Economics of public health problems
The work of many health economists is to inform choices between alternative ways of treating health problems (i.e. economic evaluation; see Chapter 37). Economic concepts and methods of analysis, however, may also help explain the underlying causes of various public health problems.
This chapter provides an overview of some of the arguments that economists have put forward to explain the substantial growth in obesity rates in recent decades. It then also examines the economic case for government intervention in reducing levels of obesity and overweight. There are also parallels in using economics to explain public health problems such as smoking or heroin addiction.
Almost all advanced industrialised countries are experiencing unprecedented growth in the prevalence of obesity – being overweight relative to a person’s height. As well as having a direct impact on morbidity, obesity and being overweight increases the risk of developing a wide range of other diseases such as type 2 diabetes, heart disease and stroke.
While the fundamental cause of obesity is physiological, with individuals consuming more calories over time than are expended, the pattern of development of obesity in populations is determined by a range of genetic, environmental, social and behavioural factors. These might include increased car use, TV viewing habits, availability of fast food outlets, production of processed foods (typically high in salt and fat) and the proportion of women in the workforce (affecting the demand for convenience foods).
Health economists have contributed to understanding the causes of the ‘obesity epidemic’ largely through arguments relating to the impact of technological changes on how (and what) we eat and whether (and how much) we exercise.