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Prevention has a good cost-effectiveness ratio (Free Mutualities)

“Chronic conditions are responsible for 86% of all deaths,” recalled Xavier Brenez, CEO of Mutualités Libres, during a symposium devoted to prevention. “50% of these deaths and 37% of work incapacity are directly linked to behavioral risk factors such as pollution, tobacco and alcohol consumption, and junk food. » The WHO has dissected the prevention policy in Belgium and puts forward some recommendations.

In addition to the considerable impact of chronic diseases on the health of our fellow citizens, they also have a significant impact on the health care budget. Xavier Brenez underlines that the members of the Free Mutualities (MLOZ) with the highest health expenses – i.e. 1% of members – have at least one or two chronic illnesses. “In total, 30.3% of total compulsory insurance expenditure is spent on this group. »
The MLOZ boss recommends investing in prevention because it reduces long-term health care costs, improves quality of life and allows individuals to play an active role in their own well-being. These prevention strategies must obviously be seriously evaluated.

Belgium can do better

Julianne Williams presented, during the conference organized on November 26, a WHO report on the prevention of non-communicable diseases and on the determinants of health in Belgium. “Focusing on the prevention of non-communicable diseases is cost-effective, improves quality of life, increases life expectancy and reduces health inequalities,” says the WHO expert. And to point out that there are very strong variations depending on the region. A study carried out in our country between 2010 and 2017 clearly shows that the number of premature deaths (per 100,000 inhabitants) is higher in Wallonia (particularly in Hainaut) than in Brussels and Flanders.

“In Belgium, 20,445 people die from tobacco every year. The economic cost of tobacco represents 8.56 billion euros per year,” underlines Julianne Williams. “Among 15-39 year olds, alcohol is the cause of 12% of road accidents, 19% of suicides, 10% of breast cancers and 60% of cirrhosis. Half of Belgians are overweight and 16% are obese. The prevalence of these pathologies is greater among people with lower incomes. The direct costs of being overweight are estimated at 3.6 billion euros per year. Adding indirect costs, they amount to 7.5 billion euros. Furthermore, 30% of the population has hypertension. 60% of strokes and 57% of ischemic heart disease are attributed to high blood pressure. We also note a higher consumption of salt – a risk factor for hypertension – in Belgium than in other European countries. »

Business practices

In addition to the efforts that can be made on an individual basis to reduce these risks, for example through physical exercise or diet, the WHO considers that measures must be taken in relation to the commercial practices of industries (tobacco, alcohol, food, oil, etc.). The organization has also produced a report on this subject covering 35 concrete cases in Europe.
The WHO also invites federal and regional authorities to pursue integrated and concerted policies using regulation and taxation (alcohol, cigarettes) as levers. Without forgetting to take health issues into account in all policies. For example, Julianne Williams points out that “policies aimed at promoting physical activity go hand in hand with access to green spaces and the design of healthy cities”.

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