Health and Economic Effects of Salt Reduction Interventions for Preventing Noncommunicable Diseases in Japan: A System Dynamics Simulation Study
Abstract
:1. Introduction
2. Materials and Method
2.1. System Dynamics Simulation Model
2.2. Model Conceptualization
2.3. Dynamic Hypothesis
2.4. Model Formulation
2.4.1. General Population Model
2.4.2. Dietary Salt Intake Model
2.4.3. NCD Model
Hypertension Sub-Model
CVD Sub-Model
CKD Sub-Model
Disability-Adjusted Life Years
2.4.4. Social Security Expenditure Model
2.4.5. Salt Reduction Intervention Model
Health Promotion Campaign Sub-Model
Product Reformulation Sub-Model
2.5. Parameterization and Data Sources
2.6. Scenario Assumptions
2.7. Validation Tests
3. Results
3.1. Model Validation
3.2. Base Run Analysis
3.3. Analysis of Scenarios
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Parameter | Initial Value | Unit | Source |
---|---|---|---|
Average dietary salt intake per day (Male) | 11.3 | gram | [11] |
Average dietary salt intake per day (Female) | 9.6 | gram | [11] |
Dietary salt intake target per day | 8 | gram | [8] |
Number of low-salt food products | 34 | product | [59] |
Number of low-salt food companies | 12 | dimensionless | [59] |
Health promotion campaign | 0.02 | dimensionless | [55] |
People aware to reduce salt intake | 94,998,675 | people | [53] |
Gross domestic product | 4,994,239 | JPY (Hundred million) | [60] |
Percentage of preventive care expenditure | 0.3 | dimensionless | [56] |
National medical care expenditure | 392,117 | JPY (Hundred million) | [4] |
Blood pressure medication cost | 36,500 | JPY | [48] |
Average cost for cardiovascular disease | 721,164 | JPY | [47] |
Average cost for kidney disease | 678,086 | JPY | [47] |
LTC expenditure | 8,641,640 | JPY (Million) | [61] |
Average premium category 1 | 59,664 | JPY | [49] |
Average premium category 2 | 56,366 | JPY | [50] |
Percentage of category 1 insured person | 0.243 | dimensionless | [62] |
Percentage of category 2 insured person | 0.335 | dimensionless | [50] |
Number of certified LTC recipients | 5,611,000 | people | [62] |
Scenarios | Policy Intervention Variables | |
---|---|---|
Low-Salt Diet Adoption Fraction | Product Reformulation Fraction | |
Base run | 0.02 | 0.05 |
Scenario 1 | 0.12 [63] | NA |
Scenario 2 | NA | 0.15 [55,64] |
Scenario 3 | NA | 0.20 [55,64] |
Simulation Parameters | R2 | MAE | RMSE | Theil Inequality Statistics | ||
---|---|---|---|---|---|---|
Medical care expenditure | 0.959 | 0.250 | 0.401 | 0.271 | 0.004 | 0.725 |
Long-term care expenditure | 0.992 | 0.067 | 0.091 | 0.295 | 0.156 | 0.549 |
Outcome Variables | Scenarios | |||
---|---|---|---|---|
Base Run | Scenario 1 | Scenario 2 | Scenario 3 | |
Disability-adjusted life years for cardiovascular disease | 55.01 | 53.48 | 52.43 | 51.87 |
(NA) | (−2.78%) | (−4.69%) | (−5.70%) | |
Disability-adjusted life years for chronic kidney disease | 9.50 | 9.20 | 9.01 | 8.91 |
(NA) | (−3.15%) | (−5.15%) | (−6.19%) | |
Diseases-associated medical care costs, trillion yen | 38.50 | 37.17 | 36.34 | 35.91 |
(NA) | (−3.46%) | (−5.62%) | (−6.73%) | |
Diseases-associated long-term care costs, trillion yen | 40.76 | 39.38 | 38.51 | 38.06 |
(NA) | (−3.40%) | (−5.53%) | (−6.64%) |
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Hassan, F.A.; Nishi, N.; Minato, N.; Sugiyama, T.; Ikeda, N. Health and Economic Effects of Salt Reduction Interventions for Preventing Noncommunicable Diseases in Japan: A System Dynamics Simulation Study. Systems 2024, 12, 478. https://doi.org/10.3390/systems12110478
Hassan FA, Nishi N, Minato N, Sugiyama T, Ikeda N. Health and Economic Effects of Salt Reduction Interventions for Preventing Noncommunicable Diseases in Japan: A System Dynamics Simulation Study. Systems. 2024; 12(11):478. https://doi.org/10.3390/systems12110478
Chicago/Turabian StyleHassan, Fatin Aminah, Nobuo Nishi, Nobuaki Minato, Takehiro Sugiyama, and Nayu Ikeda. 2024. "Health and Economic Effects of Salt Reduction Interventions for Preventing Noncommunicable Diseases in Japan: A System Dynamics Simulation Study" Systems 12, no. 11: 478. https://doi.org/10.3390/systems12110478
APA StyleHassan, F. A., Nishi, N., Minato, N., Sugiyama, T., & Ikeda, N. (2024). Health and Economic Effects of Salt Reduction Interventions for Preventing Noncommunicable Diseases in Japan: A System Dynamics Simulation Study. Systems, 12(11), 478. https://doi.org/10.3390/systems12110478