Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany.
Wittgenstein Centre (IIASA, VID/ÖAW, WU), Vienna Institute of Demography, Vienna, Austria.
PLoS One. 2018 Nov 1;13(11):e0206702. doi: 10.1371/journal.pone.0206702. eCollection 2018.
We develop and calibrate a dynamic production function model to assess how noncommunicable diseases (NCDs) will affect U.S. productive capacity in 2015-2050. In this framework, aggregate output is produced according to a human capital-augmented production function that accounts for the effects of projected disease prevalence. NCDs influence the economy through the following pathways: 1) when working-age individuals die of a disease, aggregate output undergoes a direct loss because physical capital can only partially substitute for the loss of human capital in the production process. 2) If working-age individuals suffer from a disease but do not die from it, then, depending on the condition's severity, they tend to be less productive, might work less, or might retire earlier. 3) Current NCD interventions such as medical treatments and prevention require substantial resources. Part of these resources could otherwise be used for productive investments in infrastructure, education, or research and development. This implies a loss of savings across the population and hampers economy-wide physical capital accumulation. Our results indicate a total loss of USD94.9 trillion (in constant 2010 USD) due to all NCDs. Mental health conditions and cardiovascular diseases impose the highest burdens, followed by cancer, diabetes, and chronic respiratory diseases. In per capita terms, the economic burden of all NCDs in 2015-2050 is USD265,000. The total NCD burden roughly corresponds to an annual tax rate of 10.8% on aggregate income.
我们开发并校准了一个动态生产函数模型,以评估 2015-2050 年间非传染性疾病(NCDs)将如何影响美国的生产能力。在这个框架中,总产出是根据一个人力资本增强的生产函数生产的,该函数考虑了预期疾病流行的影响。NCD 通过以下途径影响经济:1)当处于工作年龄的个体因疾病死亡时,由于物理资本只能部分替代生产过程中人力资本的损失,总产出会直接损失。2)如果处于工作年龄的个体患有疾病但未因此死亡,那么根据病情的严重程度,他们的生产力可能会降低,工作时间可能会减少,或者可能会提前退休。3)当前的 NCD 干预措施,如医疗和预防措施,需要大量资源。这些资源的一部分原本可以用于基础设施、教育或研发方面的生产性投资。这意味着整个人群的储蓄损失,阻碍了全社会的物质资本积累。我们的研究结果表明,由于所有 NCD 导致的总损失为 94.9 万亿美元(以 2010 年不变美元计)。心理健康状况和心血管疾病造成的负担最大,其次是癌症、糖尿病和慢性呼吸系统疾病。按人均计算,2015-2050 年所有 NCD 的经济负担为 26.5 万美元。NCD 的总负担大致相当于对总收入征收 10.8%的年度税率。