The relationship between health and economic outcomes such as increased productivity and economic growth is established in both the disciplines of medicine and economics. Increasingly, the reciprocal relationship between health and economic growth has been discussed in the context of ageing populations as a compensating mechanism to try and maintain economic growth as the supply of labour starts to contract. As the number of working aged people starts to decline or shrinks proportionally to the non-working aged populations, attempts to maintain productivity will require getting the most out of every available worker to try and maintain economic living standards. The relationship between health and economic outcomes suggests that how health services invest in services can influence critical economic parameters outside the health service. This article will consider the construct of health as an investment and its role in the evaluation of health technologies and the allocation of health-care resources. To illustrate some features of investing in health, we will draw on our past experience developing a government perspective health investment model that considers future tax revenues generated by investing in fertility programmes.
GrantJ. (2004) Low Fertility and Population Ageing: Causes, Consequences, and Policy Options. Cambridge, UK: RAND Corporation.
2.
Directorate General for Economic and Financial Affairs (DGEFA). (2006) The Impact of Ageing on Public Expenditure: Projections for the EU25 Member States on Pensions, Health Care, Long-term Care, Education and Unemployment Transfers (2004–2050). Special Report No. 1/2006.
3.
KlumpesP. J. M. (2003) The hidden public pension obligations in six European states: A generational accounting perspective. Accounting Forum27: 185–200.
4.
European Commission. (2000) European Economy: Generational Accounting in Europe. Directorate-General for Economic and Financial Affairs. Belgium.
5.
LazearE. P. (2006) Productivity and wages: Investment in physical and human capital must be supported by incentives. Business Economics41(4): 39–45.
6.
CaroneG.DenisC.Mc MorrowK.MourreG.RögerW. (2006) Long-term labour productivity and GDP projections for the EU25 Member States: A production function framework. European Commission Directorate-General for Economic and Financial Affairs No. 253.
7.
BraüningerD.WalterN. (2002) Productivity miracle in the aging industrial countries?. Journal of Financial Transformation6: 13–22.
8.
MantonK. G.LowrimoreG. R.UllianA. D.GuX.TolleyH. D. (2007) Labor force participation and human capital increases in an aging population and implications for US research investment. Proceedings of the National Academy of Sciences104(26): 10802–10807.
9.
LongmanP. (2004) The global baby bust. Foreign Affairs83(3): 64–79.
10.
BloomD. E.CanningD. (2000) The health and wealth of nations. Science287(5456): 1207–1209.
11.
Sala-i-MartinX.DoppelhoferG.MillerR. I. (2004) Determinants of long-term growth: A Bayesian averaging of classical estimates (BACE) approach. The American Economic Review94(4): 813–835.
van ZonA.MuyskenJ. (2005) Health as a principle determinant of economic growth. In: Lopez-CasasnovasG.RiveraB.CurraisL. (eds.) Health and Economic Growth: Findings and Policy Implications. Cambridge, MA: The MIT Press.
14.
BloomD.CanningD.SevillaJ. (2001) The Effect of Health on Economic Growth: Theory and Evidence. Cambridge: National Bureau of Economic Research. NBER Working Paper 8587.
15.
StraussJ.ThomasD. (1998) Health, nutrition, and economic. Journal of Economic Literature36(2): 766–817.
16.
SuhrckeM.McKeeM.ArceR. S.TsolovaS.MortensenJ. (2005) The Contribution of Health to the Economy in the European Union. Belgium: European Communities, ISBN 92-894-9829-3.
17.
SchultzT. W. (1962) Reflections on investment in man. The Journal of Political Economy70(5): 1–8.
18.
BeckerG. S. (1964) Human Capital: A Theoretical and Empirical Analysis, with Special Reference to Education. Chicago, IL: University of Chicago Press.
19.
GrossmanM. (1972) On the concept of health capital and the demand for health. Journal of Political Economy80: 223–255.
20.
SolowR. M. (1956) A contribution to the theory of economic growth. The Quarterly Journal of Economics70(1): 65–94.
21.
Sala-i-MartinX. (2005) On the health-poverty trap. In: Lopez-CasasnovasG.RiveraB.CurraisL. (eds.) Health and Economic Growth: Findings and Policy Implications. Cambridge, MA: The MIT Press.
22.
EdwardsL. N.GrossmanM. (1980) The Relationship Between Children's Health and Intellectual Development. NBER Working Paper No. 213.
23.
SorensonC.DrummondM.KanavosP. (2008) Ensuring Value for Money in Health Care: The Role of Health Technology Assessment in the European Union. Denmark: WHO Regional Office for Europe on behalf of the European Observatory on Health Systems and Policies.
24.
DrummondM. F.O'BrienB.StoddartG. L.TorranceG. W. (1997) Methods for the Economic Evaluation of Health Care Programmes, press 2nd edn. Oxford, UK: Oxford University Press.
25.
HauckK.SmithP. C.GoddardM. (2002) The Economics of Priority Setting for Health Care: A Literature Review. Washington DC: World Bank.
26.
MishanE. J. (1971) Evaluation of life and limb: A theoretical approach. The Journal of Political Economy79(4): 687–705.
27.
JacobsP.FassbenderK. (1997) Indirect costs in the Health Economics Evaluation Literature: A Survey Article. Edmonton: Institute of Health Economics. Canada Working Paper 97-4.
28.
TamT. Y. H.SmithM. D. (2004) Pharmacoeconomic guidelines around the world. ISPOR Connections10(4): 5–15.
World Health Organization (WHO). (2009) WHO Guide to Identifying the Economic Consequences of Disease and Injury. Geneva, Switzerland: WHO Press.
34.
ConnollyM.GalloF.HoorensS.LedgerW. (2009) Assessing long-run economic benefits attributed to an IVF-conceived singleton based on projected lifetime net tax contributions in the UK. Human Reproduction24(3): 626–632.
35.
ConnollyM.PollardM.HoorensS.KaplanB.OskowitzS.SilberS. (2008) Long-term economic benefits attributed to IVF conceived children: A lifetime tax calculation. American Journal of Managed Care14(9): 598–604.
36.
AndersenA. N. (2009) Assisted reproductive technology and intrauterine inseminations in Europe, 2005: Results generated from European registers by ESHRE. Human Reproduction1(1): 1–21.
37.
AndersenA. N.ErbK.LouisB. (2006) Register data on assisted reproductive technology (ART) in Europe including a detailed description of ART in Denmark. International Journal of Andrology29: 12–16.
38.
GoddardM.HauckK.PrekerA.SmithP. C. (2006) Priority setting in health – A political economy perspective. Health Economics Policy and Law1: 79–90.
39.
StantonM. W.RutherfordM. K. (2005) The High Concentration of US Health Care Expenditures.Rockville, MD: Agency for Healthcare Research and Quality; Research in Action Issue 19. AHRQ Pub. No. 06-0060.
40.
SummerfieldC.GillB. (2005) Social Trends No. 35 Office for National Statistics. 2001; Research Paper No. 01.23.
41.
CropperM. L.AyedeS. K.PortneyP. R. (1994) Preferences for life saving programs: How the public discounts time and age. Journal of Risk and Uncertainty8: 243–265.
42.
LewisP. A.CharnyM. (1989) Which of two individuals do you treat when only their ages are different and you can't treat both?. Journal of Medical Ethics15: 28–32.
