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Innovative strategies targeting obesity and non‐communicable diseases in S outh A frica: what can we learn from the private healthcare sector?
Author(s) -
Lambert E. V.,
KolbeAlexander T. L.
Publication year - 2013
Publication title -
obesity reviews
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.845
H-Index - 162
eISSN - 1467-789X
pISSN - 1467-7881
DOI - 10.1111/obr.12094
Subject(s) - incentive , overweight , health care , medicine , health promotion , obesity , subsidy , private sector , smoking cessation , promotion (chess) , environmental health , public health , gerontology , business , nursing , economic growth , political science , economics , pathology , politics , microeconomics , law
Summary Over 50% of S outh A frican adult women and 30% of adult men are either overweight or obese, and nearly half of all adults are insufficiently active, with major increases in obesity‐associated healthcare expenditures since 1980, a high proportion of which are paid by private health insurance. In this paper, we describe the V itality programme, an incentivized health promotion programme from S outh A frica's largest private health insurer, D iscovery H ealth, with over 2.5 million beneficiaries. Wellness activities of the programme include health risk assessments, subsidized gym memberships and smoking cessation or weight loss programmes with many incentives, including cash back on purchases of healthy foods. This incentive‐based programme has shown a significant relationship between levels of engagement in wellness activities, in particular increasing participation in fitness‐related activities, with lower healthcare expenditure and an increase in the overall ratio of healthy foods to total food purchases. This programme demonstrates that incentives may reduce the barriers for entry into care, increase preventive screening and increase engagement in healthy behaviours for prevention and management of obesity. This ‘carrots versus sticks’ approach may have implications for public health policy even in lower‐ and middle‐income settings and underserved communities.