Return on investment of public health interventions

Systematic review suggests that local and national public health interventions are highly cost-saving | Journal  of Epidemiology & Community Health 

Abstract

Background
Public sector austerity measures in many high-income countries mean that public health budgets are reducing year on year. To help inform the potential impact of these proposed disinvestments in public health, we set out to determine the return on investment (ROI) from a range of existing public health interventions.

Methods

We conducted systematic searches on all relevant databases (including MEDLINE; EMBASE; CINAHL; AMED; PubMed, Cochrane and Scopus) to identify studies that calculated a ROI or cost-benefit ratio (CBR) for public health interventions in high-income countries.

Results

We identified 2957 titles, and included 52 studies. The median ROI for public health interventions was 14.3 to 1, and median CBR was 8.3. The median ROI for all 29 local public health interventions was 4.1 to 1, and median CBR was 10.3. Even larger benefits were reported in 28 studies analysing nationwide public health interventions; the median ROI was 27.2, and median CBR was 17.5.

Conclusions

This systematic review suggests that local and national public health interventions are highly cost-saving. Cuts to public health budgets in high income countries therefore represent a false economy, and are likely to generate billions of pounds of additional costs to health services and the wider economy.

Full reference: Masters RAnwar ECollins B, et al. | Return on investment of public health interventions: a systematic review

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Stop smoking services

Feeling the heat: the decline of stop smoking services in England |Cancer Research UK and Action on Smoking and Health

no smoking

This report publishes findings from a survey of local authority tobacco control leads which indicates that half of local authorities cut budgets for stop smoking services in 2017.

The report highlights both the ongoing challenges faced by tobacco control professionals and the diversity of their responses to these challenges.

Full report: Feeling the heat: the decline of stop smoking services in England

See also: Funding cuts mean stop smoking services can’t offer support | Cancer Research UK

Transforming children and young people’s mental health

Ways for schools and colleges to support pupils’ mental health are set out in a green paper, as well as plans for new mental health support teams.

The government has published proposals to improve mental health support for children and young people in England. Over £300 million has been made available to fund them.

The government is asking people for their views on the planned measures, which are set out in a green paper. The measures include:

  • encouraging every school and college to have a ‘designated senior mental health lead’
  • setting up mental health support teams working with schools, to give children and young people earlier access to services
  • piloting a 4-week waiting time for NHS children and young people’s mental health services

Other proposals in the green paper include:

  • a new working group to look at mental health support for 16 to 25-year-olds
  • a report by the Chief Medical Officer on the impact that technology has on children and young people’s mental health, to be produced in 2018

The consultation on the green paper will run for 13 weeks until 2 March 2018.

Full paper: Transforming children and young people’s mental health provision: a green paper

This short video describes the main proposals in the green paper.

‘Early warning signs’ that austerity will impact health outcomes

New report from the International Longevity Centre (ILC-UK) identifies early warning signs that austerity will affect health outcomes for decades to come.

austerity
Image source: http://www.ilcuk.org.uk

A team of researchers at ILC-UK has written ‘Public health in Europe during the austerity years’. Using a number of independent data sources, the report finds that progress on a number of key health indicators has stalled, including life expectancy and mortality rates. The report indicates that levels of subjective health have fallen among young people aged 15 – 24 across Europe, and in all age-groups in the UK.

Cuts to preventative medicine in England, such as tobacco control programmes and sexual health services, were highlighted as austerity measures which could impact the health of young people decades into the future.

Key findings include:

  • Improvements to life expectancy and mortality rates have slowed across Europe during austerity years (2009 – 13)
  • The UK has seen the greatest fall in subjective health, with people of all ages reporting a decline in their general health
  • As a result of increasing medical costs and declining personal income, a number of countries experienced rising unmet medical needs.

Full report: Public health in Europe during the austerity years

Spending constraints associated with a higher than expected number of deaths

Study published in the British Medical Journal suggests cuts to public funding of health and social care since 2010 could be linked to almost 120,000 excess deaths in England | BMJ | OnMedica

The study reports that between 2010 and 2014, the NHS in England had a real-term annual increase in funding of 1.3%, despite rising patient demand and healthcare costs. Real-term spend on social care has fallen by 1.19% every year during the same period.

Researchers compared actual death rates for 2011 to 2014 with those that would be expected, based on trends before spending cuts came into play, and taking account of national and economic factors, such as unemployment rates and pensions.

The researchers’ analysis of the data showed that between 2001 and 2010, deaths in England fell by an average of 0.77% every year, but rose by an average of 0.87% every year between 2011 and 2014.

The spending restraints were associated with 45,368 higher than expected numbers of deaths between 2010 and 2014 compared with equivalent trends before 2010.

Full reference: Watkins J. et al. |  Effects of health and social care spending constraints on mortality in England: a time trend analysis | BMJ Open 2017

Related: Excess deaths could be linked to health spending cuts

New £15 million grant scheme to improve mental healthcare

The Beyond Places of Safety fund will focus on improving urgent mental healthcare in local areas | Department of Health 

The Department of Health has launched a £15 million fund to better support people at risk of experiencing a mental health crisis.

The Beyond Places of Safety scheme aims to improve support services for those needing urgent and emergency mental healthcare. This includes conditions such as psychosis, bipolar disorder, and personality disorders that could cause people to be a risk to themselves or others.

The Beyond Places of Safety scheme will focus on:

  • preventing people from reaching crisis point in the first place
  • helping to develop new approaches to support people who experience a mental health crisis

Full story at Department of Health