2023-09-28 14:46:10 +00:00
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abstract: 'IMPORTANCE The degree to which health and economic outcomes of
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musculoskeletal disorders are attributable to high body mass index (BMI)
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has not been quantified on a global scale.
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OBJECTIVE To estimate global health and economic outcomes associated
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with musculoskeletal disorders-low back pain (LBP), gout, and
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osteoarthritis attributable to high BMI in 2019.
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DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study used data
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of 192 countries and territories from the Global Burden of Diseases,
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Injuries, and Risk Factors Study, World Health Organization Global
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Health Expenditure, World Bank, and International Labour Organization
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databases. Data analyses were conducted from February 24 to June 16,
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2022.
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MAIN OUTCOMES AND MEASURES Prevalence, years lived with disability
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(YLDs), health care costs, and productivity losses due to morbidity from
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LBP, gout, and osteoarthritis attributable to high BMI by region and
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country. Prevalence and YLDs were calculated with the population
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attributable fraction approach. The economic burden, including health
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care costs and productivity losses due to morbidity, was also
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quantified. Health care costs borne by the public, private, and
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out-of-pocket sectors were estimated based on their corresponding
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payment shares. Productivity losses were estimated based on the output
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per worker. A sensitivity analysis was conducted to arrive at the base,
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minimum, and maximum estimates (ie, uncertainty interval {[}UI]) by
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using the mean, lower, and upper bounds of all input variables.
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RESULTS High BMI was estimated to be responsible for 36.3 million (UI,
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18.4-61.0 million), 16.9 million (UI, 7.5-32.5 million), and 73.0
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million (UI, 32.4-131.1 million) prevalent cases of LBP, gout, and
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osteoarthritis, respectively, which accounted for 7.3 million (UI,
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3.0-15.0 million) YLDs across 192 countries and territories in 2019.
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Globally, the YLDs of musculoskeletal disorders attributable to high BMI
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accounted for 1.0\% of all-cause YLDs in the working-age population aged
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15 to 84 years. The global total costs of musculoskeletal disorders
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attributable to high BMI reached \$180.7 billion (UI, \$83.8-\$333.1
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billion), including \$60.5 billion (UI, \$30.7-\$100.5 billion) in
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health care costs and \$120.2 billion (UI, \$53.1-\$232.7 billion) in
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productivity losses. In terms of the global health care costs, 58.9\%
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(\$35.6 billion; UI, \$17.8-\$59.6 billion) was borne by the public
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sector, 24.0\% (\$14.5 billion; UI, \$7.8-\$23.2 billion) by the private
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sector, and 17.1\%(\$10.3 billion; UI, \$5.1-\$17.6 billion) by the
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out-of-pocket sector. On average, the total costs accounted for 0.2\% of
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global gross domestic product. Great inequalities in the disease and
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economic burden existed across regions and countries. Nearly 80\% of
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global health care (82.4\%) and morbidity-related costs (82.9\%) were
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paid by high-income countries, whereas more than 60\%(61.4\%) of global
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YLDs occurred in middle-income countries.
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CONCLUSIONS AND RELEVANCE In this cross-sectional study of 192 countries
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and territories, a substantial amount of the health and economic impact
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of musculoskeletal disorders was attributable to high BMI. Developing
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effective policies and active participation from health professionals to
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prevent excessive weight gain are needed. More available estimates are
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also needed to facilitate a global analysis.'
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affiliation: 'Fong, DYT (Corresponding Author), Univ Hong Kong, Li Ka Shing Fac Med,
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Sch Nursing, 3 Sassoon Rd, Hong Kong, Peoples R China.
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Chen, Ningjing; Fong, Daniel Yee Tak; Wong, Janet Yuen Ha, Univ Hong Kong, Li Ka
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Shing Fac Med, Sch Nursing, Hong Kong, Peoples R China.
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Wong, Janet Yuen Ha, Hong KongMetropolitan Univ, Sch Nursing \& Hlth Studies, Hong
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Kong, Peoples R China.'
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article-number: e2250674
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author: Chen, Ningjing and Fong, Daniel Yee Tak and Wong, Janet Yuen Ha
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author-email: dytfong@hku.hk
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author_list:
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- family: Chen
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given: Ningjing
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- family: Fong
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given: Daniel Yee Tak
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- family: Wong
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given: Janet Yuen Ha
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da: '2023-09-28'
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doi: 10.1001/jamanetworkopen.2022.50674
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files: []
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issn: 2574-3805
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journal: JAMA NETWORK OPEN
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keywords-plus: LOW-BACK; OBESITY; IMPACT; PAIN
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language: English
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month: JAN
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number: '1'
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number-of-cited-references: '47'
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orcid-numbers: Fong, Daniel/0000-0001-7365-9146
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papis_id: 8a5aa85030f98d040b0c435d4a491aa1
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ref: Chen2023healtheconomic
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researcherid-numbers: Fong, Daniel/C-4269-2009
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times-cited: '1'
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title: Health and Economic Outcomes Associated With Musculoskeletal Disorders Attributable
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to High Body Mass Index in 192 Countries and Territories in 2019
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2023-10-01 08:15:07 +00:00
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type: article
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2023-09-28 14:46:10 +00:00
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unique-id: WOS:001059414400004
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usage-count-last-180-days: '0'
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usage-count-since-2013: '0'
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volume: '6'
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web-of-science-categories: Medicine, General \& Internal
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year: '2023'
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