Development of an investment case for obesity prevention and control: perspectives on methodological advancement and evidence

Abstract

Review Suggested citationMilliken OV, Ellis VL, Development of an investment case for obesity prevention and control: perspectives on methodological advancement and evidence. Rev Panam Salud Publica. 2018;42:e62. https://doi.org/10. 26633/RPSP.2018.62 As the obesity epidemic has been spreading rapidly across the Americas, national governments and regional and international organizations have called for action from the whole of society (1-4). To answer these calls, jurisdictions are seeking comprehensive investment cases that would articulate the benefits and costs of an intervention strategy across various economic actors and the factors that could affect its implementation. For example, the United Nations Interagency Task Force on the Prevention and Control of Noncommunicable Diseases has been working with countries around the globe to prepare investment cases for prevention and control of noncommunicable diseases (NCDs) and their risk factors (5).An investment case presents reasoning for an action and includes a strategy to achieve a stated objective. Drawing from recent efforts to formulate investment cases (5-7), we find that a public health investment case generally includes six steps: 1) describing the problem within a given country, including determinants and risk factors and public health and economic impacts; 2) identifying effective, feasible, and locally relevant interventions for analysis; 3) providing analysis of the costs versus benefits of intervening, and identifying synergies among interventions; 4) building a package of interventions based on the second and third steps as well as other criteria such as distributional consequences and acceptability among stakeholders; 5) identifying the funding requirements and finding resources; and 6) developing a detailed plan for implementation and evaluation of results. Figure 1 summarizes this process.The objective of this paper is to discuss how various economic methods for valuing costs and benefits can be applied to obesity-targeted interventions (the third step listed above). The paper also summarizes major evidence towards the development of an investment case for obesity prevention and control in line with the third and fourth steps. ABSTRACT

Integrating economics into the rationale for multisectoral action on obesity

“…In Latin America and the Caribbean (LAC), there is sparse, but widely varying, evidence of the health care cost burden of obesity (13). Further, in LAC, evidence from economic evaluations is uncommon in health policy formation, and few nutrition and physical activity interventions have economic evaluations (9).…”

“…The economic burden of obesity is alarmingly large (9). Nevertheless, a descriptive measure of that burden would not in itself provide a sufficient justification for what many economic sectors would see as intrusion into markets and individual choices.…”

“…Welfare economics is an established branch of economics that looks at the impact of policies on well-being at the level of individuals, markets, and society as a whole and that considers distributional effects. Our companion paper (9) looks at how welfare economics, particularly cost-benefit methodologies, can be used to assess an investment case for intervention.…”

“…The article briefly reviews economic theory and evidence that could support an integrated rationale for multisectoral action, highlighting evidence from the Americas. The authors' companion paper (9) in this special supplement discusses gaps in methods and evidence needed for a comprehensive investment case.…”

Obesidad abdominal en adultos del estado de Pernambuco, Brasil: un estudio epidemiológico de tipo transversal

“…En el caso de la región de América Latina, en los últimos treinta años hubo una reducción de las estadísticas de hambre, desnutrición y deficiencias de micronutrientes derivando hacia un aumento progresivo de las cifras de exceso de peso. En algunos países de la región latinoamericana, se observa la doble carga de la malnutrición en donde coexisten altas prevalencias de deficiencias de micro y macro nutrientes conjunto con sobrepeso y la obesidad, casos que se propagan con mayor rapidez en los países de ingresos bajos y medianos [6][7] .…”