Abstract
Obezite, özellikle çocukluk çağı obezitesinin artan oranı, dünya çapında sağlık sistemlerinin karşılaştığı en kritik sorunlardan biri haline gelmiştir. Bu çalışma, Türkiye'de çocukluk çağı obezitesinin toplam sağlık harcamaları üzerindeki kısa ve uzun vadeli etkilerini araştırmaktadır. Obezite bir sağlık sorunu olarak kısa ve uzun vadede farklı etkilere sahip olabileceğinden, tek bir modelde hem kısa hem de uzun vadeli etkileri elde etmek için Autoregressive Distributed Lag (otoregresif dağıtılmış gecikme-ARDL) yöntemi benimsenmiştir. 5-9 yaş, 10-19 yaş ve 5-19 yaş gruplarındaki çocukların obezite ölçümleri için kısa veya uzun vadede cinsiyet ve yaş gruplarına göre farklı etkileri kapsayacak şekilde ayrı modeller geliştirilmiştir. Kısa dönemde gelirin artması, ailelerin ve devletin daha fazla sağlık harcaması yapmasını sağladığından, gelir ile sağlık harcamaları arasında pozitif bir ilişki bulunmuştur. Öte yandan, uzun vadeli gelirdeki artış, olumsuz bir ilişkiyi teyit eden sağlık altyapısı ve önleyici ve tedavi olanakları sunmaktadır. Sonuçlar, tüm yaş grupları ve tüm cinsiyet grupları için obezite ve sağlık harcamaları arasında pozitif ve istatistiksel olarak anlamlı uzun vadeli bir ilişkinin varlığını ortaya koymuştur. Bulgular, uzun vadede çocuklarda obezite prevalansındaki artışın sağlık harcamalarını artıracağını doğrulamıştır. Gelir ve obezitenin sağlık harcamaları üzerinde uzun ve kısa vadede farklı etkileri vardır. Bu nedenle sağlık sektöründeki politika yapıcıların bu etkilerin farkında olması gerekmektedir. Sağlık durumu, uzun bir süre boyunca değişen uzun vadeli bir olgudur. Obezitenin sağlık harcamaları ile kısa vadede negatif bir ilişkisi vardır. Buna karşılık, gelecekte yetişkin sağlığı üzerindeki olumsuz etkilerinden dolayı sağlık harcamalarının uzun vadede artması beklenmektedir. Sonuçlar, kısa vadede kişi başına düşen gelirin sağlık harcamaları üzerindeki olumlu etkisini, uzun vadede ise tersini ortaya koymaktadır. Makroekonomik düzeydeki politika yapıcılar, sağlık altyapılarının uzun vadede toplumun ekonomik yükünü azaltacağının farkında olmalıdır.
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Abstract
Obesity has become one of the most critical problems faced by health systems worldwide, particularly the increased rate of childhood obesity. The present study investigates the short-run and long-run effects of childhood obesity on total health spending in Turkey. Since obesity may have different effects in the short and long run as a health problem, Autoregressive Distributed Lag (ARDL) method has been adopted to obtain both short and long-run effects in a single model. Separate models have developed for the obesity measures of children from age groups of 5-9 years, 10-19 years and 5-19 years to encompass the different effects based on gender and age groups in the short or long run. Since the increase of income in the short run enables families and the state to make more health expenditures, a positive relationship between income and health spending is found. On the other hand, the rise in long term income provides health infrastructure and preventive and treatment opportunities confirming a negative relationship. The results have revealed the presence of a positive and statistically significant long-run relationship between obesity and health expenditures for all age groups and all gender groups. The findings have confirmed that the increase in the prevalence of obesity in children in the long term would increase health expenditures. Income and obesity have different effects on health expenditures in the long and short run. Therefore, policymakers in the health sector must be aware of these effects. Health status is a long-run phenomenon that changes over a long period. Obesity has a negative relationship with health spending in the short run. In contrast, health spending is expected to increase in the long run due to its adverse effects on adults health in future. The results reveal the positive impact of per capita income on health expenditures in the short run and the reverse impact in the long run. The policymakers at the macroeconomic level should be aware that health infrastructures will decrease society's economic burden in the long run.
Keywords
References
- Anderson, G. F., Frogner, B. K., & Reinhardt, U. E. (2007). Health spending in OECD countries in 2004: An update. Health Affairs, 26(5), 1481-1489.
- Andreyeva, T., Sturm, R., & Ringel, J. S. (2004). Moderate and severe obesity have large differences in health care costs. Obesity Research, 12(12), 1936-1943.
- Atilgan, E., Kilic, D., & Ertugrul, H. M. (2017). The dynamic relationship between health expenditure and economic growth: is the health-led growth hypothesis valid for Turkey?. The European Journal of Health Economics, 18(5), 567-574.
- Blazquez-Fernandez, C., Cantarero, D., & Perez, P. (2014). Disentangling the heterogeneous income elasticity and dynamics of health expenditure. Applied Economics, 46(16), 1839-1854.
- Bukhari, S. A. H. A. S., & Butt, M. S. (2007). The direction of causality between health spending and GDP: The case of Pakistan. Pakistan Economic and Social Review, 45(1), 125-140.
- Cawley, J. (2010). The economics of childhood obesity. Health Affairs, 29(3), 364-371.
- Chooi, Y. C., Ding, C., & Magkos, F. (2019). The epidemiology of obesity. Metabolism: Clinical and Experimental, 92, 6-10.
- Daniels, S. R. (2009). Complications of obesity in children and adolescents. International Journal of Obesity, 33, 60-65.
- Doherty, E., Queally, M., Cullinan, J., & Gillespie, P. (2017). The impact of childhood overweight and obesity on healthcare utilisation. Economics and Human Biology, 27, 84-92.
- Finkelstein, E. A., Trogdon, J. G., Cohen, J. W., & Dietz, W. (2009). Annual medical spending attributable to obesity: Payer-and service-specific estimates. Health Affairs, 28(Supplement 1), 822–831.
- Hammond, R., & Levine. (2010). The economic impact of obesity in the United States. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 3, 285-295.
- John, J., Wolfenstetter, S. B., & Wenig, C. M. (2012). An economic perspective on childhood obesity: Recent findings on cost of illness and cost effectiveness of interventions. Nutrition, 28(9), 829-839.
- Khan, H. N., Razali, R. B., & Shafie, A. B. (2016). Modeling determinants of health expenditures in Malaysia: Evidence from time series analysis. Frontiers in Pharmacology, 7, 1-7.
- Kinge, J. M., & Morris, S. (2018). The impact of childhood obesity on health and health service use. Health Services Research, 53(3), 1621-1643.
- Kumar, S. (2013). Systems GMM estimates of the health care spending and GDP relationship: A note. European Journal of Health Economics, 14(3), 503-506.
- Lee, R. E., McAlexander, K., & Banda, J. (2011). Reversing the obesogenic environment physical activity intervention series. Human Kinetics.
- Lehnert, T., Sonntag, D., Konnopka, A., Riedel-Heller, S., & König, H. H. (2013). Economic costs of overweight and obesity. Best Practice and Research: Clinical Endocrinology and Metabolism, 27(2), 105-115.
- Martos-Moreno, G. Á., Barrios, V., Muñoz-Calvo, M. T., Pozo, J., Chowen, J. A., & Argente, J. (2014). Principles and pitfalls in the differential diagnosis and management of childhood obesities. Advances in Nutrition, 5(3), 299-305.
- Müller-Riemenschneider, F., Reinhold, T., Berghöfer, A., & Willich, S. N. (2008). Health-economic burden of obesity in Europe. European Journal of Epidemiology, 23(8), 499-509.
- Murthy, V. N. R., & Okunade, A. A. (2016). Determinants of U.S. health expenditure: Evidence from autoregressive distributed lag (ARDL) approach to cointegration. Economic Modelling, 59, 67-73.
- Pesaran, M. H., Shin, Y., & Smith, R. J. (2001). Bounds testing approaches to the analysis of level relationships. Journal of Applied Econometrics, 16(3), 289-326.
- Ritchie, H., & Roser, M. (2020). Obesity. https://ourworldindata.org/obesity#citation
- Rosin, O. (2008). The economic causes of obesity: A survey. Journal of Economic Surveys, 22(4), 617-647.
- Rtveladze, K., Marsh, T., Barquera, S., Romero, L. M. S., Levy, D., Melendez, G., ... & Brown, M. (2014). Obesity prevalence in Mexico: impact on health and economic burden. Public Health Nutrition, 17(1), 233-239.
- Sandalci, U., & Tuncer, G. (2020). Obezitenin doğrudan ve dolaylı maliyetlerine ilişkin bir değerlendirme. Aksaray Üniversitesi İktisadi ve İdari Bilimler Fakültesi Dergisi, 12(2), 29-44.
- Sonntag, D., Ali, S., & De Bock, F. (2016). Lifetime indirect cost of childhood overweight and obesity: A decision analytic model. Obesity, 24(1), 200-206.
- Thorpe, K. E., Florence, C. S., Howard, D. H., & Joski, P. (2004). The impact of obesity on rising medical spending. Health Affairs, 23(Suppl1), 480-486.
- Thorpe, K. E., Allen, L., & Joski, P. (2015). The role of chronic disease, obesity, and improved treatment and detection in accounting for the rise in healthcare spending between 1987 and 2011. Applied Health Economics and Health Policy, 13(4), 381-387.
- Türkiye Endokrinoloji ve Metabolizma Derneği. (2014). Obezite tanı ve tedavi kılavuzu. https://www.ktu.edu.tr/dosyalar/17_02_15_bb1cf.pdf
- Türkiye Endokrinoloji ve Metabolizma Derneği. (2018). Obezite tanı ve tedavi kılavuzu. https://temd.org.tr/admin/uploads/tbl_kilavuz/20190506163904-2019tbl_kilavuz5ccdcb9e5d.pdf
- Wang, G., & Dietz, W. H. (2002). Economic burden of obesity in youths aged 6 to 17 years: 1979-1999. Pediatrics, 109(5), 81–81.
- WHO. (2016). Consideration of the evidence on childhood obesity for the commission on ending childhood obesity. Geneva.
- WHO. (2020). Obesity and overweight. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
- Withrow, D., & Alter, D. A. (2011). The economic burden of obesity worldwide: A systematic review of the direct costs of obesity. Obesity Reviews, 12(2), 131-141.
- Yap, K. W., & Selvaratnam, D. P. (2018). Empirical analysis of factors influencing the public health expenditure in Malaysia. Journal of Emerging Economies and Islamic Research, 6(3), 1-14.
Details
| Primary Language | English |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Makaleler |
| Authors | |
| Publication Date | June 30, 2022 |
| Published in Issue | Year 2022 Volume: 25 Issue: 2 |
