Clustering of risk factors for non-communicable disease and healthcare expenditure in employees with private health insurance presenting for health risk appraisal: a cross-sectional study

Kolbe-Alexander, Tracy L. and Conradie, Jaco and Lambert, Estelle V. (2013) Clustering of risk factors for non-communicable disease and healthcare expenditure in employees with private health insurance presenting for health risk appraisal: a cross-sectional study. BMC Public Health, 13 (1213). pp. 1-10.

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Background: The global increase in the prevalence of NCD’s is accompanied by an increase in risk factors for these diseases such as insufficient physical activity and poor nutritional habits. The main aims of this research study were to determine the extent to which insufficient physical activity (PA) clustered with other risk factors for non-communicable disease (NCD) in employed persons undergoing health risk assessment, and whether these risk factors were associated with higher healthcare costs. Methods: Employees from 68 companies voluntarily participated in worksite wellness days, that included an assessment of self-reported health behaviors and clinical measures, such as: blood pressure (BP), Body Mass Index (BMI), as well as total cholesterol concentrations from capillary blood samples. A risk-related age, ‘Vitality Risk Age’ was calculated for each participant using an algorithm that incorporated multiplicative pooled relative risks for all cause mortality associated with smoking, PA, fruit and vegetable intake, BMI, BP and cholesterol concentration. Healthcare cost data were obtained for employees (n = 2 789). Results: Participants were 36 ± 10 years old and the most prevalent risk factors were insufficient PA (67%) and BMI ≥ 25 (62%). Employees who were insufficiently active also had a greater number of other NCD risk factors, compared to those meeting PA recommendations (chi2 = 43.55; p < 0.0001). Moreover, employees meeting PA guidelines had significantly fewer visits to their family doctor (GP) (2.5 versus 3.11; p < 0.001) than those who were insufficiently PA, which was associated with an average cost saving of ZAR100 per year (p < 0.01). Furthermore, for every additional year that the ‘Vitality Risk Age’ was greater than chronological age, there was a 3% increased likelihood of at least one additional visit to the doctor (OR = 1.03; 95% CI = 1.01 – 1.05). Conclusion: Physical inactivity was associated with clustering of risk factors for NCD in SA employees. Employees with lower BMI, better self-reported health status and readiness to change were more likely to meet the PA guidelines. These employees might therefore benefit from physical activity intervention programs that could result in improved risk profile and reduced healthcare expenditure.

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Item Type: Article (Commonwealth Reporting Category C)
Refereed: Yes
Item Status: Live Archive
Additional Information: Published version made available under open access.
Faculty / Department / School: Historic - Faculty of Sciences - Department of Nursing
Date Deposited: 23 Mar 2017 04:01
Last Modified: 23 Mar 2017 23:35
Uncontrolled Keywords: clustering of risk factors, physical activity, healthcare expenditure
Fields of Research : 14 Economics > 1402 Applied Economics > 140208 Health Economics
11 Medical and Health Sciences > 1106 Human Movement and Sports Science > 110699 Human Movement and Sports Science not elsewhere classified
11 Medical and Health Sciences > 1102 Cardiovascular Medicine and Haematology > 110201 Cardiology (incl. Cardiovascular Diseases)
Socio-Economic Objective: C Society > 92 Health > 9204 Public Health (excl. Specific Population Health) > 920401 Behaviour and Health
C Society > 92 Health > 9205 Specific Population Health (excl. Indigenous Health) > 920505 Occupational Health
Funding Details:
Identification Number or DOI: 10.1186/1471-2458-13-1213

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