{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T05:55:33Z","timestamp":1790920533049,"version":"4.1.0"},"reference-count":22,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T00:00:00Z","timestamp":1790899200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To estimate the lifetime and cumulative direct medical burden associated with childhood overweight and obesity in Kazakhstan using a dynamic age-structured modeling approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A dynamic age-structured Markov cohort model was developed to simulate the progression of children aged 5\u20139 years through successive age groups and weight states (normal weight, exclusive overweight, and obesity). Transition probabilities were reconstructed using a synthetic cohort approach based on repeated cross-sectional prevalence data and were calibrated to reproduce observed epidemiological patterns. State-specific annual direct medical costs were estimated using a normative costing approach based on national clinical protocols and tariffs. Lifetime burden was calculated as the discounted sum of future medical costs (3% discount rate). Furthermore, cumulative short-term was estimated for the period 2024\u20132035. Deterministic sensitivity analysis and structural scenario analysis were conducted to assess model robustness. Policy scenarios examined the impact of reducing childhood obesity prevalence by 5 and 10%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The average discounted lifetime cost per child was 96,996.26 KZT (USD 206.37), resulting in a total national lifetime financial impact of 194 billion KZT (USD 413 million) for the 2024 cohort of children aged 5\u20139 years. Over the 2024\u20132035 horizon, cumulative discounted direct healthcare expenditure reached 128.72 billion KZT (USD 273.9 million), with approximately 71% attributable to obesity. Sensitivity analysis showed that model results were most responsive to parameters related to obesity prevalence and costs. Structural scenarios indicated that the base-case model likely underestimates cost, with age-varying adult costs increasing estimates by up to 13.6%. Policy scenarios demonstrated that a 5 and 10% reduction in childhood obesity prevalence could reduce lifetime burden by 4.8 and 9.4%, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Childhood obesity imposes a substantial and persistent economic impact on Kazakhstan's healthcare system. Preventive interventions targeting obesity in early life may yield significant long-term cost savings and should be prioritized in national health policy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1853931","type":"journal-article","created":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T05:35:29Z","timestamp":1790919329000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Two horizons, one burden: estimating lifetime and decade-long medical costs of childhood obesity in Kazakhstan"],"prefix":"10.3389","volume":"14","author":[{"given":"Berik","family":"Koichubekov","sequence":"first","affiliation":[{"name":"Department of Informatics and Biostatistics, Karaganda Medical University","place":["Karaganda, Kazakhstan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khamida","family":"Abdikadirova","sequence":"additional","affiliation":[{"name":"Department of Physiology, 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