Chronic disease afflicts thousands of British Columbians whether as cardiovascular problems, diabetes, hypertension or any of dozens of other long term health challenges. As difficult as they are for individuals, chronic diseases also put a huge burden on the economy and health care system. Reducing the incidence of these diseases would mean reducing their costs both to the individual and to the economy.
Three risk factors account for a great proportion of chronic disease, specifically, excess weight, physical inactivity and tobacco smoking. By reducing the prevalence of these avoidable risk factors we could reduce the rate of many chronic diseases which would reduce economic costs and help people to enjoy a better quality of life.
The Provincial Health Services Authority (PHSA) just published its report on this subject: “The economic benefits of risk factor reduction in British Columbia: Excess weight, physical inactivity and tobacco smoking” calculating the true economic cost of disease and offers a prescription that is achievable.
The identified risk factors (excess weight, physical inactivity and tobacco smoking) account for more than two dozen chronic conditions including seven out of every 10 cases of chronic lung disease and type 2 diabetes, over half of all heart disease, and one-third of all colorectal cancers. The study estimates that in 2013 across BC, the annual economic burden of these three amounts to $5.6 billion ($1.8 billion due to direct health care costs and $3.8 billion from disability and premature death).
Of the three factors, the largest proportion of the economic burden can be attributed to individuals being overweight or obese. Some 40% of British Columbians had excess weight and the economic burden came to $2.6B, of which $772 million were direct costs and $1.8B indirect.
Physical inactivity contributes less to the economic burden at $1.0B. In 2013, 38% of British Columbians were inactive (direct health care costs of $350M and $673M related to disability and premature mortality).
Rates of tobacco smoking in BC have been declining for decades so that in 2013, 13.2% of British Columbians smoked. This contributed an economic burden of $2.0B ($724M direct; $1.3B indirect) annually. These figures reflect the much higher cost per individual smoker in comparison to an individual with excess weight or who is physically inactive.
The status quo is clearly not a good option. In fact, doing nothing means that by 2036 we will face a cost of $7.2B (direct $2.4B; indirect $4.8B). The PHSA is recommending action to achieve a 1% annual reduction in the incidence of each of the three key risk factors. By pursuing this goal we will be able to avoid $15 billion in cumulative healthcare costs and economic productivity losses by 2036.
Real change is possible as we have learned from past health promotion initiatives. Proven tools include public education and awareness-building, increased prevention activities and an emphasis on policy change. We can carry on as we have and complain about the costs, or we can work towards meaningful change, the benefits of which accrue not only to individuals, but to our economy and community as a whole.
Written by Dr. Paul Martiquet, Medical Health Officer for Rural Vancouver Coastal Health including Powell River, the Sunshine Coast, Sea-to-Sky, Bella Bella and Bella Coola.