A few weeks ago, we launched the ‘Preventonomics’ blog and introduced the work the PSSRU have been commissioned to carry out for the Big Lottery Fund’s A Better Start (ABS) programme. Today we want to talk about what we mean by ‘Preventonomics’.
First off, where does the name come from? It is a merger of “prevention” and “economics”. You may have heard of the popular science sensation “Freakonomics” – a book that combines pop culture and economics in a freakishly delightful read. It is also a good example of how economics can be usefully applied to a wide range of questions and provide a surprising and fresh perspective.
Prevention and promotion
In the 2005 Bangkok Charter for Health Promotion in a Globalized World, the WHO defined health promotion as “the process of enabling people to increase control over their health and its determinants, and thereby improve their health”. This is sometimes interpreted as health education and social marketing that targets behavioural risk factors. A wider definition calls for improvements that are conducive to good health, perhaps housing, working conditions, or enabling employment and food security. Similar principles can be applied when thinking about promotion activities within ABS: What are the factors or circumstances that can be improved to promote child well-being, health and development in the early years?
In contrast, prevention focusses on reducing risk factors for poor health or wellbeing. This can happen at any stage of the development of a problem. Primary prevention aims to prevent a problem from occurring in the first place. Secondary prevention tries to prevent early signs of trouble from developing into full blown problems. And tertiary prevention seeks to prevent the negative consequences of a problem by providing treatment for a current problem, or maintenance treatment for those who used to be affected.
Within ‘Preventonomics’, we see prevention and promotion as two parallel processes that work together in improving life chances in the early years. The focus of ‘Preventonomics’ is on the economics of prevention activities.
What are the economic aspects of prevention?
There is a general consensus that not enough is invested in prevention and early intervention. While the argument for early intervention and prevention is well established child development research, the economic perspective helps understand why it can be difficult for policy makers to implement. In both the US and the UK only a small proportion of GDP is spent on very young children. Shifting money into preventative services means an increase in expenditure in the short term, but financial pay-offs may not happen until the medium- to longer-term. Moreover, expenditure on prevention from one budget may lead to savings in another; perhaps higher health care costs today reduce use of additional education supports when children are older.
‘Preventonomics’ is about finding evidence of the costs associated with not implementing preventative interventions, identifying cost-effective interventions and estimating potential savings from preventative interventions. We will also show where and when expenditure and savings are likely to occur. The economics of prevention require a long-term view that considers the impact across different budgets and agencies, rather than a narrow perspective that is limited by budget cycles. While we will focus on the public sector in the short term, our longer-term estimates are going to take into account the wider benefits of prevention.
Watch this space for more information on ‘Preventonomics’ and our findings, hot off the press. Our next post will be published on April 4th.
In the meantime, why not check out the “Freakonomics” blog or visit these organisations with an interest in the early years: Wave Trust, The Breastfeeding Network, the National Literacy Trust or the Maternal Mental Health Alliance.