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改善 WIC 食品套餐预防儿童肥胖的成本效益。

Cost-effectiveness of Improved WIC Food Package for Preventing Childhood Obesity.

机构信息

Department of Nutrition.

Department of Social and Behavioral Sciences.

出版信息

Pediatrics. 2024 Jan 1;153(2). doi: 10.1542/peds.2023-063182.

Abstract

BACKGROUND AND OBJECTIVES

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) prevents food insecurity and supports nutrition for more than 3 million low-income young children. Our objectives were to determine the cost-effectiveness of changes to WIC's nutrition standards in 2009 for preventing obesity and to estimate impacts on socioeconomic and racial/ethnic inequities.

METHODS

We conducted a cost-effectiveness analysis to estimate impacts from 2010 through 2019 of the 2009 WIC food package change on obesity risk for children aged 2 to 4 years participating in WIC. Microsimulation models estimated the cases of obesity prevented in 2019 and costs per quality-adjusted-life year gained.

RESULTS

An estimated 14.0 million 2- to 4-year old US children (95% uncertainty interval (UI), 13.7-14.2 million) were reached by the updated WIC nutrition standards from 2010 through 2019. In 2019, an estimated 62 700 (95% UI, 53 900-71 100) cases of childhood obesity were prevented, entirely among children from households with low incomes, leading to improved health equity. The update was estimated to cost $10 600 per quality-adjusted-life year gained (95% UI, $9760-$11 700). If WIC had reached all eligible children, more than twice as many cases of childhood obesity would have been prevented.

CONCLUSIONS

Updates to WIC's nutrition standards for young children in 2009 were estimated to be highly cost-effective for preventing childhood obesity and contributed to reducing socioeconomic and racial/ethnic inequities in obesity prevalence. Improving nutrition policies for young children can be a sound public health investment; future research should explore how to improve access to them.

摘要

背景和目的

妇女、婴儿和儿童特别补充营养计划(WIC)旨在预防食物不安全,并为 300 多万名低收入幼儿提供营养支持。我们的目标是确定 2009 年 WIC 营养标准的改变在预防肥胖方面的成本效益,并估计对社会经济和种族/族裔不平等的影响。

方法

我们进行了成本效益分析,以估计 2009 年 WIC 食品包变化对 2010 年至 2019 年期间参与 WIC 的 2 至 4 岁儿童肥胖风险的影响。微观模拟模型估计了 2019 年预防肥胖的病例数和每获得一个质量调整生命年的成本。

结果

估计有 1400 万(95%不确定区间(UI),1370 万至 1420 万)名 2 至 4 岁的美国儿童受益于更新后的 WIC 营养标准,从 2010 年至 2019 年。在 2019 年,估计有 62700(95% UI,53900 至 71100)例儿童肥胖症得到预防,全部是来自低收入家庭的儿童,这导致健康公平状况得到改善。该更新估计每获得一个质量调整生命年的成本为 10600 美元(95% UI,9760 美元至 11700 美元)。如果 WIC 已经覆盖了所有符合条件的儿童,那么将会预防更多的儿童肥胖症病例。

结论

2009 年对 WIC 幼儿营养标准的更新被估计为预防儿童肥胖症非常具有成本效益,并有助于减少肥胖症患病率方面的社会经济和种族/族裔不平等。改善幼儿营养政策可以是一项合理的公共卫生投资;未来的研究应探讨如何改善对这些政策的获取。

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