Early childhood obesity: Association with healthcare expenditure in Australia

Abstract

Objective: To determine whether overweight or obesity among children (aged 2 to 5 years) is associated with direct healthcare costs, after adjusting for child, household, and socioeconomic characteristics. Methods: A longitudinal cohort analysis was performed in 350 children aged 2 years assessed over 3 years of follow-up. Child weight status was determined from mean BMI z-scores at 2, 3.5, and 5 years, and healthcare utilization including medicines, nonhospital, hospital, and emergency care was determined by data linkage. Using adjusted multivariable regression analyses, the relationship between total 3-year healthcare costs and weight status was examined. Observations took place in Sydney, Australia, between 2011 and 2014. Results: After adjustment for significant maternal and sociodemographic characteristics, healthcare costs of children with obesity (BMI z-score >2SD) were 1.62 (95% CI 1.12-2.34, P 5 0.01) times those of children with healthy weight. However, costs of overweight children were similar to those of healthy weight (P 5 0.96). The additional 3-year costs of healthcare for a child with obesity compared with healthy weight were $AUD 825 (95% CI $135-$2,117) for general patients and $AUD 1332 (95% CI $174-$4,280) for concession card holders. Conclusions: Prevention of obesity in early childhood may have concurrent benefits in reducing healthcare expenditure.

A 3-Arm randomised controlled trial of Communicating Healthy Beginnings Advice by Telephone (CHAT) to mothers with infants to prevent childhood obesity

“…Obesity in pre-school aged children has a high risk of progressing to obesity in later childhood [5] and potentially into adulthood [6, 7]. The adverse health consequences of childhood obesity are well documented internationally [8, 9], and in Australia obesity in very young children is associated with increased healthcare utilization [10]. There was a call for greater efforts being made to prevent childhood obesity in the early years, and even before birth [11].…”

The potential for long‐term cost‐effectiveness of obesity prevention interventions in the early years of life

“…It is estimated that 42 million children under 5 years of age are affected by overweight and obesity worldwide . Overweight and obesity in childhood have been linked to negative short‐term outcomes, such as lower educational attainment and health‐related quality of life (HRQoL) and higher health care costs . Overweight and obesity in the early years of life also lead to a higher risk of overweight and obesity in adulthood and carry an increased risk of chronic conditions including diabetes, cardiovascular diseases, and some cancers.…”

What exposures in early life are risk factors for childhood obesity?

“…Apart from implications for self‐esteem and for mental health when they are older, long‐term education and quality of life suffer . Furthermore, in a recent Australian study of children aged 2 years and followed up to age 5 years, children with obesity were more likely to be admitted to hospital and had 60% higher health‐care costs than healthy weight children . These interactions with the health system extend over the life course and may impact economic development, associations which have been noted globally …”