The economic benefits of a physically active population

The aim of this study was to explore the main economic costs of physical inactivity and to identify the key benefits to improving activity rates | RAND

This report looked at the following questions:

1. What are the potential global economic benefits associated with getting people to be more physically active and how do the economic effects vary by country?
2. What is the contribution of premature mortality associated with insufficient physical activity?
3. What is the contribution of insufficient physical activity associated with workplace productivity?
4. What level of healthcare expenditure could be saved?
5. What can public policy and private stakeholders do in order to improve physical activity levels at the population level?

The findings of the study suggest that making people physically more active is associated with economic benefits. The report proposed the following recommendations:

• Change population behaviours and attitudes to promote the increase of physical activity, supporting and encouraging individuals to shift their beliefs and motivations.
• Using both community and workplace settings, provide an environment that encourages physical activity and that supports the access to facilities.
• Encourage the participation in programmes and interventions.
• Encourage more physical activity across society by interlinking systems-wide programmes and interventions.

Full publication: The economic benefits of a more physically active population
An international analysis | RAND Corporation

Health economics: evidence resource

The health economic evidence resource (HEER) tool shows the main cost-effectiveness and return on investment evidence on activities in the public health grant | Public Health England

The HEER brings together recent economic evidence from the literature, which is commonly used and has been quality assured by Public Health England.

Each piece of evidence is summarised across over 20 criteria to provide details on how the results were created and to highlight the inputs and assumptions used in the original studies. This allows users to understand the relevance and apply the evidence to their local setting.

Full detail at Public Health England

Health economics: a guide for public health teams

Updated resources to help local commissioners achieve value for money by estimating the return on investment (ROI) and cost-effectiveness of public health programmes | Public Health England

This guide provides links to tools and reports that can help:

• assess which interventions provide the best value for money, by calculating their costs, benefits and ROI
• make the most of your budget by deciding how to split resources across different public health programmes
• compare costs, savings and clinical outcomes

These evidence resources are relevant for local decision makers as well as national policymakers.  The resources have been updated in May 2018, and can be used to estimate the value of investing in prevention and early diagnosis in your area. They pull together the best available evidence on costs, savings, and health benefits for specific topic areas in a single place, thus simplifying the process of commissioning cost-effective services.

The interactive tools produced by PHE are:

• Colorectal cancer
• NHS Diabetes Prevention Programme
• End of life care
• Weight management
• Oral health in pre-school children
• Mental health service
• Musculoskeletal conditions
• Movement into employment
• Falls prevention
• Best Start in Life
• Air pollution

Full detail at Public Health England

The economic and wellbeing value of parks and green spaces

Revaluing Parks and Green Spaces | Fields in Trust

This new report highlights that everyone, irrespective of who they are and where they live should have the right to enjoy and benefit from local parks and green spaces. Parks and green spaces are proven to help people stay physically and mentally well; places where we can all move, breathe, run and play. They are an important tool to drive social
cohesion, combat loneliness and build community spirit.

The report presents data on the economic value of parks and green spaces, enabling local authorities for the first time to make a robust, evidence-led business case for the economic and wellbeing value of parks and green spaces to local communities.

This research will enable a strategic approach to the provision of parks and green spaces by identifying areas where investment will have the most significant impact on individuals.  It presents a new and compelling argument that, in a difficult economic climate, the provision of parks and green spaces should be prioritised in areas with lower socio-economic groups and a higher representation of BAME communities given the disproportionately high level of benefits that these groups derive from parks and
green spaces.

Key findings:

• The Total Economic Value to an individual is £30.24 per year (£2.52 per month), and includes benefits gained from using their local park or green space.
• The Wellbeing Value associated with the frequent use of local parks and green spaces is worth £34.2 billion per year to the entire UK adult population.
• Parks and green spaces are estimated to save the NHS around £111 million per year based solely on a reduction in GP visits and excluding any additional savings from prescribing or referrals.

Full report: Revaluing Parks and Green Spaces | Fields in Trust

Alcohol and drugs prevention, treatment and recovery: why invest?

A new resource by Public Health England (PHE) poses this question, to support local commissioners, providers and healthcare professionals to make the case for investing in drug and alcohol treatment and interventions. 

Source: Public Health England

They have produced a set of 32 slides, like the example above which can be downloaded and shared in presentations.

All the Why invest? slides are available from PHE to download here 

There is more guidance on PHE’s website

Health economics: evidence resource

This resource provides a summary of economic evidence underpinning public health interventions

The health economic evidence resource  tool shows the key cost-effectiveness and return on investment evidence on activities in the public health grant.

Each piece of evidence is summarised across over 20 criteria to provide details on how the results were created and to highlight the inputs and assumptions used in the original studies. This allows users to understand the relevance and apply the evidence to their local setting.

Also updated is Health economics: a guide for public health teams. This guide includes health economics evidence and tools that can help:

• calculate the best public health investments or disinvestments in your local area
• compare costs, savings and clinical outcomes

 

 

Making the economic case for prevention

In this Public Health Matters blog, John Newton and Brian Ferguson explore the economic case for prevention, acknowledging that more than ever before, ‘public health’ has to make the strongest possible economic case for what it does.

Public health interventions may offer society a return on investment of £14 for each £1 spent

Each £1 invested in public health interventions could offer an average return on investment to the wider health and social care economy of £14 | NIHR Signal

This systematic review looked at 52 studies where the return on each £1 ranged from -£21.3 to £221. Legislative interventions such as sugar taxes, and health protection interventions such as vaccination programmes, gave the highest returns on investment. Interventions such as anti-stigma campaigns, blood pressure monitoring and early education programmes, provided smaller (but still favourable) returns. National campaigns offered greater returns than local campaigns. Falls prevention provided the quickest return, within 18 months.

These findings apply to high-income countries. There are some limitations to the data, as a variety of calculation techniques were used and the quality of the included studies varied. However, these are unlikely to alter the direction or approximate size of these effects. The study shows how cost-effective public health interventions can be and should inspire future research into how to better implement what is already known.

• Overview via NIHR Signal
• Original research article

Economic evaluations of seasonal influenza vaccination for the elderly

The Council of the European Union (EU) has recommended that action should be taken to increase influenza vaccination in the elderly population | BMJ Open

Image source: Joe The Goat Farmer – Flickr // CC BY 2.0

Objectives: The aims were to systematically review and critically appraise economic evaluations for influenza vaccination in the elderly population in the EU.

Results: Of the 326 search results, screening identified eight relevant studies. Results varied widely, with the incremental cost-effectiveness ratio ranging from being both more effective and cheaper than no intervention to costing €4 59 350 per life-year gained. Cost-effectiveness was most sensitive to variations in influenza strain, vaccination type and strategy, population and modelling characteristics.

Conclusions: Most studies suggest that vaccination is cost-effective (seven of eight studies identified at least one cost-effective scenario). All but one study used economic models to synthesise data from different sources. The results are uncertain due to the methods used and the relevance and robustness of the data used. Sensitivity analysis to explore these aspects was limited. Integrated, controlled prospective clinical and economic evaluations and surveillance data are needed to improve the evidence base. This would allow more advanced modelling techniques to characterise the epidemiology of influenza more accurately and improve the robustness of cost-effectiveness estimates.

Full reference: Shields. G.E. et al. (2017) Systematic review of economic evaluations of seasonal influenza vaccination for the elderly population in the European Union. BMJ Open. 7:e014847

 

Global health financing

Two studies have been published in the Lancet on global health financing.

‘Evolution and patterns of global health financing 1995–2014: development assistance for health, and government, prepaid private, and out-of-pocket health spending in 184 countries’.

Global Burden of Disease Health Financing Collaborator Network, The Lancet Volume 389, No. 10083, p1981-2004, 20 May 2017

Image source: http://www.thelancet.com

An adequate amount of prepaid resources for health is important to ensure access to health services and for the pursuit of universal health coverage. Previous studies on global health financing have described the relationship between economic development and health financing. In this study, the researchers further explore global health financing trends and examine how the sources of funds used, types of services purchased, and development assistance for health disbursed change with economic development. They also identify countries that deviate from the trends.

The Authors conclude that the availability of prepaid resources for health, such as government spending, is one of many determinants of access to health care, and can lead to population health gains. Economic development is associated with an increase in spending and specifically an increase in prepaid resources. This is at the core of the pursuit for universal health coverage.

This research also points to countries that deviate from the trends, spending more or less than expected, based on their level of economic development. This information is valuable to planners assessing funding gaps and financing opportunities, and can be used to provide insight into what future health financing challenges are likely. Tracking changes in health financing patterns across time and benchmarking against global trends is vital to addressing missed opportunities, ensuring access to medicines and high quality services, and the pursuit of universal health coverage.

Read the full text here

‘Future and potential spending on health 2015–40: development assistance for health, and government, prepaid private, and out-of-pocket health spending in 184 countries’.

Global Burden of Disease Health Financing Collaborator Network, The Lancet Volume 389, No. 10083, p2005-2030, 20 May 2017

Variation in GDP and health spending is expected to persist through 2040. Past trends and relationships suggest that health spending levels will continue to diverge globally and even within income groups. Increases in spending to reflect potential levels, as determined by GDP per capita and peer nations, would lead to more resources for health. However, the pathways to ensure these increases vary from country to country.

This analysis can inform decision makers about possible methods to mobilise funds for health, given their country’s level of development and financing environment. Despite expected increases in spending, this spending in some places will probably be insufficient to meet complex health needs, underlining the ongoing role of development assistance for health in some countries. Insights into spending trajectories and financing gaps are crucial as health stakeholders face the ambitious Sustainable Development Goals agenda and the push towards universal health coverage.

Read the full text here