Innovative Strategies Targeting Obesity and Non-communicable Diseases in South Africa: What Can We Learn from the Private Health Care Sector?

Exercise Science and Sports Science Research Unit , Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
Obesity Reviews (Impact Factor: 8). 09/2013; 14(S2). DOI: 10.1111/obr.12094
Source: PubMed


Over 50 percent of South African adult women and 30 percent of adult men are either overweight or obese, and nearly half of all adults are insufficiently active with major increases of obesity-associated health care expenditures since 1980, with a high proportion paid by private health insurance. In this paper, we describe the Vitality program, an incentivized health promotion program from South Africa's largest private health insurer, Discovery Health, with over 2.5 million beneficiaries. Wellness activities of the program include health risk assessments (HRA), subsidized gym memberships, and smoking cessation or weight loss programs with many incentives, including cash back on purchases of healthy foods. This incentive-based program has shown a significant relationship between levels of engagement in wellness activities, in particular increasing participation in fitness-related activities, with lower health care expenditure and increasing the overall ratio of healthy foods to total food purchases. This program demonstrates that incentives may reduce the barriers for entry into care, increase preventive screening, and increase engagement in healthy behaviors for prevention and management of obesity. This carrots vs sticks approach may have implications for public health policy even in lower- and middle-income settings and underserved communities.

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Available from: Tracy L Kolbe-Alexander, Jun 24, 2015
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