[ Fall 2012 ]
The cover story in this issue of Harvard Public Health explores one of the most complicated intersections in policymaking: the nexus of public health and the economy. With the November U.S. elections just two months away, voters can consider what we have learned about these closely linked issues.
One thing we know for sure: A nation’s health performance and economic performance can’t be separated. On the most fundamental level, wealthier nations tend to have better health conditions and therefore healthier people. And as HSPH’s David Bloom has shown, healthier people likewise promote economic growth, in part because they are more productive and less likely to cost health care dollars. In developing countries, a 10 percent increase in life expectancy at birth is associated with a rise in economic growth of 0.3–0.4 percent a year, according to a 2001 report by the World Health Organization’s Commission on Macroeconomics and Health. Recent events in the news confirm that as countries around the world advance, they realize that creating universal health care systems nourishes long-term economic growth.
Public health, which focuses on disease prevention and health promotion, is central to an economy-boosting healthy population. In the 20th century, public health advances accounted for 25 more years of life expectancy on average in the United States. According to the federal Centers for Disease Control and Prevention, these advances included: the eradication of smallpox and control of other infectious diseases through vaccination; improved sanitation and access to clean water; improvements in food safety and nutrition; safer workplaces; family planning; and a drop in smoking rates.
Today, different public health problems threaten economic gains, both in affluent and developing countries. Of particular concern are rising levels of noncommunicable diseases, such as obesity, diabetes, high blood pressure, heart disease, cancer, and mental disorders. In the U.S., three-quarters of health care dollars go to treating these chronic—and often preventable—diseases.
Health, of course, is an intrinsic value—an end in itself. But it is no contradiction to add that healthy people make for a healthier economy. In the U.S. and around the world, a strong and sustained investment in public health is the best policy bargain of all.
Dean of the Faculty and T & G Angelopoulos Professor of Public Health and International Development,
Harvard School of Public Health