Future health expenditures and its determinants in Latin America and the Caribbean: a multi-country projection study

Summary Background Countries in Latin America and the Caribbean (LAC) have experienced important demographic, epidemiological, economic, and policy developments that raise concerns about their ability to afford health expenditures in the future. This paper forecasts how current health expenditures (CHE) in LAC countries will change over the next 30 years and identifies key drivers of health expenditure growth. Methods A statistical model to forecast CHE based on changing disease burden, economic growth, technology, and demography was developed. CHE by age and disease group at baseline (2018/19) were estimated for countries in the LAC region based on seven index countries. Baseline expenditures were projected to 2050. Findings Per capita CHE will increase across the LAC region (median increase 2.75 times) between baseline and 2050. All Latin American countries are expected to double per capita CHE in this period. Expected increases in Caribbean countries are more variable. Large increases in CHE growth related to neoplasms, circulatory system and genitourinary conditions are observed. Growth in CHE will be highest in older age groups. Interpretation Increases in health expenditures will be driven largely by economic growth and technology, while demography and epidemiology had smaller effects. The control of health expenditures and more efficient use of health resources must become a priority for the LAC region. Funding This study was funded by the Inter-American Development Bank.Fil: Rao, Krishna D.. University Johns Hopkins; Estados UnidosFil: Roberton, Timothy. The University of Western Australia; AustraliaFil: Vecino Ortiz, Andres I.. University Johns Hopkins; Estados UnidosFil: Noonan, Caitlin M.. University Johns Hopkins; Estados UnidosFil: Lopez Hernandez, Angelica. University Johns Hopkins; Estados UnidosFil: Mora Garcia, Claudio A.. Instituto Centroamericano de Administración de Empresas; Puerto RicoFil: Prado, Andrea M.. Instituto Centroamericano de Administración de Empresas; Puerto RicoFil: Machado, Carla Jorge. Universidade Federal de Minas Gerais; BrasilFil: Vega Landaeta, Angela. Pontificia Universidad Javeriana; ColombiaFil: Palacio Martínez, Natalia. Pontificia Universidad Javeriana; ColombiaFil: Flóres, Yvonne N.. University of California at Los Angeles; Estados UnidosFil: Samuels, T. Alafia. University of the West Indies; Trinidad y TobagoFil: Metivier, Charmaine. University of the West Indies; Trinidad y TobagoFil: Laptiste, Christine. University of the West Indies; Trinidad y TobagoFil: La Foucade, Althea. University of the West Indies; Trinidad y TobagoFil: Beharry, Vyjanti. University of the West Indies; Trinidad y TobagoFil: Maceira, Daniel Alejandro. Universidad de Buenos Aires; Argentina. Centro de Estudios de Estado y Sociedad; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentin

Health and economic burden of disease of sugar-sweetened beverage consumption in four Latin American and Caribbean countries : a modelling study

OBJECTIVE: Overweight and obesity are important contributors to the non-communicable disease burden. The consumption of sugar-sweetened beverages (SSBs) has been associated with an increased risk of type 2 diabetes mellitus (T2DM), cardiovascular disease, cancer and other conditions. The objective of this study was to estimate the burden of disease attributable to the consumption of SSBs and the costs to the healthcare systems in Argentina, Brazil, El Salvador, and Trinidad and Tobago. DESIGN: Following a systematic review of models, a comparative risk assessment framework was developed to estimate the health and economic impact associated with the consumption of SSBs. SETTING: Argentina, Brazil, El Salvador, and Trinidad and Tobago. PARTICIPANTS: Overall population. PRIMARY AND SECONDARY OUTCOME MEASURES: The model estimated the effects of SSB consumption on health through two causal pathways: one mediated by body mass index (BMI) and health conditions associated with BMI and another that reflected the independent effects of SSB consumption on T2DM and cardiovascular diseases. RESULTS: The model results indicated that for all four countries, in 1 year, SSB consumption was associated with 18 000 deaths (3.2% of the total disease-related deaths), seven million disease events (3.3% of the total disease-related events), a half-million DALYs and US$2 billion in direct medical costs. This included 1.5 million cases of overweight and obesity in children/adolescents (12% of the excess weight cases) and 2.8 million cases in adults (2.8%); 2.2 million cases of type 2 diabetes (19%); 200 000 cases of heart disease (3.8%); 124 000 strokes (3.9%); 116 000 cases of musculoskeletal disease (0.2%); 102 000 cases of kidney disease (0.9%); and 45 000 episodes of asthma (0.4%). The Trinidad and Tobago population were the most affected by disease events. CONCLUSIONS: The study results indicate that the consumption of SSBs is associated with a significant burden of disease and death in Latin America and the Caribbean