Vecino-Ortiz Andres I, Roberton Timothy, López-Hernández Angelica, Noonan Caitlin M, Vega Landaeta Angela P, Maceira Daniel, Flores Yvonne N, Mora-García Claudio A, Giusti Paulina, Samuels T Alafia, Palacio-Martínez Natalia, Prado Andrea, Machado Carla, Metivier Charmaine, Laptiste Christine, La Foucade Althea, Beharry Vyjanti, Rao Krishna D
Department of International Health, Health Systems program, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America.
Faculty of Health and Medical Sciences, School of Population and Global Health, University of Western Australia, Perth, Australia.
PLOS Glob Public Health. 2025 Jul 18;5(7):e0004791. doi: 10.1371/journal.pgph.0004791. eCollection 2025.
Addressing the World Health Organization's noncommunicable disease (NCD) "best buys" is key to reducing the disease burden in Latin America and the Caribbean (LAC). Yet, the potential impact of addressing NCD risk factors on current health expenditures (CHE) in LAC countries is unknown. This study uses both Global Burden of Disease (GBD) data and administrative information to model the impact of addressing four risk factors on CHE trends for 24 LAC countries. A comparative risk assessment model estimates changes in CHE associated with reducing five NCDs. Reducing the prevalence of the four risk factors by 10% could save $ 185 billion in cumulative expenditure by 2050 (1.32% of cumulative expenditure from 2020 to 2050) for all LAC countries assessed, with substantial heterogeneity across risk factors. Reducing the prevalence of high blood pressure had the largest impact. On average, a reduction of 10% in high blood pressure, tobacco use, high blood glucose, and alcohol use would reduce cumulative CHE by US$59bn (0.4% of the cumulative CHE by 2050), US$68bn (0.5%), US$46bn (0.3%), and US$12bn (0.1%), respectively for all LAC countries. While addressing NCD risk factors is a key step to improving health in LAC countries, the impact on CHE is relatively small though meaningful in absolute terms, and additional strategies need to be implemented to control increasing CHE levels that threaten health systems' sustainability.
应对世界卫生组织的非传染性疾病（NCD）“最具成本效益干预措施”是减轻拉丁美洲和加勒比地区（LAC）疾病负担的关键。然而，应对非传染性疾病风险因素对LAC国家当前卫生支出（CHE）的潜在影响尚不清楚。本研究使用全球疾病负担（GBD）数据和行政信息，对24个LAC国家应对四个风险因素对CHE趋势的影响进行建模。一个比较风险评估模型估计了与减少五种非传染性疾病相关的CHE变化。到2050年，将四个风险因素的流行率降低10%，所有评估的LAC国家累计可节省1850亿美元（占2020年至2050年累计支出的1.32%），各风险因素之间存在很大差异。降低高血压流行率的影响最大。平均而言，将高血压、烟草使用、高血糖和酒精使用的流行率降低10%，所有LAC国家的累计CHE将分别减少590亿美元（占2050年累计CHE的0.4%）、680亿美元（0.5%）、460亿美元（0.3%）和120亿美元（0.1%）。虽然应对非传染性疾病风险因素是改善LAC国家健康状况的关键一步，但对CHE的影响相对较小，尽管从绝对值来看是有意义的，还需要实施其他策略来控制威胁卫生系统可持续性的不断增加的CHE水平。
