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Core measurements

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

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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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