Type 2 diabetes costs the Dutch economy €1 billion a year through a mixture of reduced productivity and welfare receipts, according to new research by economic research agency SEO Economic Research. The research revealed that diabetes sufferers are more likely to work fewer hours, earn lower wages and claim benefits.
Type 2 diabetes is a condition in which the body doesn’t respond properly to insulin; the Dutch Diabetes Association estimates that 1.1 million people in the Netherlands have been diagnosed. Unlike Type 1 diabetes, in which the body produces no insulin and which normally develops in childhood, Type 2 generally develops in adulthood and is more closely related to lifestyle. Around half a million Dutch citizens aged 18-67 take medication for Type 2 diabetes. The World Health Organization states that ‘factors that contribute to developing Type 2 diabetes include being overweight, not getting enough exercise, and genetics’.
The study, a collaboration between UMC Amsterdam and the University of Amsterdam, compared people with Type 2 diabetes and their siblings without the disease. The results concluded that those with Type 2 diabetes were 2.4% less likely to find paid employment. The researchers went on to say that ‘as a result, 12,000 people receive benefits, usually disability or sickness benefits. The gross monthly wage of people with diabetes at a stage requiring medication decreases on average by 3.6%, or €134. Most of this decrease is due to people working fewer hours’.
SEO Economic Research offers a number of policy proposals to combat the personal and economic impact of the disease. They suggest investing €2,400 per person in preventative measures to stop someone in the 18-67 age group from developing Type 2 diabetes that requires medication. The researchers advocate for measures such as a soft-drink tax that increases with sugar content, investment in early-detection technology, and the use of weight-loss medication for people with prediabetes who are overweight or obese.
Similar measures have been successful in other countries. Mexico introduced a soft-drink tax in 2014 and saw a 4.9% drop in new Type 2 diabetes cases over the next ten years. In the early 2000s, Finland began increasing the use of early-detection strategies such as lifestyle support and saw a 58% individual risk reduction. The use of weight-loss drugs for obesity in relation to Type 2 diabetes is an emerging science, and no peer-reviewed studies have yet been conducted to validate its efficacy.
Whether the policies suggested by SEO Economic Research will be implemented remains to be seen. In a world of complex rainbow coalitions, where strategic compromise is needed in the minutiae of every word in a budget proposal, policies that might take ten years to show results are the first to fall. With the Dutch elections taking place this October, much of the discourse has centred around economic issues such as state spending and budgetary concerns. Two of the parties in the previous collapsed cabinet – VVD and PVV – have been advocating for reduced government spending in their pre-election policy announcements. VVD is proposing wide-ranging budget cuts relating to healthcare, international cooperation and education.
Public-health experts warn that delaying prevention will only increase future costs, as the ageing population and rising obesity rates place further strain on the Dutch healthcare system. They argue that the economic case for prevention is already clear, but political will remains uncertain. Whether the next coalition chooses austerity or investment may determine not only the nation’s fiscal balance but also its long-term health.
Written by James Turrell