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HLTB15H3 (41)


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Health Studies
Iva Zovkic

HLTB15 WINTER 2013 Week #4: Public Health Agency of Canada – 4.2 – End 4.2. – Building the evidence: critical knowledge gaps in preventive health intervention evaluation  Economic evaluations have been inconsistently applied in the area of prevention because they are unequally distributed and vary in the quality of their research designs and output  Majority of economic evaluations are concentrated in areas of clinical prevention and areas of health promotion, healthy public policies and other upstream determinants of health prevention programs are ignored or little studied  Health promotion evaluations only focused on clinical preventive or personal skill development  Due to challenges o Complicated and multifaceted interventions o Need a sufficiently long term view o Hard to tease out causality and confounding factors generated through interactions between genetic, biological and behavioural risk factors and social, economic and environmental risk conditions  Example – Walking Bus Program o Safe and active transportation model for school children that has been adapted in Europe and North America o Has not reduced obesity or is not cost effective in that but there are other potential benefits such as less pollution and traffic congestion, more community cohesion, enhanced pedestrian skills, fewer road accidents, increased physical activity and exercise habits  Effectiveness of the program takes precedence of COST EFFECTIVENESS 4.3 – Expanding the evidence: the broad economic benefits of good health beyond health sector  Most of the focus has been how it saves the health system money but it helps in other sectors  Bloom and Canning have identified four avenues through which a health population can contribute to microeconomic growth (at individual or household levels) o Labour productivity o Labour supply o Education o Savings and Investment  Microeconomic growth can stimulate macroeconomic growth  Good because it will have health related economic returns as well as allow disadvantaged groups and people to reach their human, economic and social potentials 4.3.1 – Healthy public policies as preventive health interventions  Social determinants of health can exert greater impact on population health outcomes than factors such as genetics, lifestyles, or health care services HLTB15 WINTER 2013  There is greater emphasis on interventions targeting upstream determinants such as education and early childhood development  Early childhood development o Adverse socioeconomic circumstances in infancy and childhood lead to poor mental and physical development trajectories o Increased educational attainment, increased income earnings and adult productivity, reduced crime rate and welfare dependency o Benefit to cost ratio is 3:1 o Limit
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