Die volkswirtschaftlichen Effekte von Adipositas im Kindesalter

Im Jahr 2019/20 war in etwa jedes vierte Kind in Österreich von Übergewicht oder Adipositas betroffen (COSI, 2021). Adipositas steht im Zusammenhang mit einer Fülle an Folgeerkrankungen, einer geringeren Lebenserwartung und reduzierten Lebensqualität sowie mit Einkommensverlusten. Ziel dieser Studie war es, die volkswirtschaftlichen Effekte von Adipositas im Kindes- und Jugendalter für Österreich zu schätzen. Es wurde dabei zwischen direkten medizinischen und indirekten Kosten unterschieden. Intangible Kosten wie psychische Belastungen durch Stigmatisierung und Diskriminierung wurden nicht quantifiziert, da es sich hier per definitionem um Kosten handelt, die schwer in monetäre Werte zu fassen sind. Kosten wurden für das Jahr 2019 berechnet sowie die Summe an Kosten über den gesamten Lebenszyklus – pro Person und als Summe aller Geburtenkohorten der Jahre 2000 bis 2019.

In Austria, nearly every fourth child is affected by overweight or obesity as of 2020. These children are at high risk to continue to be affected by obesity over their lives. Obesity reduces a child’s health-related quality of life, affects a child’s school career – and, with it, their future income – and leads to a variety of diseases and lower life expectancy. This study estimates the economic effects resulting from childhood obesity for Austria. The analysis includes direct medical and indirect costs; costs are calculated for the year 2019 and over the entire life cycle.
The study uses obesity prevalence based on measurement data from the Austrian COSI (2021) study, from Austrian candidates for conscription (2022), as well as the German KIGGS study (2018) for children up to four years. Based on prevalence data and data on relative risks for obesity-associated health problems in children and adults, we estimate population-attributable fractions applied to diagnosis-specific average per-capita health expenditure (excluding long-term care). Indirect costs arise from income losses due to sick leave, disability, and premature mortality, as well as from a proportional income loss associated with the choice of school, the choice of profession and discrimination in the labour market. The life-cycle model includes all secondary diseases in adult life. It also considers a discount rate of 3 percent, obesity-associated mortality, and future increases in health care costs. To estimate medical and indirect costs for all birth cohorts from 2000 to 2019, we use a forecast of obesity prevalence among 20- to 24-year-olds in Austria up to the year 2039. Based on results from international long-term studies, we assume that about half of the 20- to 24-year-old population with obesity has a history of obesity during childhood or adolescence.
The resulting sum of annual costs of childhood obesity is € 12 million in 2019. Average annual costs for a child with obesity are around € 100 higher than for a child without obesity (€ 120 for adolescents). The life-cycle medical costs largely depend on the degree of obesity: for a man with obesity class I, class II, or class III total medical costs amount to around € 21 000, € 44 000, and € 68 000, respectively. For women, the corresponding values are € 21 000, € 32 000, and € 48 000. Total loss of productivity is approx. € 130 000 and € 88 000 for men and women, respectively (assuming a 10 percent penalty on wages). Finally, we estimate that around 95 000 of all children and adolescents in 2019 will enter young adulthood with obesity, which leads to a cash value of € 8.85 billion or an annuity of € 280 million in total costs. In conclusion, this study shines light on the considerable economic burden of childhood obesity in Austria. In addition, children with obesity often deal with a mental burden caused by stigmatisation and discrimination. Public health programs addressing obesity could relieve high costs not only for individuals, but also for society as a whole.