title: Overweight and obesity on the island of Ireland: an estimation of costs.
abstract: OBJECTIVE
  The increasing prevalence of overweight and obesity worldwide continues to compromise population health and creates a wider societal cost in terms of productivity loss and premature mortality. Despite extensive international literature on the cost of overweight and obesity, findings are inconsistent between Europe and the USA, and particularly within Europe. Studies vary on issues of focus, specific costs and methods. This study aims to estimate the healthcare and productivity costs of overweight and obesity for the island of Ireland in 2009, using both top-down and bottom-up approaches.
  
  
  METHODS
  Costs were estimated across four categories: healthcare utilisation, drug costs, work absenteeism and premature mortality. Healthcare costs were estimated using Population Attributable Fractions (PAFs). PAFs were applied to national cost data for hospital care and drug prescribing. PAFs were also applied to social welfare and national mortality data to estimate productivity costs due to absenteeism and premature mortality.
  
  
  RESULTS
  The healthcare costs of overweight and obesity in 2009 were estimated at €437 million for the Republic of Ireland (ROI) and €127.41 million for NI. Productivity loss due to overweight and obesity was up to €865 million for ROI and €362 million for NI. The main drivers of healthcare costs are cardiovascular disease, type II diabetes, colon cancer, stroke and gallbladder disease. In terms of absenteeism, low back pain is the main driver in both jurisdictions, and for productivity loss due to premature mortality the primary driver of cost is coronary heart disease.
  
  
  CONCLUSIONS
  The costs are substantial, and urgent public health action is required in Ireland to address the problem of increasing prevalence of overweight and obesity, which if left unchecked will lead to unsustainable cost escalation within the health service and unacceptable societal costs.
authors.affiliation: Department of Epidemiology and Public Health, University College Cork, College Road, Cork, Ireland HSE Department of Public Health, Mount Kennett House, Limerick, Ireland.
authors.forename: Anne
authors.initials: A
authors.lastname: Dee
authors.affiliation: J.E. Cairnes School of Business and Economics, NUI Galway, University Road, Galway, Ireland.
authors.forename: Aoife
authors.initials: A
authors.lastname: Callinan
authors.affiliation: J.E. Cairnes School of Business and Economics, NUI Galway, University Road, Galway, Ireland.
authors.forename: Edel
authors.initials: E
authors.lastname: Doherty
authors.affiliation: J.E. Cairnes School of Business and Economics, NUI Galway, University Road, Galway, Ireland.
authors.forename: Ciaran
authors.initials: C
authors.lastname: O'Neill
authors.affiliation: School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland.
authors.forename: Treasa
authors.initials: T
authors.lastname: McVeigh
authors.affiliation: School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland.
authors.forename: Mary Rose
authors.initials: MR
authors.lastname: Sweeney
authors.affiliation: School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland.
authors.forename: Anthony
authors.initials: A
authors.lastname: Staines
authors.affiliation: Department of Epidemiology and Public Health, University College Cork, College Road, Cork, Ireland.
authors.forename: Karen
authors.initials: K
authors.lastname: Kearns
authors.affiliation: Department of Epidemiology and Public Health, University College Cork, College Road, Cork, Ireland.
authors.forename: Sarah
authors.initials: S
authors.lastname: Fitzgerald
authors.affiliation: National Cancer Registry Ireland, Cork, Ireland.
authors.forename: Linda
authors.initials: L
authors.lastname: Sharp
authors.affiliation: School of Medicine, Dentistry and Biomedical Sciences, Institute of Clinical Sciences, UKCRC Centre of Excellence for Public Health, Queens University Belfast, Royal Victoria Hospital, Belfast, Northern Ireland.
authors.forename: Frank
authors.initials: F
authors.lastname: Kee
authors.affiliation: School of Medicine, Dentistry and Biomedical Sciences, Institute of Clinical Sciences, UKCRC Centre of Excellence for Public Health, Queens University Belfast, Royal Victoria Hospital, Belfast, Northern Ireland.
authors.forename: John
authors.initials: J
authors.lastname: Hughes
authors.affiliation: Institute of Public Health in Ireland, Dublin, Ireland.
authors.forename: Kevin
authors.initials: K
authors.lastname: Balanda
authors.affiliation: Department of Epidemiology and Public Health, University College Cork, College Road, Cork, Ireland.
authors.forename: Ivan J
authors.initials: IJ
authors.lastname: Perry
mesh_terms: D000041:Absenteeism; D002318:Cardiovascular Diseases / Q000191:economics / Q000209:etiology; D003110:Colonic Neoplasms / Q000191:economics / Q000209:etiology; D017281:Cost of Illness; D003695:Delivery of Health Care / Q000191:economics*; D003924:Diabetes Mellitus, Type 2 / Q000191:economics / Q000209:etiology; D004526:Efficiency; D005260:Female; D005705:Gallbladder Diseases / Q000191:economics / Q000209:etiology; D017048:Health Care Costs; D006801:Humans; D007494:Ireland; D017116:Low Back Pain / Q000191:economics / Q000209:etiology; D008297:Male; D061213:Mortality, Premature; D009369:Neoplasms / Q000191:economics / Q000209:etiology; D009660:Northern Ireland / Q000453:epidemiology; D009765:Obesity / Q000150:complications / Q000191:economics* / Q000453:epidemiology; D050177:Overweight; D015995:Prevalence
keywords: EPIDEMIOLOGY; HEALTH ECONOMICS