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Investment in Population Health in Five OECD Countries

Jan Bennett

DELSA/ELSA/WD/HEA
Organisation for Economic Co-operation and Development
OECD Health Working Papers No.2, 2003

Available online as PDF file [125p.] at:

http://www.oecd.org/dataoecd/30/39/2510907.pdf

 ".........There is growing interest in the potential for preventive
interventions to improve average health status in OECD countries and to
tackle remaining health inequalities. The interest is in a wide range of
interventions spanning not only health services but also measures to
influence behaviour and lifestyles and action to improve the contribution
of the social, economic and physical environments to health. These
interventions are referred to in this paper as examples of a government's
'population health investment' effort.

The paper notes the evidence on trends in health and health inequalities in
OECD countries and reviews the general case for population health
investments and the evidence on the effectiveness of selected
interventions.

It focuses on population health investment strategies and institutions in
five member countries: Australia, Canada, Korea, Sweden and Switzerland. In
particular, it reviews the methods of financing population health
investments and levels of spending on preventive activities. It illustrates
the range of measures adopted in these five countries to tackle two
particular health problems: alcohol-related harm and falls among the
elderly.

Some conclusions are drawn. There are many population health investment
activities, which have been shown to be cost-effective, involving
interventions such as health education, community participation, government
regulation and taxation. However, there are also barriers to population
health investments, including the fact that evaluation of such investments
is difficult and evidence of their cost-effectiveness is generally lacking.
Also, it is often difficult to co-ordinate action across different
government agencies when there are multiple risk factors. Finally,
population health investments may be disadvantaged by the methods of
financing adopted for public health activities - such as closed-ended
historical budgeting - compared with the more activity-related and
open-ended methods associated with curative programs in some OECD
countries. Finally, some suggestions are made about carrying forward
aspects of the population health agenda in OECD's future program of work on
health........."

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