Obesity trend in the United States and economic intervention options to change it: A simulation study linking ecological epidemiology and system dynamics modeling
Obesity trend in the United States and economic intervention options to change it: A simulation study linking ecological epidemiology and system dynamics modeling
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DOI：
10.1016/j.puhe.2018.01.013
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发表时间：
2018-08-01
期刊：
影响因子：
5.2
通讯作者：
Wang, Y.
中科院分区：
文献类型：
--
作者：
Chen, H-J.;Xue, H.;Wang, Y.
目的：研究美国人口体重状况与社会经济分布(就业状况和家庭收入)之间的国家一级动态和影响，并预测基于社会经济的干预方案对肥胖症流行的潜在影响。研究设计：生态学研究和模拟。方法：使用2001-2011年医疗费用小组调查(N=88,453名成年人)的纵向数据，我们建立并校准了一个系统动力学模型(SDM)，该模型捕捉了体重状况和社会经济状况分布之间的反馈循环，并模拟了基于就业和收入的干预选项的影响。结果：基于SDM的模拟预测了未来美国超重/肥胖患病率的上升。提高中低收入人群的收入有助于控制肥胖率的上升，而只为失业者创造就业机会并没有显示出这种效果。结论：提高中低收入人群的收入可能是抑制美国成年人口肥胖率上升趋势的有效手段，而不仅仅是提高再就业率。这项研究表明，SDM作为一个虚拟实验室来评估人口健康和经济之间相互作用的复杂分布现象的价值。(C)2018年皇家公共卫生学会。爱思唯尔有限公司出版。保留所有权利。
Objectives: To study the country-level dynamics and influences between population weight status and socio-economic distribution (employment status and family income) in the US and to project the potential impacts of socio-economic-based intervention options on obesity prevalence.Study design: Ecological study and simulation.Methods: Using the longitudinal data from the 2001-2011 Medical Expenditure Panel Survey (N = 88,453 adults), we built and calibrated a system dynamics model (SDM) capturing the feedback loops between body weight status and socio-economic status distribution and simulated the effects of employment-and income-based intervention options.Results: The SDM-based simulation projected rising overweight/obesity prevalence in the US in the future. Improving people's income from lower to middle-income group would help control the rising prevalence, while only creating jobs for the unemployed did not show such effect.Conclusions: Improving people from low- to middle-income levels may be effective, instead of solely improving reemployment rate, in curbing the rising obesity trend in the US adult population. This study indicates the value of the SDM as a virtual laboratory to evaluate complex distributive phenomena of the interplay between population health and economy. (c) 2018 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.