Abstract

Evaluation of the costs and outcomes associated with environmental policies and interventions is often required to inform public policy and allocate scarce resources. Methods to conduct assessments of cost-effectiveness have been developed in the context of pharmaceuticals, but have more recently been applied in public health, diagnostics, and other more complex interventions. The suitability of existing economic evaluation methodology has been explored in many contexts, however, this is yet to be undertaken for interventions and policies pertaining to the natural environment, such as urban green spaces and strategies to reduce indoor and outdoor air pollution. To make significant inroads into the evaluation of interventions and policies relating to the natural environment requires an understanding of the challenges faced in this context. Many of these challenges may be practical (data-related), however, a number are also methodological, and thus have implications for the appropriate framework for economic evaluation. This paper considers some of the challenges faced when conducting cost-effectiveness analyses in this context and explores what solutions have been proposed thus far. The intention is to help pave the way for consideration of which existing framework is most appropriate for the evaluation of natural environment (NE) interventions, or if a distinct framework is required. Environmental policies and interventions relating to the built environment, for example, housing, are not explicitly included here.

Highlights

  • BackgroundMany decision-making bodies use economic evidence when deciding which projects to adopt [1]

  • Many decision-making bodies use economic evidence when deciding which projects to adopt [1].Economic evaluations incorporate information on the costs and outcomes for each of the competing options that the decision-maker may choose from when allocating scarce resources

  • Methods for economic evaluation were established in pharmacoeconomics, but have been transferred to the appraisal of diagnostics, medical devices, public health interventions, and social care interventions

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Summary

Background

Many decision-making bodies use economic evidence when deciding which projects to adopt [1]. Economic evaluations incorporate information on the costs and outcomes for each of the competing options that the decision-maker may choose from when allocating scarce resources Such evaluations can be based on a single study or can synthesise evidence from multiple sources, for example, using a decision analytic model [2]. The challenges are expected to be further exacerbated be further exacerbated when evaluating public health interventions mediated by an improvement in when evaluating public health interventions mediated by an improvement in the natural outdoor the natural outdoor environment. Public health evaluation is expanding, including the evaluation of the evaluation of the effectiveness and cost-effectiveness of interventions and policies relating to the effectiveness and cost-effectiveness of interventions and policies relating to the natural environment natural environment (NE), at international, national, and local levels.

Schematic
Attribution of Effects
Non-Linearity in Effects and Uncertain Dose-Response Function
Effects Scope and Time-Horizon
Measuring and Valuing Outcomes
Cross-Sector Considerations
Equity Considerations
Cross-Sector Effects
Discussions
Full Text
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