2015 Cambridge Business & Economics Conference ISBN : 9780974211428
Trends in the Global Rise of the Prevalence of Obesity from the 1980’s- Present between Developed and Developing Countries
Marylud Silva, University of Texas at Dallas
Abstract
Purpose: Understanding and analyzing the trends associated with the economic effects due to the global rise in the prevalence of Obesity since the 1980’s between developed and developing countries.
Design/methodology/approach:The data was collected from over fifteen different peer-reviewed academic articles and the World Bank.
Findings: The findings showed that between rates of obesity, between 1980-present seem to be increasing in both developed and developing countries. The greatest increase in the rate of overweight and obesity was between 1992 and 2002, but has slowed in the last decade, more so in developing countries. There were limitations of current accurate global obesity rates, most of the data came from self reported height and weight that can sometime be over reported by males and underreported by females. In the past 33 years no country has successfully reduce obesity.
Originality/Value/Contribution: This current study is original in that it discusses the correlation between the tactics used by the Tobacco industry in the United States, to avoid profit loss, exclusively from 1954 to present, and the strategies such as Leanwashing, used by the big businesses in the Food industry, in order to promote inactivity as the primary determinant of obesity, primarily in the western world, but not limited to the United States Europe or Asia.
Terms: obesity, medical costs, overweight, food industry, leanwashing, lobbying, diet theorist, tobacco industry, BMI, nutrition
Introduction
According to the World Health Organization, WHO, since the 1980’s global prevalence obesity had nearly doubled. In 2008, when examining the adult population of 20 years and older, WHO found that more than 1.4 billion adults (accounts for 35% of adults) were overweight; and of these over 200 million men and nearly 300 million women(accounts for 11% of adults) were obese. Although obesity is preventable, overweight and obesity are leading risks for global deaths, which accounts for the deaths of 3.4 million adults each year. WHO found 65% of the world’s population lives in allhigh-income and most mid- and low-income countries where obesity kills more people than underweight.
Generally overweight and obesity are defined as abnormal or excessive fat accumulation that may impair health. The body mass index (BMI) is used worldwide to classify overweight and obesity in adults. It is measured by a person's weight in kilograms divided by the square of his height in meters (kg/m2). Generally a BMI greater than or equal to 25 is classified as overweight and a BMI greater than or equal to 30 is classified as obesity.
Although there are countless factors in research that cause obesity and overweight the three fundamental factors include poor nutrition, lack of physical activity (a combination of these two leads to an energy imbalance between calories consumed and calories expended) and genetic predisposition. Technological and economical advances have led to a global an increased intake of energy-dense foods that are high in fat; and an increase in physical inactivity due to the increasingly sedentary nature of many forms of work, changing modes of transportation, and increasing urbanization. WHO finds that changes in dietary and physical activity behavior and patterns are often the result of environmental and societal changes associated with development and lack of supportive policies in sectors such as health, agriculture, transport, urban planning, environment, food processing, distribution, marketing and education.In research to date at least four major categories ofeconomic impacts have been linked with the obesity epidemic including: direct medical costs, productivity costs, transportation costs, and human capital costs.
Supersized America
Among the high-income, mid- and low-income countries covered in this paper will draw much focus on the obesity crisis in the United States. As of 2010, WHO’s Global InfoBase, reports the prevalence of obesity amongst American males as 80.5% listing the United States as the 7th highest out of 192 countries; and American women are listed as having a prevalence of obesity of 76.7% listing the United States as the 14th highest out of the 192 countries. While factors such as, preferences, lifestyle, culture, ethnicity and income level are closely related to the choice of certain products and eating habits many developing countries are looking to the western world and tend to adopt similar eating habits as their own food culture changes. (Insert research about diets). Economic and technological developments, since World War II, introduced an industrialized American diet, and have led to greater availability and variety of food along with the availability of information and access to packaged food, which has resulted into greater obesity rates. The data shown in the maps below were collected through CDC’s Behavioral Risk Factor Surveillance System (BRFSS). Each year, state health departments use standard procedures to collect data through a series of telephone interviews with U.S. adults and include self-reported height and weight data ((Mokdad, 1999).In 2011, BRFSS had methodological changes to estimate the prevalence of self-reported obesity so the estimates below should not be compared to the most recent prevalence estimates calculated after 2013.
The data above shows how obesity has gradually increased year after year in the United States, as explained by the CDC among the states participating in the BRFSS, by 1990, ten stateshad a prevalence of obesity less than 10% and no state had prevalence equal to or greater than 15%. By 2000, no state had a prevalence of obesity less than 10%, while twenty three states had prevalence between 20–24%, and no state had prevalence equal to or greater than 25%. Finally in 2010, no state had a prevalence of obesity less than 20%. Thirty-six states had a prevalence equal to or greater than 25%; and twelve of these had a prevalence equal to or greater than 30%(Mokdad, 1999). The most recent data obtained from BRFSS, shows that by 2013 no state had a prevalence of obesity less than 20%; seven states and the District of Columbia has a prevalence of obesity between 20% and <25%; twenty three states had a prevalence of obesity between 25% and <30%; eighteen states had a prevalence of obesity between 30% and <35%; two states hadprevalence of obesitygreater or equal to 35%.
Non-discriminatory Disease
The rates of obesity have been increasing in both developing and developed countries; no country has successfully reduced obesity in 33 years, according to data from an analysis including 188 countries. In 2010, it was estimated 3.4 million deaths and 4% of years of life lost were as a result of overweight and obesity; causing concern about the health risks associatedwith rising obesity led member states of WHO to introduce a voluntary target to stop the rise in obesity by 2025(Ng, 2014) and monitor change in the prevalence of obesity among the world. Almost 30% (2.1 billion people) of the global populations are now classified as being overweight or obese; between 1992 and 2002 the rate of increase of obesity was the greatest, but in the past decade has slowed down, more so in developing nations(Ng, 2014). More than 50% of obese individuals (671 million) in the world live in ten countries: US, China, India, Russia, Brazil, Mexico, Egypt, Germany, Pakistan, and Indonesia (listed in order of number of obese individuals).
The analysis estimated prevalence of obesity in adults exceeded 50% among developing countries in for men Tonga and women in Kuwait, Kiribati, the Federated States of Micronesia, Libya, Qatar, Tonga, and Samoa. In developed countries, more men than women were overweight and obese, however, in developing countries, overweight and obesity was more prevalent in women than in men, the highest prevalence of obesity in women, 42.0%, was recorded insub-Saharan Africa in 2013. Central America and Latin Americaconsisted of 14 countries with prevalence in women of greater than 20%. The lowest rates of obesity in were found in, China and India, which also accounted for 15% of obese individuals worldwide, in 2013. In China, 3.8% of men and5.0% of women were obese, comparedwith 3.7% of men and 4.2% ofwomen in India.In developed countries, the United States reported in 2013 with a high prevalence of obesity; roughly a third of men (31.6%) and women (33.9%) were obese; and accounted for 13% of obese people worldwide in 2013(Ng, 2014).
There was a distinct noted geographic pattern in high rates of child and adolescent obesity in many countries in the Middle East and north Africa, in particular girls, and in several Pacific Island and Caribbean nations among both sexes. Looking at countries individually, the prevalence of obesity in children and adolescents ranged from as high as more than 30% for girls in Kiribati and the Federated States of Micronesia to less than 2% in Bangladesh, Brunei, Burundi, Cambodia, Eritrea, Ethiopia, Laos, Nepal, North Korea, Tanzania, and Togo (Ng, 2014). The rates of obesity amongst boys, within Western Europe, ranged from 13.9% in Israel to 4.1% in the Netherlands. The highest prevalence of child and adolescent obesity was found among Latin America, for boys it varied from11.9% in Chile and 10.5% Mexico, and for girls it varied in 18.1% in Uruguay and 12.4% in Costa Rica.
Economic Analysis
Among low- and middle-income countries, cardiovascular diseases are among the leading causes of death. Currently the CDC finds 9.3% of the US population suffers from diabetes and increase of 1.5% from 2007 (Nandi, 2014). The growing problem of obesity can be reviewed in different phases. From the 1970s to present, Phase 1 of obesity began when the average weight is steadily increasing among children from all socioeconomic levels, racial and ethnic groups, and regions of the country(McDowell, 1997).Phase 2 of obesity is began by the emergenceof serious weight-related problems (Ludwig, 2007), such as diabetes and cardiovascular disease (Gaziano, 2010). Phase 3 of obesity, when the medical complications of obesity lead to life-threatening disease; the last phase will take a few more years to acknowledge due to misdiagnoses(Ruhm,2007).
Advances in agricultural technology have led to declines in the relative price of food and is one primary explanation for the observed growth of body weight over the past quarterand higher exercise (or calorie expenditure) prices (Drichoutis, 2012). Analyses of price increases during the period of 1985-2000 for food in different categories shows that cost of sweets, fats, and caloric beverages fell substantially in relation to fresh vegetables and fruits; while the retail price of fresh fruit and vegetables increased 120 percent and the price of fats and oils increased by 38 percent (Hojjat, 2015). Developments in agriculture and food technology have made added sugars and vegetable oils readily accessible at remarkable low costs.
Using Engel’s Law, when the relative price of a good or service rises, the quantity demanded falls (Budd, 2004). Although Americans have the lowest cost food supply in the world, Table 2, shows that the typical American (33% obesity rate) spends about 7% of their income for Food; compares to the average Indonesian (4.8% obesity rate) who devotes about 43% of their spending on food (Hojjat, 2015). Generally, healthier diets cost more; the average American diet consists of almost 40 percent daily energy from added sugars and added fats which are relatively inexpensive (Frazoa, Allshouse, 2003).In the United States, the gains in life expectancy since 1970 have also been much more modest than in most other OECD countries. While life expectancy in the United States used to be one year above the OECD average in 1970, it is now more than one year below the average (OECD, 2014). Diet quality is influenced by socioeconomic position and may well be limited by financial access to nutrient-dense foods.
Obesity is the second leading preventable cause of death in the United States and is associated with multiple chronic conditions, such as high blood pressure, high cholesterol, heart disease, and stroke, Type 2 diabetes. The direct medical costs related to obesity are secondary to preventive, diagnostic and treatment services; while indirect can be measured with a higher disability insurance premium, and labor market productivity (Hojjat, 2015). In 2007, 7.8% of the U.S. population suffered from diabetes and had average total medical expenditures of about $10,478 per year; it is estimated diabetes was responsible for approximately $2,044. Compared to the general population, average medical expenditures for all adults 35 and older was approximately half the amount at, $5,185 (Meyerhoefer, 2007). Due to the multiple chronic conditions that result from overweight and obesity, employers have acknowledged the economic consequences on resulting as the loss of productivity and high medical expenses; which, in 2013, were estimated to be $170 billion in the United States.
“Thank You for Not Smoking” –The Food Industry
The food industry, unlike the tobacco industry is very diverse and fragmented; this paper will focus on three businesses, “packaged food (companies such as Kraft, General Foods, General Mills, Kellogg’s, Unilever, Nestle, Danone), beverages (companies such as Coca-Cola, PepsiCo), and fast food (companies such as McDonald’s, Burger King, Yum! Brands)” (Karnani, 2014). As the prevalence of obesity has been on the rise, the food industries’ actions to respond the concerns about their products causing harm are significantly similar to the tobacco industry in 1957, which marked the first time the U.S. Public Health Service took a position on smoking and health, after the first U.S. Surgeon General Leroy E. Burney found clear scientific evidence establishing a relationship between smoking and lung cancer.
For decades the tobacco companies had been exempt from the standards of responsibility and accountability that apply to all other American corporations.In 1958, a survey found that only 44 percent of Americans believed smoking caused cancer, while 78 percent believed so by 1968. In 1994, six tobacco company CEOs declare, under oath, that nicotine is not addictive.One executive insisted that cigarettes were no more addictive than coffee, tea or Twinkies. Representative Henry Waxman, a Democrat from California, replied, "The difference between cigarettes and Twinkies is death."This hearing would bring about government intervention with policy and systems changes, such as higher tobacco excise taxes, smoke-free indoor air laws, and access to cessation treatments, to significantly reduce death and disease from tobacco.