This document discusses the high global costs of non-communicable diseases (NCDs) related to diet and lifestyle. Some key points: - NCDs like cardiovascular disease and cancer caused over 30 million deaths globally in 2008 and cost trillions in economic losses from 2011-2030 according to WHO estimates. - Unhealthy diets high in sugar, salt, and fat along with physical inactivity account for the majority of NCD burden. Improving diets and increasing activity could significantly reduce premature deaths. - Investing in prevention through improved nutrition is estimated to cost a small fraction of the economic losses from NCDs. Yet prevention receives little funding compared to treatment costs. -

1. Food and Public Health
Tim Lang
Centre for Food Policy, City University London, UK
e: t.lang@city.ac.uk
Paper to Sustainable Food Trust ‘Truce-Cost Accounting in Food and Farming
conference, held at the Royal Geographical Society, London on December 6 2013
1

2. Global picture
• CVD caused 17 m deaths in 2008
– 30% of all deaths
– 50% of NCD deaths
• Behavioural risk factors = c80% of CVD burden
– physical inactivity, tobacco and unhealthy diet
(Gaziano, Bitton, Anand, Abrahams-Gessel & Murphy, 2010)
• Wider picture well-known = Nutrition Transition:
– dietary change, urbanisation, cultural change,
marketing, sedentary lifestyles
– Sugar, salt, fat, processed foods
2

3. WHO Global Burden of Disease (2010)
http://www.who.int/healthinfo/global_burden_disease/GlobalHealthRisks_report_full.pdf
• Calculated disability-adjusted life years (DALYs)
• 19 leading risk factors account for 58.8 m deaths
in 2004
• Food = 10 / 19
3

4. Q: Is this worth tackling?
A: Yes (even more in some regions than others)
4

5. Costs
5

6. EPIC estimates for economic losses
from NCDs in 2011-30
Estimated losses
In 2011-2030 NCDs will
cause global economic
losses:
• Diabetes: $1.7 trn
• CVD: $15.6 trn
• Cancer: $8.3 trn
…as comparison…
In 2009:
• Total global healthcare
expenditure was $5.1 trn
• Entire annual GDP of low
income countries was
approx $1 trn
6

7. EPIC estimated losses 2011-30,
by NCD 4 categories & by country income
source: Abegunde & Stanciole for WHO 2006 / Harvard& WEF
7

8. Global costs estimated
Harvard & WEF (2011)
www.weforum.org/EconomicsOfNCD
• 2010-30 NCDs estimated to cost US $30 trillion +
= 48% of global GDP in 2010
– will push millions of people below poverty line
• Prevention (alcohol, tobacco, diet, exercise) can
work:
– Would cost $2 bn p.a. for low/middle income
countries
= $0.40 per cap p.a.
8

9. UK food-related disease
• Food-related diseases (cardiovascular
diseases, cancers, diabetes) account for 125k premature
(<75yrs) deaths p.a.
• Chief Scientist’s Foresight Obesity report (2007):
– obesity’s actual costs in 2002 = c £7 billion
• This is about 2/3 of all premature deaths
http://www.bhf.org.uk/research/heart-statistics.aspx
• 30k of these deaths could be delayed or averted if UK dietary
guidelines were met
J Epidemiol Community Health 2010, doi:10.1136/jech.2010.114520
• Diet and physical inactivity account for 14% of UK DALYs in
2010 (Tobacco accounts for 12%).
www.thelancet.com Vol 381 March 23, 2013
• Food-related ill health costs UK NHS at least £6 billion p.a.
J Public Health 2011, doi: 10.1093 /pubmed /fdr033
9

10. What would the food system look like if
designed around ecological public health?
• More horticulture
– UCS study: if US agric followed the plate +180k jobs
• Less meat and dairy agriculture?
– Less grain-fed meat / dairy? (c.50% grain animals)
• Different price signals (some internalised costs)
• Different food culture (biodiversity isn’t costed)
• Different signals eg marketing vs health
10

11. Q: Why invest in food & nutrition?
• It saves lives and money + better quality of life
http://siteresources.worldbank.org/NUTRITION/Resources/281846-1131636806329/NutritionStrategyCh1.pdf
• High burden in rich countries
• low/middle income countries will overtake
• The ‘financialisation’ debate is now changing
– well-being / ‘better life’ indicators:
http://www.oecdbetterlifeindex.org/
• Cost studies consistently show heavy costs
from poor diet-related ill-health,
– Yet prevention investment doesn’t happen
11