[EQ] The Prevention of Lifestyle-Related Chronic Diseases: an Economic Framework

THE PREVENTION OF LIFESTYLE-RELATED CHRONIC DISEASES:
AN ECONOMIC FRAMEWORK

 

Franco Sassi and Jeremy Hurst

Organisation for Economic Co-operation and Development -  25-Mar-2008

OECD HEALTH WORKING PAPER NO. 32

 

Available online as PDF file [78p.] at: http://www.oecd.org/dataoecd/57/14/40324263.pdf

 

“………This paper provides an economic perspective on the prevention of chronic diseases, focusing in particular on diseases linked to lifestyle choices. The proposed economic framework is centred on the hypothesis that the prevention of chronic diseases may provide the means for increasing social welfare, enhancing health equity, or both, relative to a situation in which chronic diseases are simply treated once they emerge.

 

Testing this hypothesis requires the completion of several conceptual and methodological steps. The pathways through which chronic diseases are generated must be identified as well as the levers that could modify those pathways. Justification for action must be sought by examining whether the determinants of chronic diseases are simply the outcome of efficient market dynamics, or the effect of market and rationality failures preventing individuals from achieving the best possible outcomes. Where failures exist, possible preventive interventions must be conceived, whose expected impact on individual choices should be commensurate to the extent of those failures and to the severity of the outcomes arising from them.

 

A positive impact of such interventions on social welfare and health equity should be assessed empirically through a comprehensive evaluation before interventions are implemented…..”

 

EXECUTIVE SUMMARY

INTRODUCTION

Section 1 - Chronic diseases: an economic problem?

1.1. The burden of chronic diseases on health and longevity

1.2. The implications for social welfare and the role of prevention

1.3. Will preventive interventions improve social welfare? Testing the hypothesis

1.4. The determinants of health and disease

1.5. Main messages and conclusions

Section 2 - Are interventions to prevent chronic diseases justified?

2.1. Is there an economic case for intervention?

2.2. Market failures in lifestyle choices: a neoclassical economics perspective

2.3. Failures of rationality in lifestyle choices

2.4. Market failures and the determinants of health

2.5. Unintended health consequences of existing government policies

2.6. Main messages and conclusions

Section 3 - Preventive interventions: the options and the actors

3.1. Government intervention and theories of paternalism

3.2. Non-governmental and concerted action

3.3. Establishing what interventions are viable

3.4. A taxonomy of preventive interventions

3.5. Main messages and conclusions

Section 4 - Assessing the efficiency and distributional impact of preventive interventions

4.1. The economic evaluation of health interventions

4.2. Assessing the health impact of prevention programmes

4.3. Discounting long term impacts

4.4. Assessing the distributional impacts of prevention programmes

4.5. Main messages and conclusions

Section 5 - Conclusions. The role of economics in the prevention of chronic diseases

REFERENCES

APPENDIX . A TAXONOMY OF PREVENTIVE INTERVENTIONS
Boxes

 

 

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