Mortality, hospital days and treatment costs of current and reduced sugar consumption in Israel

Abstract

BackgroundConsumption of sugar causes tooth decay, overweight and obesity related morbidities. This paper in response to the Minister of Health’s request, provides estimates of the mortality, morbidity and health care costs attributable to sugar consumption in Israel along with the effects of reducing sugar consumption.MethodsGender specific relative risks of many diseases from overweight (25 < =BMI < 30) and obesity (BMI > =30) were applied to the national gender specific prevalence rates of overweight and obesity in order to calculate the population attributable fraction (PAF) from overweight and obesity. National expenditure on these related diseases was calculated by applying disease-specific data from a recent Canadian study to estimates of disease specific general hospital expenditures in Israel. Disease specific costs attributable to overweight and obesity were estimated from the product of these expenditures and PAF. In addition national costs of treating caries in persons under 18 years of age from sugar were calculated. Similar calculations were made to estimate the burden from sugar in terms of mortality and hospital utilisation. A recent UK modelling study was used to estimate the effect of a national program to reduce calorific consumption of sugar from 12.45 to 10% in 5 years.ResultsConditions associated with overweight or obesity accounted annually for 6402 deaths (95% CI 3296–8760) and 268,009 hospital days. Dental costs attributable to sugar consumption were 264 million NIS. In total, obesity, overweight and sugar consumption accounted for 2449 million in direct treatment costs (0.21% of GDP), rising to 4027 million (0.35% of GDP) when indirect costs were included. A national program of reducing energy from sugar consumption from 12.45 to 10% over 5 years is considered have a very feasible short-term goal. Even if the program does not impose taxes on sugar consumption, this would save 778 million NIS as well as 1184 lives.ConclusionSugar consumption causes a huge monetary and mortality burden. Estimates of potential decreases in this burden justify the current prioritisation given by the health minister of creating and implementing a national program to reduce sugar consumption, which is likely to be cost-saving (ie: averted treatment costs will exceed intervention costs).

Ethnic disparities in receiving benefits for disability following postpartum mental illness during first two years after delivery: an Israeli nationwide study

“…A major factor influencing claiming of benefits is awareness that such rights exist, and knowledge of the eligibility rules and claiming procedures [ 25 ]. A gap has been found between Jews and Arabs regarding knowledge and understanding of health insurance [ 26 ], and this may also be the case regarding NII benefit eligibility rights. In the case of conditions such as PPD, women in ethnic minority groups may also be less cognizant of the fact that they are suffering from a postpartum emotional disorder [ 27 ].…”

“…This may influence all ethnic groups, since tagging someone as mentally ill may interfere with future possibilities, such as employment. Further, most people experiencing mental health problems do not seek professional help, and the stigma of mental illness is considered a major barrier to seeking appropriate treatment [ 26 ]. A recent study conducted in Israel found that only 76% of women participated in a screening initiative for PPD and participation was associated with more positive attitudes toward seeking help [ 33 ].…”

Burden of Underweight in Israel

“…Using the general hospital cost estimates as a base, estimates of disease‐specific out‐of‐hospital pharmaceuticals and other care (including ambulatory care) costs were made as follows: for breast cancer, CRC, and stroke, estimates were calculated directly from a recent similar study on the burden of sugar consumption in Israel; for dementia, depression, musculoskeletal disorders, chronic pancreatitis and COPD, estimates were based on overall health service costs . Therefore, hospital costs were multiplied by a factor of 13.3%/22.7% and (41.9% + 22.1%)/22.7% in order to estimate out‐of‐hospital pharmaceutical and other care costs.…”

“…Therefore, hospital costs were multiplied by a factor of 13.3%/22.7% and (41.9% + 22.1%)/22.7% in order to estimate out‐of‐hospital pharmaceutical and other care costs. Head and neck cancer cost estimates were based on the combined totals for all 8 cancers listed in the burden of sugar study …”

“…Head and neck cancer cost estimates were based on the combined totals for all 8 cancers listed in the burden of sugar study. 20 All costs were expressed in New Israeli Shekels (NIS) and converted at an exchange rate of 3.60 NIS to U.S. dollars expressed at 2017 exchange rate. 18 Both future costs and DALYs were discounted using a 3%/annum rate.…”