Projection scenarios of body mass index 2013–2030 for Public Health Planning in QuebecReport as inadecuate

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BMC Public Health

, 14:996

Biostatistics and methods


BackgroundProjection analyses can provide estimates of the future health burden of increasing BMI and represent a relevant and useful tool for public health planning. Our study presents long-term 2013–2030 projections of the prevalence and numbers of individuals by BMI category for adult men and women in Quebec. Three applications of projections to estimate outcomes more directly pertinent to public health planning, as well as an in-depth discussion of limits, are provided with the aim of encouraging greater use of projection analyses by public health officers.

MethodsThe weighted compositional regression method is applied to prevalence time series derived from sixteen cross-sectional survey cycles, for scenarios of linear change and deceleration. Estimation of the component of projected change potentially amenable to intervention, future health targets and the projected impact on type 2 diabetes, were done.

ResultsObesity prevalence in Quebec is projected to rise steadily from 2013 to 2030 in both men from 18.0-19.4% to 22.2-30.4% and women from 15.5-16.3% to 18.2-22.4%. Corresponding projected numbers of obese individuals are 579,000-625,000 to 790,000-1,084,000 in men and 514,000-543,000 to 661,000-816,000 in women. These projected increases are found to be primarily an ‘epidemiologic’ rather than ‘demographic’ phenomenon and thus potentially amenable to public health intervention. Assessment of obesity targets for 2020 illustrates the necessity of using projected rather than current prevalence; for example a targeted 2% drop in obesity prevalence relative to 2013 translates into a 3.6-5.4% drop relative to 2020 projected levels. Type 2 diabetes is projected to increase from 6.9% to 9.2-10.1% in men and from 5.7% to 7.1-7.5% in women, from 2011–2012 to 2030. A substantial proportion of this change 25-44% for men, and 27-43% for women is attributable to the changing BMI distribution.

ConclusionsObesity in Quebec is projected to increase and should therefore continue to be a public health priority. Application of projections to estimate the proportion of change potentially amenable to intervention, feasible health targets, and future chronic disease prevalence are demonstrated. Projection analyses have limitations, but represent a pertinent tool for public health planning.

KeywordsProjections Forecasting Obesity Body mass index Type 2 diabetes Health targets Public health Public health planning Health burden AbbreviationsBMIBody mass index

CCHSCanadian Community Health Survey

ESQQuebec Health Survey Enquête Santé Québec

ESSQuebec Health and Social Survey Enquête Sociale et de Santé

GLSGeneralised Least Squares

ISQQuebec Statistics Institute Institut de la Statistique du Québec

MSSSQuebec Ministry of Health Ministère de la Santé et des Services Sociaux du Québec

NPHSNational Population Health Survey

T2DType 2 Diabetes.

Electronic supplementary materialThe online version of this article doi:10.1186-1471-2458-14-996 contains supplementary material, which is available to authorized users.

Denis Hamel, Yun Jen, Patricia Lamontagne, Sylvie Martel, Colin Steensma contributed equally to this work.

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Author: Ernest Lo - Denis Hamel - Yun Jen - Patricia Lamontagne - Sylvie Martel - Colin Steensma - Chantal Blouin - Russell Steele


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