The costs of lifestyle-related illnesses straining Medaids

The rapid rise in lifestyle-related illnesses, resulting from higher rates of obesity in particular, indicate that an unhealthy diet and sedentary lifestyle are fast replacing tobacco as one of the leading causes of preventable diseases.


In fact, according to Dr Peter Hill of Met-S Care, obesity has become a modern day global pandemic that is contributing to deaths from non-communicable diseases (NCD) such as high blood pressure, diabetes, heart disease, cancer, non-alcoholic fatty liver disease and dementia at a faster rate than ever before.


According to figures quoted in a Financial Mail article in 2014, 38m or 68% of deaths reported worldwide in 2012 were due to NCDs. Nearly three-quarters of these, or 28m, occurred in low- and middle-income countries, with about 48% dying before the age of 70.


Health Minister, Aaron Motsoaledi, was quoted as saying that in Africa it is projected that NCDs at current rates will overtake all other causes of mortality by 2030. He says in South Africa, an estimated 40% of deaths from NCDs among men and 29% among women occur before the age of 60.


Data released by Statistics SA confirms this. It is predicted that by 2030 deaths from NCDs will be five times higher than deaths from communicable diseases including HIV/Aids and Tuberculosis and that the cause of 75% of deaths globally will be from NCD’s.


SA has all the features of an unhealthy nation. Of growing concern is the current increase in obesity in adolescents.


According to Motsoaledi, “If 23% of school-going kids are classified as obese and overweight, in 10 to15 years they will be lining up in our clinics with high blood pressure and diabetes. There’s no question about it.”


With obesity comes the risk of Metabolic Syndrome, diagnosed when three or more lifestyle-related chronic conditions or disorders are found together. This increases the risk of heart disease, strokes and diabetes.


Fedhealth’s Jeremy Yatt confirms this trend, noting the rise in the number of medical scheme beneficiaries who have multiple chronic conditions. A report from The Council for Medical Schemes on the prevalence of chronic diseases in the population covered by medical schemes in South Africa, shows the number of beneficiaries who were diagnosed and treated for multiple CDL (Chronic Disease Listing) conditions increased by more than 25% in 2013 compared to 2012 with the number of beneficiaries with four or more CDL conditions increasing by about 78%.


In Fedhealth’s own profile the number of incidences per 1000 members for hypertension for example has increased by 14% between 2011 and 2014. And for diabetes Type 2 this percentage increase has been 19%.


“This risk profile negatively impacts the risk profiles of all medical schemes, particularly as the upward trend in diagnosis and treatment of many chronic conditions on the CDL continued in 2014. This small percentage of beneficiaries is in fact driving as much as 30% of the total costs,” says Yatt.


Minister Motsoaledi believes the situation is not sustainable and if we don’t start addressing the problem and reversing some of our eating trends, SA will plunge into another public and private health crisis.


Hill adds that though obesity is caused by multiple factors, what we eat and how much we eat is a major factor specifically when it comes to sugar-sweetened foods, snacks and beverages, ultra-processed foods and fast foods.


One sugar-sweetened beverage a day increases the likelihood of being overweight by 55% in children and 30% for adults.


Hill says starch and sugar are refined carbohydrates and because they are easily converted into blood glucose they drive insulin levels upwards and if these high levels are sustained over time often make people insulin resistant. “Bread, pasta, biscuits, cakes, breakfast cereals, sweets and chocolate, sugar-sweetened foods, snacks and beverages and fruit juice are just some of the products that drive our insulin levels,” he says.


“We all end up paying for obesity directly or indirectly,” says Yatt. “Health-care costs are 20% more for moderately obese individuals and 50% more for severe obesity. Obese workers cost their employers 50% more in paid-time off than non-obese colleagues. Being obese places individuals and their families under financial strain with more medical bills and penalties for life and health insurance,” he says.


Minister Motsoaledi believes the only way for Africa to survive this pandemic is prevention.


“Information about food content must be easily understood to allow the public to make comparisons. For example, the Food & Drug Administration in the US has just passed regulations to ensure that calorie counts appear on every food item, even popcorn at movies,” she says. “Regulations are needed for adverts, especially in or near schools, and for children on TV, the Internet and their cellphones,” he says.


“People need to be encouraged and empowered to shift towards healthier diets and self care and education is the key,” concludes Yatt.