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SUMMARY
REVENTING OBESITY IN YOUNG PEOPLE
IN NEW-CALEDONIA
2019-2023
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Warning
This summary is intended to facilitate the reading and use of the report of the territorial audit
office. Only the report engages the territorial audit office.
The answers, if expressed, of the administrations, organizations and local bodies concerned
are included after the report.
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TABLE OF CONTENTS
1
A MAJOR PHENOMENON FOR YOUNG NEW CALEDONIANS
.........................
4
2
A DISEASE WITH MULTIPLE CAUSES
....................................................................
5
3
A
DISEASE
WITH
MAJOR
HEALTH,
SOCIAL
AND
ECONOMIC
CONSEQUENCES
............................................................................................................
5
4
HETEROGENEOUS PREVENTION POLICIES WITH DISPARATE RESULTS. 6
5
STRENGTHEN THE STRATEGY TO COMBAT OBESITY AMONG YOUNG
PEOPLE
.............................................................................................................................
7
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In New Caledonia in 2021, nearly four out of ten adults are obese. Halting the rise in obesity
among young people is a public health issue with major repercussions for public finances, both
in terms of the expenditure incurred in prevention and the potential savings if the prevalence
rate stabilizes or decreases.
As part of a joint survey with French Polynesia, the Territorial Audit Office chose to examine
obesity prevention policies for young people aged between 15 and 25, the age at which they
are able to make their own decisions about their eating habits and lifestyle, decisions that have
a lasting impact on their health.
1
A MAJOR PHENOMENON FOR YOUNG NEW CALEDONIANS
Obesity is defined by the World Health Organization as an abnormal or excessive accumulation
of body fat that can damage health. Screening young people for obesity is tricky because the
indicator most commonly used to measure it is the body mass index, which is ill-suited to
different age groups and changes in body fat distribution. In children and adolescents, body
mass is analyzed using reference curves.
Although it is a non-communicable disease, obesity is now considered to be a global
“epidemic” due to its prevalence in almost all populations. In 2016, according to the World
Health Organization, 13 % of the world's adult population was obese.
The prevalence of obesity in New Caledonia (38 % in 2022) is significantly higher than in
France (15 % in 2019), and is still higher than in Australia and New Zealand (31 % and 33 %
respectively in 2022), but lower than in the other South Pacific island territories.
Graph n° 1: Distribution of obesity prevalence in New Caledonia by age and gender in
2022
Source : Enquête Baromètre Santé Adulte 2021-2022
18%
31%
46%
29%
42%
48%
0%
10%
20%
30%
40%
50%
60%
18-24 ans
25-44 ans
45-64 ans
Hommes
Femmes
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Young people are little aware of being overweight or obese. New Caledonia's ‘Baromètre
Santé jeune 2019
’ survey shows that only 4
% of 16 to 18-year-olds consider themselves to
be much too fat, whereas the prevalence of obesity is 23 % among 18 to 24-year-olds. Around
15% of 18 to 24-year-olds were unaware of their corpulence in 2022.
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A DISEASE WITH MULTIPLE CAUSES
The determinants of obesity are linked to individual factors (the individual's perception of
obesity) and to an environment conducive to the development of obesity, described as
“obesogenic”, combining socio
-economic and cultural factors. In New Caledonia, the
community to which people belong, their level of education, lifestyle, eating habits, sedentary,
lack of physical activity and sleep are all major risk factors. Surveys show that obesity is more
prevalent in Polynesian and Melanesian communities.
Consumption of fruit and vegetables is falling and is below the levels recommended
internationally, while consumption of sugary drinks is too high. The Territorial Audit Office calls
on the government to review the measures regulating the fruit and vegetable market in order
to broaden the range of products available to consumers, and to put in place a system to limit
the amount of sugar added to products sold in the region.
A sedentary lifestyle and a lack of physical activity and sleep are also conducive to the
development of obesity, which particularly affects young people as a result of the increasing
use of screens, school timetables and transport times, and the observed decline in the practice
of sport. The Territorial Audit Office calls on the government and the provinces to reverse these
factors by continuing to educate people about the use of screens, developing the practice of
sport and adapting it to obese people.
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A DISEASE WITH MAJOR HEALTH, SOCIAL AND ECONOMIC
CONSEQUENCES
Obesity has health, social and economic consequences. In New Caledonia, the chronic
diseases significantly associated with overweight and obesity include type II diabetes,
hypertension and sleep apnea, as well as cardiovascular and musculoskeletal diseases. At a
social level, obesity has repercussions on school results and quality of life, compounded by
stigmatization, discrimination and harassment. Finally, on an economic level, obesity
represents a high cost for New Caledonia.
The Territorial Audit Office was able to estimate the initial direct cost of obesity using CAFAT
data. This cost amounts to 3.05 billion CFP per year. This initial estimate represents a minority
cost of obesity because it does not consider all the pathologies linked to obesity. Using a spatial
comparison with New Zealand, which has a population structure similar to that of New
Caledonia, and France, which has a healthcare structure similar to that of New Caledonia, the
Territorial Audit Office was able to estimate the direct and indirect cost of obesity at between
10 and 35 billion CFP per year.
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Chart n° 1: Cost of obesity
Source : territorial audit office
Although obesity is classified as a disease by the WHO, it is not one of the 32 long-term
illnesses. An obese patient therefore has no entitlement to long-term sickness cover for this
condition. The Territorial Audit Office invites the government to modify deliberation no. 280 of
19 December 2001 relating to social security in New Caledonia by adding obesity to the list of
long-term illnesses for cases requiring particularly costly treatment.
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Heterogeneous prevention policies with disparate results
The obesity prevention policy is the responsibility of New Caledonia and the provinces. Already
identified in the Do Kamo health plan adopted by Congress in 2016, the obesity prevention
policy was designated a health priority in July 2023.
Various actions have been undertaken, based on prevention programs and regulatory
measures implemented by each actor, at territorial or provincial level. A behavioral tax on sugar
was passed by Congress in 2024 to encourage a reduction in the consumption of sweetened
products. Other provincial prevention measures are based on education for healthy eating, the
development of appropriate physical activities and the fight against addictions. However, these
programs are not coordinated and most have not been evaluated.
The reports available point to a lack of coordination between the institutional actors and a lack
of coherence in the actions implemented, a fragmented approach and insufficient use of certain
levers for action (women's associations and religious bodies, for example), a limited
multidisciplinary nature and the absence of political leadership, which means that the obesity
prevention policy cannot be integrated into all public policies.
Overall costs of
obesity
Indirect costs
Premature deaths
Loss of productivity
Absenteeism (paid or
unpaid)
Lower in presence
productivity
Direct medical costs
Appearance of
related diseases
(diabetes, sleep
apnoea, etc.)
Heavier care
(childbirth)
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The Territorial Audit Office believes that New Caledonia could better coordinate the various
levels of action by issuing calls for projects in line with objectives that it would fund.
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STRENGTHEN THE STRATEGY TO COMBAT OBESITY AMONG
YOUNG PEOPLE
While the programs implemented by the health and social services agency and the provinces
do address the causes of obesity, such as eating habits, physical activity and sport, sedentary
lifestyles and lifestyle-related environmental factors, some of the actions do not include a
provisional budget or performance indicators. Under these conditions, these programs have
not been evaluated, which the Territorial Audit Office regrets. It recommends that multi-year
obesity prevention plans be put in place and evaluated after three years of implementation.
Obesity screening and monitoring is carried out unevenly across the country and the data
collected is not shared, making it difficult to use. Lastly, the care pathway needs to be
formalized and treatment specified within a dedicated health organization plan. Tracking
spending on prevention and health insurance in a specific sub-objective will make it possible
to adapt healthcare provision to needs and carry out the program evaluations required to adapt
public policies.
At the end of its audit, the Territorial Audit Office made six recommendations aimed at
improving the performance of the policy to prevent obesity among young people.
1.
Review the regulatory measures for the fruit and vegetable market in order to broaden
the range of products on offer to consumers.
2.
Regulate the amount of added sugar in products sold in New Caledonia so that it does
not exceed that of similar products sold in France.
3.
Continue to develop screen-based education and sports activities for young people by
facilitating access to sport and adapting activities for people suffering from obesity.
4.
Set up multi-year plans for obesity prevention policies and evaluate them every three
years.
5.
Systematically collect health data enabling obesity to be measured, carry out surveys
covering all age groups and organize the use of the information collected.
6.
Formalize the treatment pathway for obesity in a health organization plan and monitor
expenditure as part of New Caledonia's objectives for health insurance and prevention
expenditure.
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PRESS RELEASE
In New Caledonia, in 2021, nearly four adults out of ten were obese. Halting the
progression of obesity among young people is a public health challenge with significant
implications for public finances, both due to the expenses incurred in prevention and the
potential savings if the prevalence rate stabilizes or decreases.
The 2025 Annual Public Report of the Cour des comptes is dedicated to public policies in favor
of young people. The Territorial Audit Office of New Caledonia participated in this report, as
part of a joint investigation conducted with French Polynesia, by examining the policies
implemented in the prevention of obesity among young people aged 15 to 25. At these ages,
young people are capable of making their own decisions regarding their dietary habits or
lifestyle, decisions that will have lasting effects on their health.
A phenomenon with significant prevalence among young people
Obesity, considered a "global epidemic," significantly affects New Caledonia, where 38 % of
the adult population was obese in 2022, a rate higher than that of mainland France (15 %) and
neighboring countries like Australia or New Zealand (31 % and 33 %, respectively). The
prevalence of obesity is 23 % among young people aged 18 to 24, but 15 % of this age group
is unaware of their weight, which complicates prevention and management.
A disease with lasting consequences on health, social, and economic levels
Obesity in New Caledonia is influenced by individual factors and an obesogenic environment,
particularly affecting Polynesian and Melanesian communities. It places a heavy burden on
public health and the local economy, with annual direct and indirect costs estimated between
10 and 35 billion CFP francs. The Territorial Audit Office invites the government to better
regulate access to fruits and vegetables, to control the amount of sugar in products sold on
the territory, to continue education on screen time and the promotion of sports, and to
include obesity in the list of long-term conditions for patients requiring costly care.
Prevention of obesity among young people must be the subject of a strengthened
strategy
The prevention of obesity in New Caledonia has been recognized as a health priority since
2023. The territory, the health and social agency, and the provinces have implemented action
programs, but these are insufficiently coordinated and their respective impacts have not been
measured. The Territorial Audit Office recommends adopting regular evaluations and
formalizing an adapted care pathway to strengthen the effectiveness of prevention policies,
particularly for young people.
Read our full report