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Core measurements

This document analyzes the core measurements from the EHES study regarding mortality causes in Europe, focusing on cardiovascular diseases, cancer, and respiratory illnesses. It highlights the economic implications and reporting biases related to obesity, hypertension, and diabetes. The findings indicate that obesity-related issues account for significant health costs and premature deaths. Furthermore, it emphasizes the need for standardized health measurements to obtain reliable data, aiding in public health planning and intervention strategies.

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Core measurements

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  1. Core measurements Hanna Tolonen EGHI subgroup on HES, 2nd March 2011, Luxembourg

  2. Causes of death in EU Circulator diseases Cancer Ischemic heart disease Respiratory diseases http://epp.eurostat.ec.europa.eu/statistics_explained/index.php/Causes_of_death_statistics

  3. EHES core measurements • Anthropometric measurements • Weight • Height • Waist circumference • Blood pressure • Blood samples • Total cholesterol • HDL cholesterol • Fasting glucose

  4. Why these measurements?

  5. Anthropometric measurements

  6. Main complications of obesity

  7. Economic implications of obesity Cost of obesity • Intangible costs due to • missed opportunities • psychological problems • poorer quality of life • Direct costs due to • medical costs to treat the diseases associated with obesity • Indirect costs due to lost productivity: • absenteeism • premature death

  8. Obesity as a public health problem • 2-8% of health costs in Europe are due to obesity or diseases stemming from obesity • 10-13% of deaths are obesity related in different parts of EuropeSource: WHO http://www.euro.who.int/obesity

  9. Reporting bias - obesity

  10. Reporting bias – weight and height • Self-reported BMI underestimates measured BMI • Varies by BMI level ,age, sex, ethnicity • Over the years, the difference between self-reported and measured BMI has increased • Stommel M, Schoenburn CA. BMC Public Health 2009,9:421 • Shiely F, Perry IJ, et al. BMC Public Health 2010, 10: 560

  11. Reporting bias – waist circumference • Self-reported waist circumference underestimated real waist circumference • Women underestimate more than men • Underestimation increases by increased BMI Source: Bigaard J, Spaggaard I et al. J Nutr. 2005; 135: 2263-2270

  12. Bloodpressure

  13. Reporting bias - hypertension • 10-20% of people with elevated bloodpressure are unawareof their condition

  14. Cholesterol

  15. High cholesterol is a risk factor • Coronary heart disease • Stroke

  16. Reporting bias – high cholesterol • Up to 30% of people with elevated total cholesterol are unaware of their condition

  17. Economic implications of CVD • Total costs (2006) • €192 billion • 10% of health care costs • Indirect costs due to productivity loss • €41 billion • 2/3 due to premature deaths • 1/3 due to illness • Informal care • € 42 billion • Direct costs of health care • €110 billion Source: http://www.heartstats.org/uploads/documents\PDF.pdf

  18. diabetes

  19. Complications of diabetes • foot infections • chronic skin infections • gum disease and tooth loss • vision problems • heart disease and blood circulation problems

  20. Economic implications of diabetes Cost of diabetes • Intangible costs due to • decreased quality of life • discrimination in the workplace • difficulty or limitations in obtaining jobs • Direct costs due to • medical care, drugs, insulin and supplies • cost to health care sector (hospital admissions) • Indirect costs due to lost productivity: • sickness, absences, disability, premature retirement or death

  21. Economic implications of diabetes • 3-15% of health costs in Europe are due to direct costs of diabetes related illnesses • Indirect costs of diabetes through loss of productivity is estimated to be at least as high as direct costs Jönsson A. Diabetologia 2002; 45: S5-S12 WHO Fact Sheet no 236. Diabetes: cost of diabetes (2002)

  22. Reporting bias - diabetes • Up to 30% of those with diabetes do not know that they have diabetes

  23. EHES core measurements • Included to previous national HESs • Can be standardized in population survey • Clear interpretation of the results • Can be modified in the population • Can be administered in the survey setting • Acceptable to the participants • Ethically acceptable • Reasonable cost

  24. Standardization of measurements

  25. Standardization of measurements • To obtain reliable and comparable results from EU standardization of the measurements is needed • Training • Devices • Measurement protocols • External quality control

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