Josiah Hickson

Bio: Josiah Hickson is an academic researcher from Deloitte. The author has contributed to research in topics: Perspective (graphical) & Total cost. The author has an hindex of 2, co-authored 2 publications receiving 34 citations.

Social and economic cost of eating disorders in the United States: Evidence to inform policy action

Abstract: Objective To estimate one-year costs of eating disorders in the United States (U.S.) from a societal perspective, including the costs to the U.S. health system, individual and family productivity costs, lost wellbeing, and other societal economic costs, by setting and payer. Findings will inform needed policy action to mitigate the impact of eating disorders in the U.S. Method Costs of eating disorders were estimated using a bottom-up cost-of-illness methodology, based on the estimated one-year prevalence of eating disorders. Intangible costs of reduced wellbeing were also estimated using disability-adjusted life years. Results Total economic costs associated with eating disorders were estimated to be $64.7 billion (95% CI: $63.5-$66.0 billion) in fiscal year 2018-2019, equivalent to $11,808 per affected person (95% CI: $11,754-$11,863 per affected person). Otherwise Specified Feeding or Eating Disorder accounted for 35% of total economic costs, followed by Binge Eating Disorder (30%), Bulimia Nervosa (18%) and Anorexia Nervosa (17%). The substantial reduction in wellbeing associated with eating disorders was further valued at $326.5 billion (95% CI: $316.8-$336.2 billion). Discussion The impact of eating disorders in the U.S. is substantial when considering both economic costs and reduced wellbeing (nearly $400 billion in fiscal year 2018-2019). Study findings underscore the urgency of identifying effective policy actions to reduce the impact of eating disorders, such as through primary prevention and screening to identify people with emerging or early eating disorders in primary care, schools, and workplaces and ensuring access to early evidence-based treatment.

Economic impact of delirium in Australia: a cost of illness study.

Abstract: Objectives To estimate the economic impact of delirium in the Australian population in 2016–2017, including financial costs, and its burden on health. Design, setting and participants A cost of illness study was conducted for the Australian population in the 2016–2017 financial year. The prevalence of delirium in 2016–2017 was calculated to inform cost estimations. The costs estimated in this study also include dementia attributable to delirium. Main outcome measures The total and per capita costs were analysed for three categories: health systems costs, other financial costs including productivity losses and informal care and cost associated with loss of well-being (burden of disease). Costs were expressed in 2016–2017 pound sterling (£) and Australian dollars ($A). Results There were an estimated 132 595 occurrences of delirium in 2016–2017, and more than 900 deaths were attributed to delirium in 2016–2017. Delirium causes an estimated 10.6% of dementia in Australia. The total costs of delirium in Australia were estimated to be £4.3 billion ($A8.8 billion) in 2016–2017, ranging between £2.6 billion ($A5.3 billion) and £5.9 billion ($A12.1 billion). The total estimated costs comprised financial costs of £1.7 billion and the value of healthy life lost of £2.5 billion. Dementia attributable to delirium accounted for £2.2 billion of the total cost of delirium. Conclusions These findings highlight the substantial burden that delirium imposes on Australian society—both in terms of financial costs associated with health system expenditure and the increased need for residential aged care due to the functional and cognitive decline associated with delirium and dementia. To reduce the substantial well-being costs of delirium, further research should seek to better understand the potential pathways from an episode of delirium to subsequent mortality and reduced cognitive functioning outcomes.

Labour Market Effects of Bushfires and Floods in Australia: A Gendered Perspective*

Abstract: We study the labour market effects of bushfires and floods within Australia over the past two decades, focusing on gender as a determinant of vulnerability. Whilst floods unambiguously increased the labour supply of both genders (creating around 13,500 jobs per year), the likelihood of female employment is particularly vulnerable to bushfires, falling by 1.6 percentage points (or around 5,000 jobs per year). This effect is partially explained by industry sector, with bushfires lifting overall male employment through industries including mining and transport, while reducing more female-dominated services sector participation. We also examine intrahousehold dynamics, finding strong evidence for an ‘added worker’ effect.

Epidemiology of binge eating disorder: prevalence, course, comorbidity, and risk factors.

Abstract: Purpose of review Binge eating disorder (BED) is a new diagnosis in the Fifth Edition of the Diagnostic and Statistic Manual of Mental Disorders (DSM-5) and the Eleventh Revision of the International Classification of Diseases (ICD-11). Recent findings DSM-5 BED is currently estimated to affect 1.5% of women and 0.3% of men worldwide; a lifetime diagnosis of DSM-5 BED is reported by 0.6-1.8% of women and 0.3-0.7% of men. In adolescence, BED is even more prevalent, but often transient. Many adults with BED report longstanding symptoms; less than half are recognized in healthcare. Commonly co-occurring conditions include obesity, type 2 diabetes, and hypertension. In a nationally representative US-based study, up to 23% of individuals with BED had attempted suicide, and virtually all (94%) reported lifetime mental health symptoms: 70% mood disorders, 68% substance use disorders, 59% anxiety disorders, 49% borderline personality disorder, and 32% posttraumatic stress disorder. Data on mortality are scarce, but the standardized mortality ratio of BED is estimated to be 1.5-1.8. Various minority statuses, deprivation, violence, trauma, and major mental illness may increase the risk of BED. Summary BED is often invisible and overlooked, perhaps due to societal biases. For this reason, prevention, detection, and management of BED are closely linked with social justice and equity.

International drive to illuminate delirium: A developing public health blueprint for action.

Abstract: Ara S. Khachaturian1 KathleenM. Hayden2 JohnW. Devlin3 Lee A. Fleisher4 Sarah Lenz Lock5 ColmCunningham6 Esther S. Oh7 Tamara G. Fong8,9,10 DonnaMarie Fick11 Edward R.Marcantonio12 Vijeth Iyengar13† Kenneth Rockwood14 George A. Kuchel15 Roderic G. Eckenhoff16 AlasdairM.J. MacLullich17 Richard N. Jones18 Daniel Davis19 PatriciaM. D’Antonio20 Keith N. Fargo21 Marilyn S. Albert22 Jeff D.Williamson23 ShariM. Ling24‡ JoanWeiss25§ Jason Karlawish26 Ronald C. Petersen27 DanG. Blazer28 Zaven S. Khachaturian1 Sharon K. Inouye29

Binge eating disorder

Abstract: Binge eating disorder (BED) is characterized by regular binge eating episodes during which individuals ingest comparably large amounts of food and experience loss of control over their eating behaviour. The worldwide prevalence of BED for the years 2018–2020 is estimated to be 0.6–1.8% in adult women and 0.3–0.7% in adult men. BED is commonly associated with obesity and with somatic and mental health comorbidities. People with BED experience considerable burden and impairments in quality of life, and, at the same time, BED often goes undetected and untreated. The aetiology of BED is complex, including genetic and environmental factors as well as neuroendocrinological and neurobiological contributions. Neurobiological findings highlight impairments in reward processing, inhibitory control and emotion regulation in people with BED, and these neurobiological domains are targets for emerging treatment approaches. Psychotherapy is the first-line treatment for BED. Recognition and research on BED has increased since its inclusion into DSM-5; however, continuing efforts are needed to understand underlying mechanisms of BED and to improve prevention and treatment outcomes for this disorder. These efforts should also include screening, identification and implementation of evidence-based interventions in routine clinical practice settings such as primary care and mental health outpatient clinics. Binge eating disorder is an eating disorder that is characterized by loss of control of eating behaviour and episodes of eating very large amounts of food. This Primer discusses the epidemiology, mechanisms, diagnosis and treatment of binge eating disorder.