The following post by Glenna Crooks, PhD, founder and President of Strategic Health Policy International, Inc, is part of Disruptive Women’s “The Value of Health: Creating Economic Security in the Developing World” series.

Glenna Crooks solves some of the toughest health care problems of our times by distilling chaos and complexity into recognizable and easily digestible, action-oriented insights. Her clients, businesses and governments around the world, have used her Centricity Principle™ approach to create successful organizational, national and global transformational strategies.

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It has been long recognized that the growth of a nation’s economy improves the health of its people.

The converse is also true. Improving health is an economically wise and productive investment.

In fact, that’s the reason that health systems were established – by the King and the employer – documented as far back as 4,000 years ago.

There is good news to today’s world: a positive cycle of gains in both health and economic security occurs as either one is improved.^[1]

Have we taken the value of health for granted? I think so and find that especially the case among those of us in the health community. We talk endlessly about improving health outcomes as if those outcomes were an end in themselves. We have fallen victim to the notion that health expenditures are a cost, rather than an investment. We have forgotten our origins in economic growth and security. We have set our sights too low.

It’s high time we set higher goals. Disease creates barriers and slows progress towards economic status and security. As health improves, people experience both immediate and long-term economic benefits. Individuals become more productive; they enhance not only the quality of their lives but their capacity to enrich economic well-being.^[2] “Health is an economic engine.”^[3] This is true not only for individuals but also for families and societies.

World Health Organization (WHO) and World Bank benchmark reports outline the relationship between good health and economic development; good health is not only a means to reduce poverty, but also a means to accelerate national and personal economies.^[4],^[5]

• Individual health increases personal productivity and earnings. Extending healthy years of life increases the number of working, income-earning years. Healthier workers are more productive economically during their working years as well.
• Good health reduces the funding required to treat disease, allowing people and nations to invest in other needs.
• A healthy population encourages foreign investment, technology transfer, and facilitates access to global markets.^[6]
• Healthy children are more prepared for school, miss fewer days of school, attend school for more years, and learn more while in school.  In addition, longer life span is associated with more years in school and each year of schooling results in a 15% higher starting wage and a doubling of the rate of subsequent salary increases.^[7]
• Natural resources previously inaccessible due to disease (e.g., agricultural acreage unusable because of malaria) are made available for production and farming.^[8]

Health benefits everyone. Illness harms everyone – not only those who are sick, but also other, healthy household members. The healthy must work harder or longer to make up for lost of income when the major breadwinner is ill and in some societies, girls miss school to care for sick relatives.^[9] As households cope with illness, they may also reduce spending – including on food – to account for declining in income.^[10] These adjustments have ripple effects through the entire family, though are not generally counted in cost of disease because they are losses borne by the household overall.^[11]

In recent decades, education and on-the-job training were viewed as the principle determinants of human productivity.  In recent years, however, economists have recognized health as equally important and it is time that those of us in health care do likewise.

Half of overall economic growth in the US in the past 100 years is estimated to be related to improvements in health and cross-national studies have shown that the 27-year difference in the life expectancy between low- and high-income countries – 51 vs. 78 years – is associated with a difference of 1.6% in annual compounded economic growth rates.^[12] The return on improvement in health is very large, overshadowing gains from most other investments.^[13]

These issues are not trivial. Though wealthy and poor countries benefit, the poor in any country benefit most and the imperatives for health today, stated well by the Institute of Medicine, have never been greater.

It is in both our domestic and our international interests.^[14] Here’s hoping that as the new year approaches that we will provide the quality of care we have pledged in healing oaths and that we will set our sights even higher, returning people to productive lives in the workforce – or if they are not enriching our economy but enriching our hearts – to fruitful lives in families and communities across this nation and the world.

In other blog posts I have noted the critical role of women as “Dr” Mom, Sister, Friend, Spouse — and policy maker. In this series, the role of women in the development of the developing world has also become clear. That role is critical. It can’t be ignored. Here’s hoping that as the new year approaches we will pledge to help them. Their heroic efforts will be made ever more successful if we do.

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^[1] Mirvis DM, Bloom DE. Population Health and Economic Development in the US. JAMA 2008;300(1):94-95.

^[2] Sachs JD. Macroeconomics & Health: Investing in Health for Economic Development. WHO Publications 2001:21.

^[3] Bloom DE, Canning D. The health and wealth of nations. Science. 2000; 287(5456):1207-1209, as cited in Mirvis DM, Bloom DE. Population Health and Economic Development in the US. JAMA 2008;300(1):94.

^[4] Sachs JD. Macroeconomics & Health: Investing in Health for Economic Development. WHO Publications 2001:1-210.

^[5] World Bank: World Development Report: Investing in Health. Oxford University Press 1993;iii:17-37.

^[6] Mirvis DM, Bloom DE. Population Health and Economic Development in the US. JAMA 2008;300(1):94.

^[7] Mirvis DM, Bloom DE. Population Health and Economic Development in the US. JAMA 2008;300(1):93-94.

^[8] World Bank: World Development Report: Investing in Health. Oxford University Press 1993;iii:17.

^[9] World Bank: World Development Report: Investing in Health. Oxford University Press 1993;19.

^[10] World Bank: World Development Report: Investing in Health. Oxford University Press 1993;21.

^[11] World Bank: World Development Report: Investing in Health. Oxford University Press 1993;18.

^[12] Mirvis DM, Bloom DE. Population Health and Economic Development in the US. JAMA 2008;300(1):94.

^[13] Yusuf S, Nabeshima K, Ha W. Income and Health in Cities: the Messages from Stylized Facts. J Urban Health: Bulletin of the NY Acad Med 2007;18(1):i35.

^[14] Howson CP, Fineberg HV, Bloom BR. The pursuit of global health: the relevance of engagement for developed countries. Lancet 1998;351:586.

This entry was posted on Monday, December 7th, 2009 at 9:09 am and is filed under Access, Cost, Global Health, Health Reform, Policy. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.