As the nation goes to the polls to cast important votes tomorrow, it does so at a time of one of the most challenging global economics period in recent memory. Some policy wonks say that these times will shove health below the radar, as the nation struggles to address more basic productivity concerns. Others disagree, saying rising unemployment will trigger the ‘intolerability quotient’ on the uninsured as we reach the ‘tipping point’ at which a solution, regardless of popularity – or even wisdom – will be legislated.

It will be unfortunate if health care is positioned as merely the ‘problem,’ when health is also the solution. It would be unfortunate if we voted on Tuesday for the candidate we felt might offer the better health care solution, but did not take important health steps ourselves.

Health is an important component of our national and personal economy: half of economic growth in the US in the past 100 years is estimated to be related to improvements in our health.¹ The value of health has also been demonstrated with more recent data, showing that improvements in survival and health between 1970 and 1999 accounted for at least 8% of the increased output of the formal labor force.²

This is a recent insight, since traditionally economists have viewed education and on-the-job training as the primary drivers of productivity in human capital. My economist friends tell me that the traditional labor economists are stunned and wondering how they could have missed the value of health – and they tell me that the data supporting the value of health and wealth are better than the value of education of health.

No one makes a more compelling – or entertaining – case for this than Hans Rosling of the Karolinska Institute, whose lecture can be viewed here, and whose data can be explored in greater depth at www.gapminder.org.

So, as you’re waiting in long lines anticipated tomorrow, I’d urge you to contemplate the role of health in our personal and collective futures:

- Better health increases personal productivity, allowing us longer healthy lives, increasing the number of productive working years and improving the quality of life during those years.
- Better health means a smaller proportion of health care funds is required for treating disease, allowing for other investments and purchasing.
- Better health in children means they are more prepared for school; miss fewer days of school; attend school for more years and, learn more while in school. Longevity is associated with an increase in the length of education, and each year of schooling results in 15% higher starting wages and a doubling of the rate of subsequent salary increases.³
- If we are healthy, employers can reduce the inefficiencies created in work and production schedules from worker illness, realize more gains from training, and exploit the benefits of specialization.⁴

Prevention is the best place to begin and there is no better way during the influenza season than to prevent the flu through immunization. Whether through the injection or the newer nasal spray, it saves money and is more cost-effective than most other preventive measures we take in the US.⁵

Flu shots have been demonstrated to have a positive impact on the workplace, reducing absenteeism and lost productivity, which exceeds the cost of medical care for flu! In the US, medical costs of influenza are estimated at US$10.4 billion annually and the total economic burden of the disease – medical costs as well as lost earnings and deaths – were estimated at US$87.1 billion.⁶ That’s an economic loss we can’t afford in any year, but especially now.

But it’s not just for those in the workforce, but for all of us. Flu shots for seniors have reduced hospital admissions for, and deaths from, influenza, and reduced deaths among the elderly for any cause during the influenza season.⁷ Seniors immunized against influenza experienced 20% lower risk of cardiovascular and cerebrovascular events, and a 50% lower risk of all-cause mortality.⁸ Influenza vaccination also reduces the incidence of pneumonia in the elderly.⁹

References
1. Mirvis DM, Bloom DE. Population Health and Economic Development in the US. JAMA 2008;300(1):94.
2. Mirvis DM, Bloom DE. Population health and Economic Development in the US. JAMA 2008;300(1):93.
3. Mirvis DM, Bloom DE. Population Health and Economic Development in the US. JAMA 2008;300(1):93.
4. World Bank: World Development Report: Investing in Health. Oxford University Press 1993;18.
5. Ehreth, J. Value of Vaccines Vaccine 2003;21:4114.
6. Molinari NA, Ortega-Sanchez IR, Messonnier ML. The annual impact of seasonal influenza in the US: Measuring disease burden and costs. Vaccine 2007;25:5086-5087.
7. Jefferson T, Rivetti D, Rivetti A, et al. Efficacy and effectiveness of influenza vaccines in elderly people: a systematic review. Lancet 2005;366:1165.
8. Andre FE, Booy R, Bock HL, et al. Vaccination greatly reduces disease, disability, death and inequity worldwide. WHO Bulletin 2008;86(2):143.
9. Jefferson T, Rivetti D, Rivetti A, et al. Efficacy and effectiveness of influenza vaccines in elderly people: a systematic review. Lancet 2005;366:1165.

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