Assessment of health producing measures across different sectors

To date, economic evaluation of health producing measures has concentrated on health care treatments and technologies. However, it is increasingly being recognized that many health promoting measures are in other sectors, such as education, safety programmes, income maintenance and improvements to the physical environment. This paper examines the principles of assessing health promoting measures across different sectors and reviews current practice. Such assessments pose methodological challenges not often encountered in health care evaluations, in framing the evaluation, in identifying, measuring and valuing costs and benefits, and in interpreting results. It is concluded that intersectoral economic evaluation is unlikely to provide a complete technical solution to the problem of allocating resources within and between sectors of the economy, but that the application of an economic way of thinking could yield benefits. Five proposals are made for taking matters forward. These include undertaking more pilot studies, insisting on a minimum data set to justify spending plans and increasing the incentives for intersectoral collaboration.