A health inequality impact assessment of leveling down overweight and obesity

Abstract

Abstract Background Social differences in the proportion of overweight and obesity have increased in recent decades. Health impact assessments provide population-level valuations of changes in disease prevalence related to scenarios with different risk factors levels. These scenarios can be focused on reducing overweight and obesity among people with low socioeconomic position. Methods This study included the projected population of Copenhagen, Denmark in year 2040 (n = 742,130). Using the DYNAMO-HIA tool we conducted a health inequality impact assessment. Future prevented disease prevalence (IHD, diabetes, stroke, and multi-morbidity) and change in life expectancy related to an equalized scenario were estimated in a scenario where the prevalence of overweight/obesity (OWOB) in the group of people with short and medium educational attainment was reduced to the levels of people with long education. Results A higher proportion of people with short and medium education were OWOB than among people with long education and they had higher prevalence of cardiometabolic diseases. The diabetes prevalence among people with short education was reduced by 8-10% for men and 12-13% for women and life expectancy with diabetes decreased by one year in the group of women with short education. No notable effect of the equalized OWOB was seen regarding life expectancy with and prevalence of stroke and IHD. Conclusions Reaching the low prevalence of OWOB observed among people with high educational level, will reduce future cardiometabolic disease, increase life expectancy and meanwhile reduce the social inequality in health. These findings can serve as relevant references points for public health planners. Key messages This study is the first to combine advanced mathematical modelling and population data to assess changes in health from reducing socioeconomic inequality in obesity and overweight. These results propose valuable reference values for outcome assessments of interventions on inequalities in health.