Abstract
BackgroundAdult obesity is linked to a greater need for social care because of its association with the development of long term conditions and because obese adults can have physical and social difficulties which inhibit daily living. Obesity thus has considerable social care cost implications but the magnitude of these costs is currently unknown. This paper outlines an approach to estimating obesity-related social care costs in adults aged over 65 in England.MethodsWe used univariable and multivariable logistic regression models to investigate the relation between the self-reported need for social care and potential determinants, including body mass index (BMI), using data from Health Survey for England. We combined these modelled estimates of need for social care with the mean hours of help received, conditional on receiving any help, to calculate the expected hours of social care received per adult by BMI.ResultsBMI is positively associated with self-reported need for social care. A one unit (ie 1 kg/m2) increase in BMI is on average associated with a 5% increase in the odds of need for help with social care (odds ratio 1.05, 95% CI 1.04 to 1.07) in an unadjusted model. Adjusting for long term illness and sociodemographic characteristics we estimate the annual cost of local authority funded care for those who receive it is £599 at a BMI of 23 but £1086 at a BMI of 40.ConclusionBMI is positively associated with self-reported need for social care after adjustment for sociodemographic factors and limiting long term illness. The increase in need for care with BMI gives rise to additional costs in social care provision which should be borne in mind when calculating the cost-effectiveness of interventions aimed at reducing obesity.
Highlights
Adult obesity is linked to a greater need for social care because of its association with the development of long term conditions and because obese adults can have physical and social difficulties which inhibit daily living
Local authorities are responsible for social care provision and are perceived to face a considerable cost burden from obesity-related social care costs but there are few published estimates of social care resource use or cost related to body mass index (BMI) levels
In addition to BMI we considered sociodemographic characteristics which may have an independent association with need for help with social care (sex, age, ethnicity, index of multiple deprivation (IMD) quintile, equivalised household income tertile, marital status, number of adults in the household, number of children in the household); and a binary variable indicating the presence of any limiting long term illness including mental illness
Summary
Adult obesity is linked to a greater need for social care because of its association with the development of long term conditions and because obese adults can have physical and social difficulties which inhibit daily living. This paper outlines an approach to estimating obesity-related social care costs in adults aged over 65 in England. The association of obesity with the development of long term conditions means that obesity is linked to a greater need for social care. Local authorities in England have had responsibility for public health service commissioning since April 2013 [11]. The first phase of the tool included the costs to the health service of selected comorbidities associated with obesity but did not reflect the wider social costs of obesity because of a lack of available evidence with which to calculate them robustly. There is a lack of published data that directly link obesity with social care need [2] or enable a calculation of obesity-related social care costs
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