Abstract

BackgroundIncreasingly, decision-makers are interested in understanding the returns on investments in programs and policies that promote health and prevent chronic diseases. While the costs of these programs are more easily quantified, many of the outcomes they aspire to achieve are intangible and lack obvious market values. The subjective well-being (SWB) method was developed to value a wide range of non-market goods, including health outcomes directly in monetary terms. This paper presents an application of the SWB approach to estimate the monetary value of health-promoting behaviours as the intermediate outcomes of health promotion and chronic disease prevention programs and policies.MethodsLife satisfaction (LS) was used as a proxy of individuals’ SWB. Based on the combined Canadian Community Health Survey 2009–10 data, we modeled LS as a function of income and healthy behaviours, controlling for the socio-demographic factors associated with LS at the individual level using ordinary least squares regression. Equivalent effects of income and healthy behaviours on LS derived from the models allowed us to estimate the trade-off between income and healthy behaviours.ResultsWe found that income and healthy behaviours were positively associated with LS. The values of increased physical activity, an additional daily serving of fruits/vegetables, and not smoking are respectively $631, $115 and $563 per week. These represent the amounts of additional weekly income required to maintain an individual at their level of LS in the absence of each of these behaviours.ConclusionsThe SWB method holds promise as a method to monetize the value of a range of non-market goods, including healthy behaviours for which market values do not exist. The SWB method can be applied efficiently and cost-effectively using readily available survey data.

Highlights

  • Decision-makers are interested in understanding the returns on investments in programs and policies that promote health and prevent chronic diseases

  • As income was used as a reference value in the life satisfaction (LS) model to which other variables were compared, individuals with missing values on household income were omitted to ensure biases were not introduced from imputation

  • We found that income has a positive indirect impact on LS through marital status, Table 1 Life satisfaction, household income, health behaviours, and selected socio-demographic factors of Canadians aged 12 years and older, Canadian Community Health Survey, 2009–10 (n = 74,577)

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Summary

Introduction

Decision-makers are interested in understanding the returns on investments in programs and policies that promote health and prevent chronic diseases. This paper presents an application of the SWB approach to estimate the monetary value of health-promoting behaviours as the intermediate outcomes of health promotion and chronic disease prevention programs and policies. Health behaviours frequently targeted by healthy living programs including healthy eating, physical activity, and smoke-free living do not have market values or existing market relationships that help infer monetary values, limiting further economic analysis to inform decision making or communicate impact to the public. Economists have at their disposal two established valuation techniques that have a long tradition in cost-benefit analysis [3]. Limitations to the contingent method include unreliable, unrealistic estimates or strategic behaviour when respondents are presented with situations with which they are unfamiliar [6, 7]

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