Using economic evidence to help make the case for investing in health promotion and disease prevention

This policy brief is one of a new series to meet the needs of policy-makers and health system managers. The aim is to develop key messages to support evidence-informed policy-making. The 2008 Tallinn Charter: Health Systems for Health and Wealth recognized that investing in health means investing in human development, social well-being and wealth. It stated that ‘health systems are more than health care and include disease prevention, health promotion and efforts to influence other sectors to address health concerns in their policies’. Ten years on, investment in health promotion and disease prevention activities, at least within the health sector, remains stubbornly low in many countries. For instance, OECD countries typically allocate between 2% and 4% of total health sector spending to these activities. Moreover, between 2009/2010 and 2012/2013 on average spending fell in real terms and still in 2014/2015 was only growing at around 2% per annum, a rate that is much lower than before the onset of the global economic crisis. There are many different reasons for this, but undoubtedly some budget holders in health systems are sceptical about the case for focusing more on public health, contending that there is insufficient evidence available to justify such an investment. In this policy brief we argue that this scepticism about the evidence is overstated. Moreover, the existing evidence base can in fact be adapted to be useful in many different systems and country contexts across the WHO European Region.