title: Improved estimation of the health and economic burden of chronic disease risk factors in Manitoba.
abstract: BACKGROUND
  There are analytic challenges involved with estimating the aggregate burden of multiple risk factors (RFs) in a population. We describe a methodology to account for overlapping RFs in some sub-populations, a phenomenon that leads to "double-counting" the diseases and economic burden generated by those factors.
  
  
  METHODS
  Our method uses an efficient approach to accurately analyze the aggregate economic burden of chronic disease across a multifactorial system. In addition, it involves considering the effect of body weight as a continuous or polytomous exposure that ranges from no excess weight through overweight to obesity. We then apply this method to smoking, physical inactivity and overweight/obesity in Manitoba, a province of Canada.
  
  
  RESULTS
  The annual aggregate economic burden of the RFs in Manitoba in 2008 is about $1.6 billion ($557 million for smoking, $299 million for physical inactivity and $747 million for overweight/obesity). The total burden represents a 12.6% downward adjustment to account for the effect of multiple RFs in some individuals in the population.
  
  
  CONCLUSIONS
  An improved estimate of the aggregate economic burden of multiple RFs in a given population can assist in prioritizing and gaining support for primary prevention initiatives.
authors.affiliation: School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada. hans@krueger.ca
authors.forename: H
authors.initials: H
authors.lastname: Krueger
authors.forename: D
authors.initials: D
authors.lastname: Williams
authors.forename: A E
authors.initials: AE
authors.lastname: Ready
authors.forename: L
authors.initials: L
authors.lastname: Trenaman
authors.forename: D
authors.initials: D
authors.lastname: Turner
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease / Q000191:economics* / Q000453:epidemiology*; D017281:Cost of Illness; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D008350:Manitoba / Q000453:epidemiology; D008875:Middle Aged; D009765:Obesity / Q000191:economics* / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D057185:Sedentary Behavior; D012907:Smoking / Q000191:economics* / Q000453:epidemiology
keywords: chronic disease; obesity; physical inactivity; population attributable fraction; risk factors; tobacco smoking