UNICEF Peru, Melitón Porras 350, Lima, 15074, Peru.
RTI International, 3040 East Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC, 27709-2194, USA.
Int J Behav Nutr Phys Act. 2024 Nov 6;21(1):127. doi: 10.1186/s12966-024-01677-5.
Between 2006 and 2016 the prevalence of overweight and obesity among children and adolescents aged 5-19 years in Peru increased from 22.7 to 27.0%. This investment case quantifies the economic impacts of childhood and adolescent overweight and obesity in Peru. It identifies and quantifies the potential impact of a set of new or expanded interventions that can strengthen current national efforts to prevent and reduce child and adolescent overweight and obesity.
A deterministic Markov cohort model with a societal cost perspective estimated reductions in mortality and morbidity from implementing interventions to prevent and reduce child and adolescent overweight and obesity and the impact in savings in healthcare costs and gains in wages and productivity. Interventions identified through a review of published literature includes a school-based social marketing campaign, exclusive breastfeeding promotion and support, a healthy food and drink policy for school premises, and a 20% subsidy on fruits and vegetables for people living below the national poverty line. The return on investment (ROI) was calculated along with the estimated cost savings associated with the interventions. Analysis was conducted to test ROI sensitivity to changes in the key parameters and assumptions.
Between 2025 and 2092, the expected combined direct and indirect healthcare costs attributable to child and adolescent overweight and obesity in Peru are 210.6 billion USD. The direct healthcare costs are 1.8 billion USD, and the indirect costs are 208.8 billion USD. Expected savings for all interventions combined is 13.9 billion USD with a per-person savings of 12,089.8 USD. The expected ROI of the four interventions combined is 39.3 USD (30-years), 64.6 USD (50-years), and 164.1 USD (66-years) per one USD invested.
The overweight and obesity epidemic among children and adolescents in Peru requires wide-ranging and expanded implementation of policies to achieve long-term reductions in prevalence. This study's findings show that the four priority interventions have high ROIs and can be used to guide policy to address the complex interplay of factors that contribute to the obesogenic environment.
2006 年至 2016 年期间，秘鲁 5-19 岁儿童和青少年超重和肥胖的患病率从 22.7%上升至 27.0%。本投资案例量化了儿童和青少年超重和肥胖问题给秘鲁带来的经济影响。它确定并量化了一系列新的或扩大的干预措施的潜在影响，这些措施可以加强当前预防和减少儿童和青少年超重和肥胖的国家努力。
采用具有社会成本视角的确定性马尔可夫队列模型，估算了实施预防和减少儿童和青少年超重和肥胖的干预措施所带来的死亡率和发病率降低情况，以及在节省医疗保健成本和提高工资和生产力方面的影响。通过对已发表文献的审查，确定了干预措施，包括基于学校的社会营销活动、纯母乳喂养的推广和支持、学校场地的健康食品和饮料政策，以及对生活在国家贫困线以下的人群的水果和蔬菜 20%的补贴。还计算了投资回报率（ROI）以及与干预措施相关的估计成本节约。对分析进行了测试，以检验 ROI 对关键参数和假设变化的敏感性。
预计 2025 年至 2092 年，秘鲁与儿童和青少年超重和肥胖相关的直接和间接医疗保健总成本将达到 2106 亿美元。其中直接医疗保健成本为 18 亿美元，间接成本为 2088 亿美元。预计所有干预措施的综合节省为 139 亿美元，人均节省 12089.8 美元。四项干预措施的综合预期投资回报率为 39.3 美元（30 年）、64.6 美元（50 年）和 164.1 美元（66 年）。
秘鲁儿童和青少年的超重和肥胖问题需要广泛和扩大实施政策，以实现长期降低患病率的目标。本研究结果表明，四项优先干预措施具有较高的投资回报率，可以用于指导政策，以解决导致肥胖环境的复杂因素相互作用。
