The document discusses the rising obesity rates among adolescents and the health and economic implications of preventive measures. It highlights various interventions, including health education, regulatory approaches, and community initiatives, while questioning their cost-effectiveness and impact on health inequalities. The findings suggest that comprehensive strategies involving multiple stakeholders are essential for effective prevention efforts.

1. Improving Lifestyles, Tackling Obesity: the Health and Economic Impact of Prevention Michele Cecchini OECD - Health Division

2. Obesity: a Growing Problem

3. Change in obesity rates 2001-02 vs 2005-06 15 year-olds boys girls OECD analysis on: Currie et al. international report from the HSBC Survey, WHO Europe United States Canada Greece Italy Iceland Portugal Spain Finland Austria OECD Hungary Luxembourg Germany Norway Sweden Ireland Turkey Czech Republic France Switzerland Denmark United Kingdom Belgium Poland Slovak Republic Netherlands

4. Scope of OECD/WHO Analyses Regional analysis Country analyses

5. Cancers Stroke Ischemic heart disease Physical activity P 0 adequate physical act P 1 insuff .physical act Body mass index N normal weight U pre-obesity V obesity Blood pressure Z 0 normal Z 1 hypertension Cholesterol A 0 normal A 1 hypercholesterolemia Glycaemia B 0 normal B 1 diabetes Fat F 0 low fat intake F 1 medium fat intake F 2 high fat intake Fibre Y 0 adequate fibre intake Y 1 low fibre intake Socio-economic status I 0 upper I 1 lower

6. Interventions Health education and health promotion Regulation and fiscal measures Primary-care based interventions Mass media campaigns Fiscal measures (fruit and vegetables and foods high in fat) Physician counselling of individuals at risk School-based interventions Government regulation or industry self-regulation of food advertising to children Intensive physician and dietician counselling of individuals at risk Worksite interventions Compulsory food labelling

7. Expectations Must Be Realistic Does prevention improve health? Does it reduce health expenditure? Does it improve health inequalities? Is it cost-effective?

8. Prevention Does Save Lives… 1 LY/DALY every 115/121 people 1 LY/DALY every 12/10 people

9. … But Does Not Necessarily Save Money!

10. Health Outcomes and Expenditure Physician-Dietician Counselling Health outcomes Impact on health expenditure

11. Interventions vs. Age Note: risk equals to 1 for 50 year olds and no intervention

12. Spending on prevention is a good long-term investment

13. Distributional Impact School-based interventions Fiscal measures

14. Multiple interventions Health outcomes Impact on health expenditure (selected diseases) Multiple int. 1 : school-based intervention + mass media camp + physician-dietician counselling Multiple int. 2 : food labelling + food advert self-regulation + school-based interventions + mass media campaigns + physician-dietician counselling

15. Policy Implications Prevention is an effective and cost-effective way to improve population health Prevention can decrease health expenditure and improve inequalities, but not to a major degree Comprehensive strategies combining population and individual approaches provide best results Involvement of relevant stakeholders is key to the success of prevention

16. OECD work on prevention Obesity and the economics of prevention: fit not fat OECD health working papers HWP 32, 45, 46, 48 Paper in Lancet series on chronic diseases www.oecd.org/health/prevention www.oecd.org/health/fitnotfat [email_address]