California county health programs yield high returns

http://www.eurekalert.org/pub_releases/2016-06/uoc--cch061316.php

Public Release: 16-Jun-2016
California county health programs yield high returns
Return on investment high for prevention programs vs. medical care
University of California - Berkeley

Return on investment in county public health departments in California exceeds return on investment in many other areas of medical care, according to a new study by a University of California, Berkeley economist.

In the study, highlighted by the American Journal of Public Health and published online on June 16 ahead of print publication, Timothy Brown, a health economist with UC Berkeley's School of Public Health, estimated from his analysis of data for the years 2001 through 2009 that each dollar that counties spent on public health programs in California returned $67 to $88 dollars of value in terms of improved health outcomes.

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Unlike medical care, which primarily focuses on treating disease, county public health departments focus on the prevention of disease. Brown also concluded that the return from Medicare's national investment in four major health conditions was far less than the return from county public health spending. For heart disease, Type 2 diabetes, stroke and breast cancer, Brown's review of the research literature revealed that returns on Medicare expenses ranged from $1.10 to $4.80 per dollar spent.

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Public health departments regulate food service establishments, provide disease screening and treatment for communicable disease, offer prenatal care, regulate various aspects of the water supply, provide immunizations, and provide other services that can immediately improve population health, as well as improve population health over the longer term. Health departments also engage in activities that attempt to influence county populations to adopt healthier habits, which primarily affect population health over the longer term.

To understand the potential long-term health impacts of investment in public health, Brown and colleagues published two earlier studies that provided key information used in the return-on-investment calculations in this study. One study found that, on average, a single year of county public health spending continued to improve general health status in the population for over four years, ultimately improving the general health status of over 216,000 people.

A second study found that beyond its effects on general health status, the same single year of public health spending also saved the lives of over 29,000 people who otherwise would have died, with this effect playing out over a ten-year period.

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