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SPORTS MEDICINE :
MEDICAL CONDITIONS: OBESITY:
Prudent Ways to Fight Childhood Obesity
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Prudent Ways to Fight Childhood Obesity
By Jane E. Brody
June 22, 2015 5:45 am
Well
New York Times
http://well.blogs.nytimes.com/2015/06/22/
seeking-efficient-paths-to-slimmer-children/
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A shorter URL for the above link:
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http://tinyurl.com/pgzcv4n
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The time is long overdue for legislators, schools, policy wonks and
parents to deal more effectively with what is clearly one of the nations
most costly health care problems.
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In the meantime, parents and other adults who influence young lives can
adopt the techniques found most likely to keep children lean and healthy
and extend those benefits well into their adult years. For families as
well as institutions, the dollar and health savings can be significant.
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The project, initial results of which were published recently by The
American Journal of Preventive Medicine, is called the Childhood Obesity
Cost-Effectiveness Study, or Choices. It examined in exhaustive detail the
costs and benefits of four possible approaches to curbing childhood
obesity: placing an excise tax on sugar-sweetened beverages; ending the
tax write-off for advertising on childrens television; increasing moderate
to vigorous physical activity in schools; and fostering healthier habits
(more physical activity, better nutrition and less screen time) in
preschool settings.
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As you might expect, these approaches vary both in their implementation
costs and effects on childrens weight, but before this analysis, there was
no clear guidance as to which gave the biggest bang for the buck (another
apt clich. The research team of experts, from the Harvard School of Public
Health, the University of Washington School of Medicine, Columbia
University Mailman School of Public Health, Deakin University in Melbourne
and the University of Queensland, modeled the preventive interventions as
if applied nationwide to children in 2015. Their resulting estimates of
expected benefits to childrens weight (and subsequent health) and the cost
of implementation were based on scores of controlled studies in a wide
variety of settings.
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While each approach can have a positive effect, two stood out as most
likely to lower childrens body mass index, also called B.M.I., for the
least cost and greatest returns on the investment: an excise tax on
sugar-sweetened beverages and eliminating the tax subsidy on TV
advertising to children.
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For each unit of B.M.I. lowered per person during the first two years, the
TV ad change would cost $1.16 per person but would also generate about $80
million a year and save $343 million in health care costs for the United
States as a whole over the course of a decade. Instituting a
1-cent-per-ounce tax on sugar-sweetened drinks would cost $3.16 per B.M.I.
unit lowered but save an estimated $23.2 billion over 10 years and bring
in $12.5 billion a year nationally.
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The complete article may be read at the URL above.
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Cost Effectiveness of Childhood Obesity Interventions
Evidence and Methods for CHOICES
Steven L. Gortmaker, PhD
, Michael W. Long, ScD
, Stephen C. Resch, PhD
, Zachary J. Ward, MPH
, Angie L. Cradock, ScD
, Jessica L. Barrett, MPH
, Davene R. Wright, PhD
, Kendrin R. Sonneville, ScD
, Catherine M. Giles, MPH
, Rob C. Carter, PhD
, Marj L. Moodie, DrPH
, Gary Sacks, PhD
, Boyd A. Swinburn, MD
, Amber Hsiao, MPH
, Seanna Vine, MPH
, Jan Barendregt, PhD
, Theo Vos, MD, PhD
, Y. Claire Wang, MD, ScD
Article has an altmetric score of 50
DOI: http://dx.doi.org/10.1016/j.amepre.2015.03.032
July 2015 Volume 49, Issue 1, Pages 102111
American Journal of Preventive Medicine
http://www.ajpmonline.org/article/S0749-3797%2815%2900154-3/abstract
Access this article on
Science Direct
http://linkinghub.elsevier.com/retrieve/
pii/S0749-3797(15)00154-3?showall=true
http://tinyurl.com/ocngd36
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Science Direct Link for This Article
http://www.sciencedirect.com/science/article/pii/S0749379715001543
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This is a fee based article and journal.
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Introduction
The childhood obesity epidemic continues in the U.S., and fiscal crises
are leading policymakers to ask not only whether an intervention works but
also whether it offers value for money. However, cost-effectiveness
analyses have been limited. This paper discusses methods and outcomes of
four childhood obesity interventions: (1) sugar-sweetened beverage excise
tax (SSB); (2) eliminating tax subsidy of TV advertising to children (TV
AD); (3) early care and education policy change (ECE); and (4) active
physical education (Active PE).
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snip
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Results
Population reach varied widely, and cost per BMI change ranged from $1.16
(TV AD) to $401 (Active PE). At 10 years, assuming maintenance of the
intervention effect, three interventions would save net costs, with SSB
and TV AD saving $55 and $38 for every dollar spent. The SSB intervention
would avert disability-adjusted life years, and both SSB and TV AD would
increase quality-adjusted life years. Both SSB ($12.5 billion) and TV AD
($80 million) would produce yearly tax revenue.
Conclusions
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The cost effectiveness of these preventive interventions is greater than
that seen for published clinical interventions to treat obesity.
Cost-effectiveness evaluations of childhood obesity interventions can
provide decision makers with information demonstrating best value for the
money.
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The complete New York Times article may be read at the URL for that
article above.
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David Dillard
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