Thank you for the invitation to be here.
I'm an obesity researcher. I'm an epidemiologist. I've been working for about 15 years in the area of obesity in Canada doing similar studies to what you've just heard about, in other words, tracking prevalences of obesity over time as well as trying to estimate the burden of obesity on the heath care system in Canada.
Rather than going into any more statistics, in a nutshell, we're in the midst of a worldwide epidemic of childhood obesity right now. We've done a recent international comparison of 34 different countries around the world--mainly North America and Europe--and of these countries, Canada rates fifth in the prevalence of overweight kids right now. The United States is a little bit ahead of us. They're ranked second or third right now. So they're on the podium, but we're catching up to them.
In a nutshell, we're all aware of this dramatic increase in the prevalence of obesity. In adults, it has gone up. But the scary thing really is that it has escalated at a far greater pace in our kids than the adults. This is a major concern of mine as well as other obesity researchers working in the area.
Again, just to touch a bit on the socio-economic and the provincial variation, we do see in the Atlantic provinces higher rates of obesity than in other parts of Canada. Within each region of Canada, we see distinct gradients along socio-economic class; in other words, those in the lower socio-economic strata have higher prevalences of obesity, particularly in the kids--you see nice, clear gradations across the country. Nevertheless, even taking this into account, the lower socio-economic status of the Atlantic provinces does not explain the high prevalence. There's something else going on there that we need to investigate.
With that in mind, we know that there are several health risks of obesity. Dr. Finegood mentioned a few. Higher rates of dyslipidemia, hypertension, and diabetes are now appearing in kids. The big thing we have to keep in mind is that these kids, this generation, are growing up and there is a strong tracking of obesity from childhood into adulthood. Although we have an epidemic of obesity right now, it's just the tip of the iceberg. This next generation, as they move into adulthood, will really put a spike into our health care costs.
Dr. Finegood mentioned the metabolic syndrome. Today among adults we see this clustering of risk factors: heart disease, diabetes, and hypertension. This is becoming more and more evident among kids. In the United States right now, about 50% of boys and about 30% of girls have more than one cardiovascular disease risk factor. We're talking about 12- to 17-year-olds, and many of them have multiple--two, three, or four--risk factors.
We've done some studies in Quebec. The kids who have four or more risk factors, kids 8 to 18 years of age, have between 20 and 40 times the risk of being overweight or obese. So we know the risks. They're substantial. And that's what we're faced with right now, a high prevalence and a high risk.
What does this translate into? We've done some work on the economic cost of obesity and the economic cost of physical inactivity in this country. Most of that work has been done in adults, because although kids are obese, the diseases associated with obesity take several years to develop. Obese kids don't have heart attacks and they don't have strokes until they become adults.
One study in the United States has estimated some economic costs of obesity. They found that in the last 20 years hospital discharges related to obesity have tripled, and the health care costs associated with obesity have also tripled--that's in children and in 20 years.
In terms of the economic toll in Canada, we've done several studies trying to estimate that. Right now we're paying about $4.5 billion a year treating obesity and obesity-related disorders in this country--$4.5 billion. When you factor in the cost, for example, of physical inactivity, which is a separate cost, that's more than $5 billion as well.
These can be broken down into both direct and indirect costs. The direct health care costs associated with obesity are about $1.6 billion a year. These are health care expenditures directly related to doctors, hospitals, nurses, drugs, and research—$1.6 billion a year.
The indirect costs, the things that are harder to measure, are even more substantial. They're about $2.7 billion. These are such things as lost productivity at work and mortality. If somebody dies at the age of 45 or 50 from a stroke from being obese, we've lost productivity from that individual from our society, let alone all the taxes they could have paid. These are the things when you estimate the indirect costs of obesity. It's a burden on our society.
So that's the number we're working with now: $4.3 billion.
It does not take into account the burgeoning child obesity epidemic, which is coming up. Right now, these costs range from between 3% to 5% of our total health care costs—3% to 5%—and as these kids grow up, I can see that going up quite substantially in the coming years.
From the perspective of a researcher working in the area, those are my comments today. I'd like to leave it there.