Economic Measures
Evidence and Data
Introduction
Our aim in sharing this methodology is to facilitate wider application of it — to additional products and services — and to encourage adaptation and refinement of the methods. This page offers a library of resources — links to studies that provide evidence for the linking of different health behaviors to common chronic diseases and to resources for information on the prevalence and costs of those diseases. If you are interested in contributing to this library — by offering updated resources or additional studies, please contact us at measures@buildingh.org.
Linking Behavior to Disease
The following studies analyze the quantitative relationships between selected health behaviors (or the consumption of certain nutrients) and common chronic diseases.
relationship
calorie consumption → weight gain
Source
Hall K, Sacks G, Chandramohan D, et al. Quantification of the effect of energy imbalance on bodyweight. Lancet. 2011;378:9793. doi:10.1016/S0140-6736(11)60812-X
dietary fiber consumption → cardiovascular disease
Threapleton D, Evans C, Nykjaer C, et al. Dietary fibre intake and risk of cardiovascular disease: systematic review and meta-analysis. BMJ 2013;347:f6879. doi:10.1136/bmj.f6879
dietary fiber consumption → depression
Saghafian F, Hajishafiee M, Rouhani P and Saneei P. Dietary fiber intake, depression, and anxiety: a systematic review and meta-analysis of epidemiologic studies. Nutr Neurosci. 2022:26(2);108-126. doi:10.1080/1028415X.2021.2020403
dietary fiber consumption → type 2 diabetes
Yao B, Fang H, Xu W et al. Dietary fiber intake and risk of type 2 diabetes: a dose–response analysis of prospective studies. Eur J Epidemio. 2014:29:79-88. doi:10.1007/s10654-013-9876-x
physical activity (daily step count) → cardiovascular disease
Sheng M, Yang J, Bao M et al. The relationships between step count and all-cause mortality and cardiovascular events: A dose–response meta-analysis. J Sport Health Sci 2021;10(6):620-628. doi:10.1016/j.jshs.2021.09.004
physical activity (daily step count) → depression
Bizzozero-Peroni B, Díaz-Goñi V, Jiménez-López E, et al. Daily Step Count and Depression in Adults: A Systematic Review and Meta-Analysis. JAMA Netw Open 2024;7(12):e2451208. doi:10.1001/jamanetworkopen.2024.51208
sleep duration → cardiovascular disease
Yin J, Jin X, Shan Z et al. Relationship of sleep duration with all-cause mortality and cardiovascular events: a systematic review and dose-response meta-analysis of prospective cohort studies. J Am Heart Assoc 2017;6(9):e005947. doi:10.1161/JAHA.117.005947
sleep duration → depression
Li X, Wei J, Zhang X, Meng Z and Zhu W. Relationship between night-sleep duration and risk for depression among middle-aged and older people: A dose–response meta-analysis. Front Physiol 2023;14:1085091. doi:10.3389/fphys.2023.1085091
sleep duration → obesity
Zhou Q, Ming Z and Dongsheng H. Dose-response association between sleep duration and obesity risk: a systematic review and meta-analysis of prospective cohort studies. Sleep Breath 2019;23:1035-1045. doi:10.1007/s11325-019-01824-4
sleep duration → type 2 diabetes
Shan Z, Ma H, Xie, M et al. Sleep Duration and Risk of Type 2 Diabetes: A Meta-analysis of Prospective Studies. Diabetes Care 2015;38(3):529–537. doi:10.2337/dc14-2073
sodium consumption → cardiovascular disease
Wang YJ, Yeh TL, Shih MC, et al. Dietary Sodium Intake and Risk of Cardiovascular Disease: A Systematic Review and Dose-Response Meta-Analysis. Nutrients 2020; 12(10):2934. doi:10.3390/nu12102934
sodium consumption → hypertension
Filippini T, Malavolti M, Whelton PK, et al. Sodium Intake and Risk of Hypertension: A Systematic Review and Dose–Response Meta-analysis of Observational Cohort Studies. Curr Hypertens Rep 2022; 24:133–144. doi:10.1007/s11906-022-01182-9
sugar-sweetened beverage (SSB) consumption → cardiovascular disease
Yin J, Zhu Y, Malik V et al. Intake of Sugar-Sweetened and Low-Calorie Sweetened Beverages and Risk of Cardiovascular Disease: A Meta-Analysis and Systematic Review. Adv Nutr. 2021:12(1);89-101. doi:10.1093/advances/nmaa084
sugar-sweetened beverage (SSB) consumption → depression
Wang Y, Zhao R, Wang B, Zhao C, Zhu B and Tian X. The Dose-Response Associations of Sugar-Sweetened Beverage Intake with the Risk of Stroke, Depression, Cancer, and Cause-Specific Mortality: A Systematic Review and Meta-Analysis of Prospective Studies. Nutrients. 2022:14(4);777. doi:10.3390/nu14040777
sugar-sweetened beverage (SSB) consumption → hypertension
Xi B, Huang Y, Reilly KH et al. Sugar-sweetened beverages and risk of hypertension and CVD: a dose–response meta-analysis. Br J Nutr. 2015;113(5):709-717. doi:10.1017/S0007114514004383
sugar-sweetened beverage (SSB) consumption → type 2 diabetes
Qin P, Li Q, Zhao Y et al. Sugar and artificially sweetened beverages and risk of obesity, type 2 diabetes mellitus, hypertension, and all-cause mortality: a dose–response meta-analysis of prospective cohort studies. Eur J Epidemiol 2020;35:655-671. doi:10.1007/s10654-020-00655-y
sugar-sweetened beverage (SSB) consumption → weight gain
Malik VS, Pan A, Willett WC and Hu FB. Sugar-sweetened beverages and weight gain in children and adults: a systematic review and meta-analysis. Am J Clin Nutr. 2013:98(4);1084-1102. doi:10.3945/ajcn.113.058362
TV viewing time → cardiovascular disease
Grøntved A and Hu, H. Television Viewing and Risk of Type 2 Diabetes, Cardiovascular Disease, and All-Cause Mortality: A Meta-analysis, JAMA 2011;305(23):2448-2455. doi:10.1001/jama.2011.812
TV viewing time → depression
Zhou Q, Guo C, Yang X, et al. Dose–response association of total sedentary behaviour and television watching with risk of depression in adults: A systematic review and meta-analysis, J Affect Disord 2023;324:652-659. doi:10.1016/j.jad.2022.12.098
TV viewing time → obesity
Guo C, Zhou Q, Zhang D et al. Association of total sedentary behaviour and television viewing with risk of overweight/obesity, type 2 diabetes and hypertension: A dose–response meta-analysis. Diabet Obes Metab 2019;22(1);79-90. doi:10.1111/dom.13867
TV viewing time → type 2 diabetes
Grøntved A and Hu, H. Television Viewing and Risk of Type 2 Diabetes, Cardiovascular Disease, and All-Cause Mortality: A Meta-analysis, JAMA 2011;305(23):2448-2455. doi:10.1001/jama.2011.812
Disease Prevalence
The following sources provide information on prevalence for several common chronic conditions.
Disease/Condition
Source
Date
Cardiovascular Disease
Benjamin E, Muntner P, Alonso A et al. Heart Disease and Stroke Statistics—2019 Update: A Report From the American Heart Association. Circulation. 2019; 139(10):e56-e528. doi:10.1161/CIR.0000000000000659
2018
Depression
National Institute of Mental Health. Major Depression. National Institute of Mental Health website.
2021
Hypertension
Fryar C, Kit B, Carroll MD and Afful J. Hypertension Prevalence, Awareness, Treatment, and Control Among Adults Age 18 and Older: United States, August 2021–August 2023. NCHS Data Brief No. 511, October 2024.
2023
Obesity
Emmerich SD, Fryar CD, Stierman B, and Ogden CL. Obesity and Severe Obesity Prevalence in Adults: United States, August 2021–August 2023. NCHS Data Brief No. 508, September 2024. CDC National Center for Health Statistics.
2023
Type 2 Diabetes
Centers for Disease Control and Prevention. National Diabetes Statistics Report. CDC Diabetes.
2023
Healthcare Costs
Data on annual treatment costs for different conditions can be found in the resources listed below.
Source
Disease
Year
Cardiovascular Disease
Kazi DS, Elkind MSV, Deutsch A et al. Forecasting the Economic Burden of Cardiovascular Disease and Stroke in the United States Through 2050: A Presidential Advisory From the American Heart Association. Circulation. 2024;150(4). doi:10.1161/CIR.000000000000125
2022
Depression
Greenberg PE, Fournier A-A, Koenigsberg SH et al. The Economic Burden of Adults with Major Depressive Disorder in the United States (2010 and 2018). PharmacoEconomics.2021;39:653–665. doi:10.1007/s40273-021-01019-4
2020
Hypertension
Kazi DS, Elkind MSV, Deutsch A et al. Forecasting the Economic Burden of Cardiovascular Disease and Stroke in the United States Through 2050: A Presidential Advisory From the American Heart Association. Circulation. 2024;150(4). doi:10.1161/CIR.000000000000125
2022
Obesity and Overweight
Waters H and Graf M. America’s Obesity Crisis: The Health and Economic Costs of Excess Weight. Milken Institute. October 2018.
2016
Type 2 Diabetes
Parker D, Lin J, Mahoney T, et al. Economic Costs of Diabetes in the U.S. in 2022. Diabetes Care. 2024; 47(1):26–43. doi:10.2337/dci23-0085
2022
To normalize costs to the same year so that they reflect the effect of inflation, one source is the US Health Care Inflation Rate, which reflects the year over year change in the health care component of the US Consumer Price Index. See: YCharts. US Health Care Inflation Rate. YCharts.com. https://ycharts.com/indicators/us_health_care_inflation_rate.