi> <mi>r</mi> <mi>e</mi> <mi>c</mi> <mi>t</mi> <mi>t</mi> <mi>a</mi> <mi>x</mi> <mi>r</mi> <mi>e</mi> <mi>v</mi> <mi>e</mi> <mi>n</mi> <mi>u</mi> <mi>e</mi> <mo>,</mo> <mi>r</mi> <mi>e</mi> <mi>s</mi> <mi>p</mi> <mi>e</mi> <mi>c</mi> <mi>t</mi> <mi>i</mi> <mi>v</mi> <mi>e</mi> <mi>l</mi> <mi>y</mi> <mo>,</mo> <mi>d</mi> <mi>u</mi> <mi>e</mi> <mi>t</mi> <mi>o</mi> <mi>l</mi> <mi>o</mi> <mi>w</mi> <mi>e</mi> <mi>r</mi> <mi>e</mi> <mi>m</mi> <mi>p</mi> <mi>l</mi> <mi>o</mi> <mi>y</mi> <mi>m</mi> <mi>e</mi> <mi>n</mi> <mi>t</mi> <mi>a</mi> <mi>n</mi> <mi>d</mi> <mi>i</mi> <mi>n</mi> <mi>c</mi> <mi>o</mi> <mi>m</mi> <mi>e</mi> <mi>c</mi> <mi>o</mi> <mi>m</mi> <mi>b</mi> <mi>i</mi> <mi>n</mi> <mi>e</mi> <mi>d</mi> <mi>w</mi> <mi>i</mi> <mi>t</mi> <mi>h</mi> <mi>h</mi> <mi>i</mi> <mi>g</mi> <mi>h</mi> <mi>e</mi> <mi>r</mi> <mi>s</mi> <mi>i</mi> <mi>c</mi> <mi>k</mi> <mi>l</mi> <mi>e</mi> <mi>a</mi> <mi>v</mi> <mi>e</mi> <mo>.</mo> <mi>E</mi> <mi>x</mi> <mi>c</mi> <mi>e</mi> <mi>s</mi> <mi>s</mi> <mi>O</mi> <mi>A</mi> <mi>O</mi> <mo>-</mo> <mi>a</mi> <mi>t</mi> <mi>t</mi> <mi>r</mi> <mi>i</mi> <mi>b</mi> <mi>u</mi> <mi>t</mi> <mi>a</mi> <mi>b</mi> <mi>l</mi> <mi>e</mi> <mi>h</mi> <mi>e</mi> <mi>a</mi> <mi>l</mi> <mi>t</mi> <mi>h</mi> <mi>c</mi> <mi>a</mi> <mi>r</mi> <mi>e</mi> <mi>c</mi> <mi>o</mi> <mi>s</mi> <mi>t</mi> <mi>s</mi> <mi>w</mi> <mi>e</mi> <mi>r</mi> <mi>e</mi></math> 5.4 billion (¥769 billion), while additional pension payment spending of $0.5 billion (¥77 billion) was estimated, due to higher levels of early retirement. Conclusions: While the health implications of OAO are well documented, this fiscal analysis demonstrates the significant economic burden of OAO both to the healthcare system and broader government accounts. Policies aimed at reducing population-level obesity have the potential to benefit government accounts through increasing employment and reducing public spending, which can offset the cost of implementing these policies.","PeriodicalId":16012,"journal":{"name":"Journal of Health Economics and Outcomes Research","volume":"11 2","pages":"125-132"},"PeriodicalIF":2.3000,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11555824/pdf/","citationCount":"0","resultStr":"{\"title\":\"Assessing the Fiscal Burden of Overweight and Obesity in Japan through Application of a Public Economic Framework.\",\"authors\":\"Ataru Igarashi, Cillian Copeland, Nikos Kotsopoulos, Riku Ota, Silvia Capucci, Daisuke Adachi\",\"doi\":\"10.36469/001c.123991\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Introduction: Obesity continues to represent a significant public health concern, with a broad impact from both a health and economic perspective. 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Results were estimated based on the 2023 Japanese working-age population aged 18 to 70 years. Results: The total fiscal burden of OAO in Japan, defined as BMI of at least 25, is estimated at US <math><mn>13.41</mn> <mi>b</mi> <mi>i</mi> <mi>l</mi> <mi>l</mi> <mi>i</mi> <mi>o</mi> <mi>n</mi> <mo>(</mo> <mrow><mo>¥</mo></mrow> <mn>1925</mn> <mi>b</mi> <mi>i</mi> <mi>l</mi> <mi>l</mi> <mi>i</mi> <mi>o</mi> <mi>n</mi> <mo>)</mo> <mo>,</mo> <mi>r</mi> <mi>e</mi> <mi>p</mi> <mi>r</mi> <mi>e</mi> <mi>s</mi> <mi>e</mi> <mi>n</mi> <mi>t</mi> <mi>i</mi> <mi>n</mi> <mi>g</mi> <mn>0.4</mn></math> 6.3 billion (¥901 billion) and <math><mn>1.2</mn> <mi>b</mi> <mi>i</mi> <mi>l</mi> <mi>l</mi> <mi>i</mi> <mi>o</mi> <mi>n</mi> <mo>(</mo> <mrow><mo>¥</mo></mrow> <mn>179</mn> <mi>b</mi> <mi>i</mi> <mi>l</mi> <mi>l</mi> <mi>i</mi> <mi>o</mi> <mi>n</mi> <mo>)</mo> <mi>i</mi> <mi>n</mi> <mi>d</mi> <mi>i</mi> <mi>r</mi> <mi>e</mi> <mi>c</mi> <mi>t</mi> <mi>a</mi> <mi>n</mi> <mi>d</mi> <mi>i</mi> <mi>n</mi> <mi>d</mi> <mi>i</mi> <mi>r</mi> <mi>e</mi> <mi>c</mi> <mi>t</mi> <mi>t</mi> <mi>a</mi> <mi>x</mi> <mi>r</mi> <mi>e</mi> <mi>v</mi> <mi>e</mi> <mi>n</mi> <mi>u</mi> <mi>e</mi> <mo>,</mo> <mi>r</mi> <mi>e</mi> <mi>s</mi> <mi>p</mi> <mi>e</mi> <mi>c</mi> <mi>t</mi> <mi>i</mi> <mi>v</mi> <mi>e</mi> <mi>l</mi> <mi>y</mi> <mo>,</mo> <mi>d</mi> <mi>u</mi> <mi>e</mi> <mi>t</mi> <mi>o</mi> <mi>l</mi> <mi>o</mi> <mi>w</mi> <mi>e</mi> <mi>r</mi> <mi>e</mi> <mi>m</mi> <mi>p</mi> <mi>l</mi> <mi>o</mi> <mi>y</mi> <mi>m</mi> <mi>e</mi> <mi>n</mi> <mi>t</mi> <mi>a</mi> <mi>n</mi> <mi>d</mi> <mi>i</mi> <mi>n</mi> <mi>c</mi> <mi>o</mi> <mi>m</mi> <mi>e</mi> <mi>c</mi> <mi>o</mi> <mi>m</mi> <mi>b</mi> <mi>i</mi> <mi>n</mi> <mi>e</mi> <mi>d</mi> <mi>w</mi> <mi>i</mi> <mi>t</mi> <mi>h</mi> <mi>h</mi> <mi>i</mi> <mi>g</mi> <mi>h</mi> <mi>e</mi> <mi>r</mi> <mi>s</mi> <mi>i</mi> <mi>c</mi> <mi>k</mi> <mi>l</mi> <mi>e</mi> <mi>a</mi> <mi>v</mi> <mi>e</mi> <mo>.</mo> <mi>E</mi> <mi>x</mi> <mi>c</mi> <mi>e</mi> <mi>s</mi> <mi>s</mi> <mi>O</mi> <mi>A</mi> <mi>O</mi> <mo>-</mo> <mi>a</mi> <mi>t</mi> <mi>t</mi> <mi>r</mi> <mi>i</mi> <mi>b</mi> <mi>u</mi> <mi>t</mi> <mi>a</mi> <mi>b</mi> <mi>l</mi> <mi>e</mi> <mi>h</mi> <mi>e</mi> <mi>a</mi> <mi>l</mi> <mi>t</mi> <mi>h</mi> <mi>c</mi> <mi>a</mi> <mi>r</mi> <mi>e</mi> <mi>c</mi> <mi>o</mi> <mi>s</mi> <mi>t</mi> <mi>s</mi> <mi>w</mi> <mi>e</mi> <mi>r</mi> <mi>e</mi></math> 5.4 billion (¥769 billion), while additional pension payment spending of $0.5 billion (¥77 billion) was estimated, due to higher levels of early retirement. Conclusions: While the health implications of OAO are well documented, this fiscal analysis demonstrates the significant economic burden of OAO both to the healthcare system and broader government accounts. 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引用次数: 0

摘要

导言：肥胖症仍然是一个重大的公共卫生问题，对健康和经济都有广泛的影响。分析目的本分析从政府角度出发，通过捕捉肥胖导致的税收损失和政府转移支付的增加，评估超重和肥胖（OAO）在日本造成的财政后果。方法：使用特定年龄流行率模型估算 OAO 的财政负担，该模型跟踪不同体重指数 (BMI) 类别的日本人口。该模型使用了日本的财政数据，包括就业活动和政府支出，以计算税收和转移成本。我们进行了有针对性的文献回顾，以确定估算 OAO 对就业、收入、病假、退休和死亡率影响的数据。这些修正因素被应用于日本的流行病学和财政预测，以计算政府税收和支出。随后计算了减少 OAO 对普通人群的增量影响。结果以 2023 年日本 18 至 70 岁的工作年龄人口为基础进行估算。结果：日本 OAO 的总财政负担（定义为体重指数至少为 25）估计为 134.1 亿美元（1925 亿日元），分别为 463 亿美元（9010 亿日元）和 1.2 b i l l i o n ( ¥ 179 b i l l i o n ) i n d i r e c t a n d i n d i r e c t a x r e v n u e ， r e s p e c t i v e l y ， d u e t l o w e r e m p l o y m e n t a n d i n c o m e c o m b i n e d w i t h i g h e r s i c k l e a v e 。由于提前退休的人数增加，预计将增加 54 亿美元（7,690 亿日元）的养老金支出。结论：尽管 OAO 对健康的影响有据可查，但这项财政分析表明，OAO 对医疗保健系统和更广泛的政府账户都造成了巨大的经济负担。旨在减少人口肥胖的政策有可能通过增加就业和减少公共开支使政府账户受益，从而抵消实施这些政策的成本。

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Assessing the Fiscal Burden of Overweight and Obesity in Japan through Application of a Public Economic Framework.

Introduction: Obesity continues to represent a significant public health concern, with a broad impact from both a health and economic perspective. Objective: This analysis assesses the fiscal consequences of overweight and obesity (OAO) in Japan by capturing obesity-attributable lost tax revenue and increased government transfers using a government perspective. Methods: The fiscal burden of OAO was estimated using an age-specific prevalence model, which tracked the Japanese population across different body mass index (BMI) categories. The model was populated with fiscal data for Japan, including employment activity and government spending, to calculate tax revenue and transfer costs. A targeted literature review was conducted to identify data estimating the impact of OAO on employment, income, sick leave, retirement, and mortality. These modifiers were applied to Japanese epidemiological and fiscal projections to calculate government tax revenue and spending. The incremental impact of reducing OAO in the general population was subsequently calculated. Results were estimated based on the 2023 Japanese working-age population aged 18 to 70 years. Results: The total fiscal burden of OAO in Japan, defined as BMI of at least 25, is estimated at US $13.41 b i l l i o n (¥ 1925 b i l l i o n), r e p r e s e n t i n g 0.4$ 6.3 billion (¥901 billion) and $1.2 b i l l i o n (¥ 179 b i l l i o n) i n d i r e c t a n d i n d i r e c t t a x r e v e n u e, r e s p e c t i v e l y, d u e t o l o w e r e m p l o y m e n t a n d i n c o m e c o m b i n e d w i t h h i g h e r s i c k l e a v e . E x c e s s O A O - a t t r i b u t a b l e h e a l t h c a r e c o s t s w e r e$ 5.4 billion (¥769 billion), while additional pension payment spending of $0.5 billion (¥77 billion) was estimated, due to higher levels of early retirement. Conclusions: While the health implications of OAO are well documented, this fiscal analysis demonstrates the significant economic burden of OAO both to the healthcare system and broader government accounts. Policies aimed at reducing population-level obesity have the potential to benefit government accounts through increasing employment and reducing public spending, which can offset the cost of implementing these policies.