Projection scenarios of body mass index (2013–2030) for Public Health Planning in Quebec

BMC Public Health

Russell Steele³  Chantal Blouin²  Colin Steensma¹  Sylvie Martel²  Patricia Lamontagne²  Yun Jen²  Denis Hamel²  Ernest Lo⁴ 

[1]Public Health Agency of Canada, 200, boulevard René-Lévesque Ouest, Montréal, Québec H2Z 1X4, Canada

[2]Institut National de Santé Publique du Québec, 190 blvd Crémazie Est, Montréal, Québec H2P 1E2, Canada

[3]Department of Mathematics and Statistics, McGill University, 805 Sherbrooke Ouest, Montreal, Québec H3A 2K6, Canada

[4]Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Purvis Hall, 1020 Pine Avenue West, Montréal, Québec H3A 1A2, Canada

关键词: Health burden;    Public health planning;    Public health;    Health targets;    Type 2 diabetes;    Body mass index;    Obesity;    Forecasting;    Projections;   

Others  :  1126676
DOI  :  10.1186/1471-2458-14-996

 received in 2014-03-21, accepted in 2014-09-16,  发布年份 2014

【 摘 要 】

Background

Projection analyses can provide estimates of the future health burden of increasing BMI and represent a relevant and useful tool for public health planning. Our study presents long-term (2013–2030) projections of the prevalence and numbers of individuals by BMI category for adult men and women in Quebec. Three applications of projections to estimate outcomes more directly pertinent to public health planning, as well as an in-depth discussion of limits, are provided with the aim of encouraging greater use of projection analyses by public health officers.

Methods

The weighted compositional regression method is applied to prevalence time series derived from sixteen cross-sectional survey cycles, for scenarios of linear change and deceleration. Estimation of the component of projected change potentially amenable to intervention, future health targets and the projected impact on type 2 diabetes, were done.

Results

Obesity prevalence in Quebec is projected to rise steadily from 2013 to 2030 in both men (from 18.0-19.4% to 22.2-30.4%) and women (from 15.5-16.3% to 18.2-22.4%). Corresponding projected numbers of obese individuals are (579,000-625,000 to 790,000-1,084,000) in men and (514,000-543,000 to 661,000-816,000) in women. These projected increases are found to be primarily an ‘epidemiologic’ rather than ‘demographic’ phenomenon and thus potentially amenable to public health intervention. Assessment of obesity targets for 2020 illustrates the necessity of using projected rather than current prevalence; for example a targeted 2% drop in obesity prevalence relative to 2013 translates into a 3.6-5.4% drop relative to 2020 projected levels. Type 2 diabetes is projected to increase from 6.9% to 9.2-10.1% in men and from 5.7% to 7.1-7.5% in women, from 2011–2012 to 2030. A substantial proportion of this change (25-44% for men, and 27-43% for women) is attributable to the changing BMI distribution.

Conclusions

Obesity in Quebec is projected to increase and should therefore continue to be a public health priority. Application of projections to estimate the proportion of change potentially amenable to intervention, feasible health targets, and future chronic disease prevalence are demonstrated. Projection analyses have limitations, but represent a pertinent tool for public health planning.

【 授权许可】

   
2014 Lo et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

Figure 3.

Figure 4.

Figure 5.

【 参考文献 】

• [1]Audet N: L'évolution De L'excès De Poids Chez Les Adultes Québécois De 1990 à 2004: Mesures Directes. Institut de la Statistique du Québec: Québec, Canada; 2007.
• [2]Lamontagne P, Hamel D: Surveillance Du Statut Ponderal Chez Les Adultes Quebecois - Portrait Et Evolution De 1987 a 2010. Québec, Canada: Institut National de Santé Publique du Québec; 2012.
• [3]Ng M, Fleming T, Robinson M, Thomson B, Graetz N, Margono C, Mullany EC, Biryukov S, Abbafati C, Abera SF, Abraham JP, Abu-Rmeileh NM, Achoki T, AlBuhairan FS, Alemu ZA, Alfonso R, Ali MK, Ali R, Guzman NA, Ammar W, Anwari P, Banerjee A, Barquera S, Basu S, Bennett DA, Bhutta Z, Blore J, Cabral N, Nonato IC, Chang JC: Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 2014, 384:766-781.
• [4]Guh DP, Zhang W, Bansback N, Amarsi Z, Birmingham CL, Anis AH: The incidence of co-morbidities related to obesity and overweight: a systematic review and meta-analysis. BMC Public Health 2009, 9:88. doi:10.1186/1471-2458-9-88.:88-89 BioMed Central Full Text
• [5]Katzmarzyk PT, Reeder BA, Elliott S, Joffres MR, Pahwa P, Raine KD, Kirkland SA, Paradis G: Body mass index and risk of cardiovascular disease, cancer and all-cause mortality. Can J Public Health 2012, 103:147-151.
• [6]WHO: Obesity: Preventing and Managing the Global Epidemic. Geneva: World Health Organization; 2000.
• [7]Withrow D, Alter DA: The economic burden of obesity worldwide: a systematic review of the direct costs of obesity. Obes Rev 2011, 12:131-141.
• [8]Finkelstein EA, Khavjou OA, Thompson H, Trogdon JG, Pan L, Sherry B, Dietz W: Obesity and severe obesity forecasts through 2030. Am J Prev Med 2012, 42:563-570.
• [9]Levi J, Segal L, St Laurent R, Lang A, Rayburn J: F as in Fat: How Obesity Threatens America's Future. Trust for America's Health: Washington, DC; 2012.
• [10]Mills T: Forecasting obesity trends in England. J R Statist Soc A 2009, 172(Part 1):107-117.
• [11]Sassi F, Devaux M, Cecchini M, Rusticelli E: The Obesity Epidemic: Analysis of Past and Projected Future Trends in Selected OECD Countries. Paris: Organisation for Economic Co-operation and Development; 2009.
• [12]Twells L, Gregory D, Reddigan J, Midodzi WK: Current and predicted prevalence of obesity in Canada: a trend analysis. Can Med Assoc J 2014, 2:E18.
• [13]Wang YC, McPherson K, Marsh T, Gortmaker SL, Brown M: Health and economic burden of the projected obesity trends in the USA and the UK. Lancet 2011, 378:815-825.
• [14]Courtemanche R, Tarte F: Plan de sondage de l'enquête Santé Québec. Cahier technique 87–02. In Ministère de la Santé et des Services Sociaux. Gouvernement du Québec: Québec; 1987.
• [15]Daveluy C, Pica L, Audet N, Courtemanche R, Lapointe F, Côté L, Baulne J: Enquete Sociale et De Sante 1998. Cahier Technique et Methodologique: Documentation Generale. Québec: Gouvernement du Québec; 2014.
• [16]Statistics Canada: National Population Health Survey - Household Component - Cross Sectional. Ottawa; http://www23.statcan.gc.ca/imdb/p2SV.pl?Function=getSurvey&SDDS=3236 webcite
• [17]Beland Y: Canadian community health survey–methodological overview. Health Rep 2002, 13:9-14.
• [18]Statistics Canada: Canadian Community Health Survey - Annual Component (CCHS). Ottawa; 2013. http://www23.statcan.gc.ca/imdb/p2SV.pl?Function=getSurvey&SDDS=3226 webcite
• [19]Research Triangle Institute: SUDAAN Language Manual, Volumes 1 and 2, Release 11. NC: Research Triangle Park; 2012.
• [20]Statistics Canada: Bootvar User Guide v3.2. Ottwa; 2010.
• [21]Wolter KM: Introduction to Variance Estimation. New York: Springer-Verlag; 1985.
• [22]Institut de la Statistique du Québec en collaboration avec l'Institut national de santé publique du Québec et le Ministère de la Santé et des Services sociaux: Guide Spécifique Des Aspects Méthodologiques Des Données D'enquêtes Sociosanitaires Du Plan Commun de Surveillance, ESCC cycles 1.1, 2.1, 3.1 et 2007–2008, Plan Commun de Surveillance de l'état de Santé de la Population et de ses Déterminants. Québec: Gouvernement du Québec; 2011.
• [23]Institut de la statistique du Québec: Guide a L'intention Des Chercheurs Exploitant Des Donnees Au Centre D'acces Des Donnees De Recherche De L'institut De La Statistique Du Quebec (Cadrisq). Québec: Gouvernement du Québec; 2013.
• [24]Statistics Canada: Guide for Researchers under Agreement with Statistics Canada. Ottawa; 2005.
• [25]André D, Payeur F, Lachance JF: Perspectives Démographiques du Québec et Des Régions 2006–2056. Institut de la Statistique du Québec: Québec; 2009.
• [26]Aitchison J: The Statistical Analysis of Compositional Data. London: Chapman and Hall; 1986.
• [27]Von Ruesten A, Steffen A, Floegel A, Van Der AD, Masala G, Tjonneland A, Halkjaer J, Palli D, Wareham NJ, Loos RJ, Sørensen TI, Boeing H: Trend in obesity prevalence in European adult cohort populations during follow-up since 1996 and their predictions to 2015. PLoS One 2011, 6:e27455.
• [28]Mokdad AH, Ford ES, Bowman BA, Dietz WH, Vinicor F, Bales VS, Marks JS: Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001. JAMA 2003, 289:76-79.
• [29]Must A, Spadano J, Coakley EH, Field AE, Colditz G, Dietz WH: The disease burden associated with overweight and obesity. JAMA 1999, 282:1523-1529.
• [30]Leufkens H, Haaijer-Ruskamp F, Bakker A, Dukes G: Scenario analysis of the future of medicines. British Medical Journal 1994, 309:1137-1140.
• [31]Schwartz P: The Art of the Long View. New York: Doubleday; 1996.
• [32]Nadeau C, Asakawa K, Flanagan W: Modelling Population Health: Dynamic Micro-Simulation of Trends in the Distribution Of Bmi on Future Health Outcomes and Health-Care Costs in Canada (Ccdpc Science Seminar Presentation). 2012.
• [33]Sassi F: Obesity and the Economics of Prevention: Fit Not Fat. Paris: Organisation for Economic Co-operation and Development; 2011.
• [34]Wang YC, Colditz GA, Kuntz KM: Forecasting the obesity epidemic in the aging U.S. population. Obesity (Silver Spring) 2007, 15:2855-2865.
• [35]McPherson K, Marsh T, Brown M: Foresight. Future Choices - Modelling Future Trends in Obesity & Their Impact on Health. London: Tackling Obesities; 2007.
• [36]Backholer K, Mannan HR, Magliano DJ, Walls HL, Stevenson C, Beauchamp A, Shaw JE, Peeters A: Projected socioeconomic disparities in the prevalence of obesity among Australian adults. Aust N Z J Public Health 2012, 36:557-563.
• [37]Wang Y, Beydoun MA, Liang L, Caballero B, Kumanyika SK: Will all Americans become overweight or obese? estimating the progression and cost of the US obesity epidemic. Obesity (Silver Spring) 2008, 16:2323-2330.
• [38]Allison J, Kiefe CI, Weissman NW: Can data-driven benchmarks be used to set the goals of healthy people 2010? Am J Public Health 1999, 89:61-65.
• [39]Fukuda Y, Nakamura K, Takano T: A combination of an extrapolation method and a benchmark method to develop quantitative health targets for Japan. Health Policy 2002, 61:201-212.
• [40]Ministère de la santé et des services sociaux (MSSS): Programme National de Santé Publique 2003–2012: Mise à Jour 2008. Québec: Gouvernement du Québec; 2008.
• [41]U.S.Department of Health and Human Services: Healthy People 2010: Understanding and Improving Health. 2nd edition. Washington, DC: US Dept of Health and Human Services; 2000.
• [42]Van Herten LM, Gunning-Shepers LJ: Targets as a tool in health policy. Part II: guidelines for application. Health Policy 2000, 53:13-23.
• [43]Foot DK, Lewis RP, Pearson TA, Beller GA: Demographics and cardiology, 1950–2050. J Am Coll Cardiol 2000, 35:1067-1081.
• [44]van der Heijden K: Scenarios and forecasting: two perspectives. Technological Forecasting and Social Change 2000, 65:31-36.
• [45]Venable J, Ma Q, Ginter P, Duncan WJ: The use of scenario analysis in local public health departments: alternative futures for strategic planning. Public Health Reports 1993, 108:701-710.
• [46]Hakulinen T, Teppo L, Saxen E: Do the predictions for cancer incidence come true? Experience from Finland. Cancer 1986, 57:2454-2458.
• [47]Moller B, Weedon-Fekjaer H, Haldorsen T: Empirical evaluation of prediction intervals for cancer incidence. BMC Med Res Methodol 2005, 5:21. BioMed Central Full Text
• [48]Bray F, Moller B: Predicting the future burden of cancer. Nat Rev Cancer 2006, 6:63-74.
• [49]Hakulinen T: The future cancer burden as a study subject. Acta Oncol 1996, 35:665-670.
• [50]Allman-Farinelli MA, Chey T, Bauman AE, Gill T, James WPT: Age, period and birth cohort effects on prevalence of overweight and obesity in Australian adults from 1990 to 2000. European Journal of Clinical Nutrition 2008, 62:898-907.
• [51]Reither E, Hauser R, Yang Y: Do birth cohorts matter? Age-period-cohort analyses of the obesity epidemic in the United States. Social Science & Medicine 2009, 69:1439-1448.
• [52]Rokholm B, Baker JL, Sorensen TI: The levelling off of the obesity epidemic since the year 1999–a review of evidence and perspectives. Obes Rev 2010, 11:835-846.
• [53]Robinson WR, Keyes KM, Utz RL, Martin CL, Yang Y: Birth cohort effects among US-born adults born in the 1980s: foreshadowing future trends in US obesity prevalence. International Journal of Obesity 2013, 37:448-454.
• [54]Jiang T, Gilthorpe M, Shiely F, Harrington J, Perry I, Kelleher C, Tu Y: Age-period-cohort analysis for trends in body mass index in Ireland. BMC Public Health 2013, 13:889. BioMed Central Full Text
• [55]Ministère de la santé et des services sociaux (MSSS): Investir Pour L'avenir. Plan Gouvernmental de Promotion des Saines Habitudes de vie et de Prevention des Problemes Relies au Poids, 2006–2012. 2006.
• [56]Egger G, Swinburn B: An "ecological" approach to the obesity pandemic. BMJ 1997, 315:477-480.
• [57]Connor GS, Tremblay M, Moher D, Gorber B: A comparison of direct vs. self-report measures for assessing height, weight and body mass index: a systematic review. Obes Rev 2007, 8:307-326.
• [58]McAdams MA, van Dam RM, Hu FB: Comparison of self-reported and measured BMI as correlates of disease markers in US adults. Obesity (Silver Spring) 2007, 15:188-196.
• [59]Spencer EA, Appleby PN, Davey GK, Key TJ: Validity of self-reported height and weight in 4808 EPIC-Oxford participants. Public Health Nutr 2002, 5:561-565.
• [60]Connor GS, Shields M, Tremblay MS, McDowell I: The feasibility of establishing correction factors to adjust self-reported estimates of obesity. Health Rep 2008, 19:71-82.
• [61]Ezzati M, Martin H, Skjold S, Vander HS, Murray CJ: Trends in national and state-level obesity in the USA after correction for self-report bias: analysis of health surveys. J R Soc Med 2006, 99:250-257.
• [62]Connor GS, Tremblay MS: The bias in self-reported obesity from 1976 to 2005: a Canada-US comparison. Obesity (Silver Spring) 2010, 18:354-361.
• [63]Shields M, Connor GS, Janssen I, Tremblay MS: Bias in self-reported estimates of obesity in Canadian health surveys: an update on correction equations for adults. Health Rep 2011, 22:35-45.
• [64]Visscher TL, Viet AL, Kroesbergen IH, Seidell JC: Underreporting of BMI in adults and its effect on obesity prevalence estimations in the period 1998 to 2001. Obesity (Silver Spring) 2006, 14:2054-2063.
• [65]Janssen I: The public health burden of obesity in Canada. Can J Diabetes 2013, 37:90-96.