Quantifying the added societal value of public health interventions in reducing health inequality

Abstract: It is possible to estimate the health inequality impacts of public health interventions using bespoke distributional cost effectiveness analysis, as evidenced by a recent adaptation of an economic evaluation of smoking cessation services. If this is not feasible, health inequality impacts could be derived using a simple method based on readily available information about their cost, health effects and target population or disease. This seminar describes the simple method for communicating the value of health inequality impacts of public health interventions for comparison against the bespoke approach. We used the data on costs and health outcomes produced for interventions within NICE public health guidance, and combined it with information about the socioeconomic characteristics of the target population or disease. Using the results from a survey of the general public that asked how much population health they would be willing to sacrifice in order to reduce inequality in life expectancy between the richest and the poorest, we then estimated a societal value of effects on health inequality. Most public health interventions (69%) outdo existing activities in improving health and reducing health inequality. Summing across all interventions recommended by NICE revealed 23.2 million years of additional full health and a reduction in the life expectancy gap between the least healthy and most healthy from 13.8 to 13.3 years of full health. At the general public level of preference for health inequality reduction, this is equivalent in value to an additional 5.4 million years of full health. Information on health inequality impacts reveals the added societal value of investment in public health interventions over and above increasing population health, and may suggest an alternative order of prioritisation compared to looking at total health impact alone.