This chapter looks at how the country’s health investment remains resolutely focused on curative care. Perhaps people spend more on cure than they do on prevention because they believe keeping people healthy is too expensive. But is this true? An analysis set out to assess the return on investment for high-income countries that adopt efforts to improve health. The authors found that the median return on investment for public health interventions was 14 to 1—that is, for every dollar invested, it yields the same dollar back and another 14. They also found that the more these interventions were established at the wider, national level, the higher the return, rising up to about 40 to 1 for the best investments. These interventions include vaccination programs, taxes on sugar-sweetened beverages, building better cities to reduce falls, and early youth interventions to limit teenage pregnancy and delinquency. In other words, these are classic efforts to promote the public’s health by shaping the conditions in which people live.
‘What You See is All There is’: The Importance of Heuristics in Cost-Benefit Analysis (CBA) and Social Return on Investment (SROI) in the Evaluation of Public Health Interventions