Untangling the health consequences and adverse labour market outcomes of obesity in the Australian adult population: new insights from longitudinal data

Untangling the health consequences and adverse labour market outcomes of obesity in the Australian adult population: new insights from longitudinal data

The rising prevalence of obesity is a pressing public health issue worldwide. The prevalence of obesity has almost tripled since 1975, and in 2016 it was estimated that over 650 million adults aged 18 years and above were obese, worldwide. Rising obesity is also a serious public health concern in Australia. The prevalence of obesity has sharply increased since 1995, and nearly one in three adults in Australia are obese. It is estimated that more than three-quarters of Australia’s adult population will be either overweight or obese by 2025. The high prevalence and severity of obesity impose a substantial burden on Australian individuals, families, the health system and the economy. Understanding obesity-induced health and economic costs and ascertaining the source of these costs are imperative for formulating appropriate public policies. Therefore, this thesis aims to investigate the prevalence, identify the associated risk factors, and disentangle the various burdens of obesity. This thesis put a particular emphasis on the economics of obesity. It applies a wide range of health econometric techniques to provide new evidence on the relationships between obesity, health and labour market outcomes. This ‘PhD by publication’ thesis is an accumulation of twelve individual studies using data from a nationally representative longitudinal survey, Household, Income and Labour Dynamics in Australia Survey (HILDA). The research articles included are divided into three main parts: prevalence and risk factors of obesity; health and well-being costs of obesity; and adverse labour market outcomes of obesity.

▪ The rising prevalence and risk factors of adult obesity in Australia: The first part of the thesis outlines the prevalence and associated risk factors of adult obesity in Australia. It includes three individual studies. The first study demonstrates the trend in the prevalence of adult obesity and its association with geographic remoteness. The second reveals the impact of disadvantaged neighbourhood and lifestyle characteristics on obesity. The third explores the association between job-related factors and obesity in the Australian adult population following a retrospective research design.

▪ Untangling the health consequences of adult obesity in Australia: The second part of the thesis includes five individual studies that articulate the health and well-being costs of obesity in Australia. The first study captures the chronic disease burden of obesity in Australia. The second explores the longitudinal association between obesity and disability. The third shows the link between obesity and higher healthcare services utilization. The fourth reveals the relationships between obesity and self-assessed general and mental health. The fifth demonstrates the diminishing health-related quality of life due to different comorbid chronic diseases in the obese population.

▪ Obesity and adverse labour market outcomes: The third part of the thesis consists of four separate studies on adverse labour market outcomes. These four articles demonstrate that obese people have higher absenteeism, higher presenteeism, lower levels of job satisfaction, and increased employment discrimination.

The evidence from this thesis should be helpful for health policy-makers to find ways to reduce the rising prevalence of obesity, health and well-being costs, and the associated adverse labour market outcomes.

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