Analyzing the Relationship Between Economics and Public Health

I recently read the Channel NewsAsia commentary on healthspan and the “longevity dividend”, and it reminded me of a misconception I used to hold early in my career. I believed that reducing healthcare spending would automatically reduce GDP. After all, GDP is measured by expenditure and healthcare is a large component of national spending. This is true at a surface level, but it misses a deeper economic reality. When population health improves, we spend less on avoidable complications, repeated hospitalisations and long-term care because people genuinely require fewer sick-span services. The reduction in health expenditure is not a loss to the economy. It is a reallocation. Resources that are freed up do not disappear. They flow into more productive sectors that drive long-term growth. These include education, skills development, innovation, retail, family wellbeing and community participation. These sectors have far higher economic multipliers than spending on dialysis, amputations, strokes or frailty management that could have been prevented upstream. This is the core insight of the CNA commentary. A one-year gain in healthy life can add billions in preserved productivity and cost savings. It shifts ageing from being viewed as a fiscal burden to becoming a source of national strength. When older adults stay healthy, families remain economically active, the workforce stabilises and the overall economy becomes more resilient. As a clinician trained in public health and health economics, I now see that healthspan is not just a medical priority. It is an economic strategy. Investing in prevention, nutrition, physical activity and community-based support is far more impactful than trying to restore health after it has already declined. Singapore has demonstrated again and again that we can turn constraints into strategic advantage. The next frontier is to turn longevity into a story of health preservation and economic vitality. The question is no longer whether we can afford to invest in healthspan. The real question is whether we can afford not to. https://lnkd.in/gxD9mM9S

Delighted to see the UK’s Office for Budget Responsibility look at the long term impact of better health for the UK economy in their latest Fiscal Risks and Sustainability publication (https://shorturl.at/BpUfo).   It’s a standard starting point for long run macroeconomic projections to model the impact of an ageing population. The focus is invariably on rising health costs, pensions and falling GDP with fewer people of working age. What the OBR do though is look at what would happen if Brits live not just longer but in better health. Of course. the main argument for improving health is a pure welfare argument – health is important and as we live longer the largest health challenge is how we age and tackling ageing related diseases and achieving a compression of morbidity – that is making healthspan catch up with lifespan.   But as I stress in my book ,The Longevity Imperative (https://amzn.eu/d/9JVgj5y) we have to achieve a three dimensional longevity dividend – we already have longer lives but how do we make them not just longer but healthier, more productive and more engaged for longer. That is how we support the economy, tackle the pensions crisis and ease health funding pressures. The OBR does a great job of looking at what happens if people are healthier for longer. More people alive in better health means more people working (more taxes, lower social security payments) and lower health costs but of course it does mean more people living longer (good thing) albeit at the cost of higher pensions. But as the following chart shows the overall effect is positive for the public finances – lower fiscal deficits and lower government debt. So better health is great for us individually but also benefits the economy. That’s the three-dimensional longevity dividend.   Of course, the key question is how do we achieve these better health outcomes and can they be realised at a cost that is still beneficial for public finances. This is where a lot needs to be done but a shift to prevention as a way of keeping us healthy seems inevitable. Which diseases to focus on, what form of prevention (from drugs through to socio-economic determinants) and how to deliver them is a growing agenda. We already have some answers and ideas but need a lot more but the OBR report is clear. There is a tendency to think of the ageing society as something we can't do anything about. The population is ageing. But there is so much that we can do to change how we age. Shifting our health system in response to increases in life expectancy and a shift in the disease burden to chronic disease is central to making sure we seize not just the welfare benefits that longer healthier lives bring but also the economic benefits that make prevention a macroeconomic investment. #healthspan #healthyageing #UKHealth  

Thrilled to share our new publication, co-authored with Dr. Athanasios Chantzaras: "The Economics of Prevention and Quality of Care: Policy Insights from the EU’s COVID-19 Response." The article provides a critical analysis of European healthcare systems through the lens of the COVID-19 pandemic. The core argument is that prevention and quality of care are not just public health ideals but economic necessities for building resilient and sustainable health systems. The pandemic served as a real-world "stress test," exposing the consequences of historical underfunding and fragmentation in these areas. *Key Analytical Points* *Underfunding and Fragmentation: The research highlights that despite their proven cost-effectiveness and long-term benefits, prevention and quality of care have been consistently underfunded across many EU member states. This has led to fragmented, rather than integrated, systems, which proved brittle under the strain of the pandemic. Economic Elasticity: The study's empirical findings confirm that prevention expenditure is income- and budget-elastic. This means that as a country's income or health budget increases, so does its spending on prevention. However, this spending doesn't automatically translate to better outcomes. The paper argues that efficiency and impact are highly dependent on the quality of a country's institutional capacity and governance. The COVID-19 Stress Test: The pandemic's varied impact across EU countries demonstrated the link between pre-existing health system structures and crisis responsiveness. Countries with robust, well-governed systems that had already invested in prevention and primary care were better able to manage the surge in demand and maintain continuity of non-COVID services. Conversely, those with fragmented, underfunded systems struggled, leading to higher mortality rates and significant disruptions in routine healthcare. Policy Recommendations: The article's central policy recommendation is to shift from a reactive, short-term approach to a proactive, value-based one. This involves embedding efficiency metrics, dynamic modelling, and performance-based allocation into fiscal planning. This would ensure that resources are allocated to interventions that not only save lives but also maximize long-term economic and social value. Essentially, it advocates for treating healthcare as a strategic investment rather than an expense. In summary, the analysis moves beyond the public health narrative to make a compelling economic case for prioritizing prevention and quality. It uses the COVID-19 crisis as a case study to demonstrate that investing in these areas is crucial for improving health outcomes, enhancing system resilience, and ensuring fiscal sustainability in the face of future shocks. The link is below https://lnkd.in/dJg2VGaV #universityofathensMBA #whoathens #healtheconomics #healthmanagement #whoprevention

Health Economics (Early View): In Norway’s oil-price slump, poor #health increased job-loss risk—especially for women and the young. For white‑collar workers it raised #unemployment; for older/blue‑collar workers it pushed uptake of health benefits. Health and Unemployment During a Negative Labor Demand Shock Espen Bratberg, Tor Helge Holmås, Egil Kjerstad, Kjell Vaage ABSTRACT The association between unemployment and health is well documented, but causality remains unclear. This paper investigates how pre-existing health conditions amplify the effects of adverse labor market shocks. Using variation in local unemployment generated by a shock in the petroleum prices that hit the geographic center of the petroleum industry in Norway, but left other regions more or less unaffected, our study reveals that workers with compromised health face a higher likelihood of unemployment during downturns. Heterogeneity analysis reveals differences in susceptibility based on gender, age, education, and job type. Females exhibit greater sensitivity to health, and the youngest age group is most affected. Furthermore, higher education and white-collar jobs correlate with amplified health-related unemployment effects. Conversely, poor health in combination with high age, low education, and blue-collar jobs increases the uptake of social insurance during the economic downturn, pointing toward the substitutability between unemployment benefits and health-related benefits. https://lnkd.in/d_jFKd33

Ultra-processed profits vs public health – time to rethink the food economy The Make America Healthy Again (MAHA) report places a direct spotlight on the food and beverage industry – and rightly so. With its critique of ultra-processed foods, excessive sugar, and the corporate capture of regulatory bodies, the movement revives a neglected truth: health is not just a moral imperative – it’s a macroeconomic one. The rise of chronic diseases like obesity, diabetes, and cardiovascular illness is not coincidental. It’s the result of decades of aggressive marketing, product engineering, and political lobbying from large food and drink conglomerates. In the US, life expectancy gains are slowing, even reversing in parts of the country. The World Health Organization warns of a 10-year gap in healthy life expectancy between populations, often driven by diet-related illness. Meanwhile, cardiovascular disease alone costs the EU over €282 billion each year. The burden of preventable diseases is now one of the biggest threats to economic productivity in aging societies. As labour markets shrink and healthcare systems stretch, prevention becomes a fiscal strategy. Japan and parts of Europe have shown what’s possible with policy-backed food environments: lower sugar intake, more whole foods, and measurable GDP benefits through healthier workforces. Yet many Western systems still reward volume over nutritional value. MAHA’s core message is simple: if we want long-term economic resilience, we must address the short-term incentives that shape our food supply. That means rethinking subsidies, marketing practices, and the regulatory capture of public institutions. 👍 Sharp and necessary commentary by Camilla Cavendish in this weekend’s Financial Times. Hashtags: #healthyeconomy #fmcg #foodindustry #nutrition #healthpolicy #publichealth #cardiovasculardisease #ultraprocessedfood #economichealth #chronicdisease #investinhealth #gdpgrowth #agingpopulation #regulatoryreform #healthcarecosts #preventivemedicine #sustainability #retail #foodtech #europe #usa #northamerica #healthcareinnovation #futureofhealth #economicgrowth #sugarreduction #consumerhealth #foodregulation #marketingstrategy #wellbeing #globalhealth

Brain Health as Capital: A Defining Paper for 2026 A major contribution this year in Stroke, journal of the American Heart Associationm by Tatjana Rundek and Rose Du of University of Miami Miller School of Medicine University of Miami— does something important. https://lnkd.in/gjPd7j8Z It doesn’t just review advances in stroke and dementia care. It reframes brain health as capital. What makes this paper particularly sophisticated is how seamlessly the authors weave together: • Neuroengineering breakthroughs (brain–machine interfaces restoring speech and motor function) • Advances in thrombectomy and acute stroke systems of care • Disease-modifying Alzheimer’s therapies • AI-enabled biomarkers and early detection • Environmental exposomics (air pollution, PFAS, upstream drivers) • Vascular risk and lifestyle science • Preventive neurology as a discipline • And critically — economic framing through brain capital This is not siloed neuroscience. It is systems neuroscience aligned with public health, economics, and infrastructure strategy. The authors explicitly position brain health as societal infrastructure — akin to energy, roads, and digital systems — requiring coordinated investment across policy, community, environment, and health systems. The “Brain Capital Model” figure crystallizes this shift: individual drivers embedded within family, community, region, and national governance systems. That integration is the brain economy in action. 2026 is the year of action for the brain economy, kicked off by the World Economic Forum–McKinsey Health Institute Brain Economy Insights Report. The global narrative has moved from awareness to implementation. This paper reflects that inflection point: - Prevention-first neurology - AI-enabled population screening - Environmental and lifestyle policy reform - Integration of kidney–heart–brain frameworks - Brain capital as an economic growth strategy Importantly, the authors underscore the staggering macroeconomic stakes: global annual losses from brain health degradation projected in the trillions — and equally large gains from investing in resilience. The message is clear: Brain health is not merely a clinical outcome. It is a productive asset. It is resilience infrastructure. It is economic strategy. The next phase now demands: • Scalable prevention models • Brain-positive workplace innovation • Cross-sector investment frameworks • Regional brain economy implementation (cities, states, G7/G20 alignment) • Metrics that link biomarkers to productivity and economic vitality The science is advancing rapidly. The economic case is strengthening. The systems models are maturing. Now is the time to operationalize. The future of economic resilience will depend on how seriously we treat the brain as capital. #BrainEconomy #BrainCapital #PreventiveNeurology #Stroke #Dementia #AI #PublicHealth #EconomicResilience

It’s finally out! Our working paper on the “Economic Impact of Noncommunicable Diseases in Egypt”. The paper reiterates the link between #economicgrowth and #health. Economic growth relies on #humancapital, physical capital, and the factors influencing both. Two-thirds of the #wealthofnations come from human capital, shaped by the #knowledge, #skills, and #health people gain over time. #Egypt has significantly reduced the burden of communicable, maternal, and child health diseases over the last six decades. However, #noncommunicablediseases have been rising, resulting in serious economic impacts on productivity and human capital. The paper estimates the #economicimpact of #NCDs. In 2022, the direct and indirect costs of NCDs, including #productivityloss, ranged between 5.04 and 7.74% of #GDP, with total economic costs reaching 9.28% of GDP. The paper suggests three policy priorities to address the NCD rise. First is to focus on #primaryprevention targeting behavioral and environmental risk factors through population-based interventions; the second is the focus on #secondaryprevention and strengthening #primaryhealthcare across public and private sectors to reduce medical costs; and the third is accelerating the implementation of the Universal Health Insurance System #UHIS to improve #healthcoverage and productivity. #Egypt; #Burdenofdisease; #Costofillness; #absenteeism; #presenteeism. The paper is co-authored with Mariam M. Hamza, Ph.D. and reviewed by Prof. Hala Sakr and Prof. Heba Nassar. This paper is part of Egypt Economic Development and Policies Project #EEDP implemented under the guidance of Dr. Mahmoud Mohieldin, FREcon, Dr. Racha Ramadan and Dr. Rana Hendy.

🚨 New Research Alert! 🚨 I’m excited to share our latest work, which is the first pre-print using Health-GPS, the Centre for Health Economics & Policy Innovation's (CHEPI) dynamic policy simulation tool! 🔎 What is Health-GPS? Health-GPS is a microsimulation model that projects the long-term health and economic impacts of policies by simulating individual-level risk factors, disease progression, and healthcare costs. It allows policymakers to test interventions before implementation, helping to design more effective public health strategies. 📝 What did we study? In this pre-print, we model the impact of taxing foods high in fat, sugar, and sodium (HFSS) in India. Some key findings: ✅ A 28% tax on HFSS foods could prevent 9.4 million cases of major diet-related diseases over 30 years, including heart disease, stroke, diabetes, and kidney disease. ✅ This policy could avert 18.7 million disability-adjusted life years (DALYs) and save $15.3 billion in healthcare costs. ✅ Tax revenue from food and beverages would increase by 20.8%, while household food spending would remain largely unchanged. As more countries explore fiscal policies to tackle NCDs, simulation tools like Health-GPS are vital for understanding long-term impacts before policies are enacted. Read the full pre-print here: https://lnkd.in/eYwgsKxA #HealthPolicy #PublicHealth #ObesityPrevention #FiscalPolicy #HealthEconomics #CHEPI #HealthGPS

Trade policy isn’t just about economics. It’s about people, access, and resilience. 🇨🇦 🗞️ As global trade tensions escalate, discussions around U.S. tariffs, supply chains, and economic resilience are dominating the headlines. But one issue remains largely overlooked: how do trade policies impact healthcare? 🌍 At the World Trade Organization in Switerzland last year, I engaged with Deputy Director Angela Ellard and Ambassador Nadia B. Theodore in conversations about how trade policies shape health, education, and economic mobility. 🩺 Reflecting on those discussions now, as a Global Health & Economics graduate student at The Johns Hopkins University, I see how trade decisions don’t just move markets, they determine who has access to life-saving medical care. ⚠️ Tariffs on medical imports and pharmaceuticals drive up drug prices, making essential medicines less affordable. ⚠️ Higher costs of steel and aluminum make it more expensive to build hospitals, manufacture medical devices, and maintain healthcare infrastructure. ⚠️ Trade restrictions disrupt supply chains, delaying the global distribution of vaccines and life-saving treatments. 🔹 So how can we prioritize global health in trade negotiations to ensure that these policies benefit people, not just markets? #GlobalTrade #GlobalHealth #WTO #InternationalRelations #EconomicPolicy #TradeWar #USTariffs Johns Hopkins School of Advanced International Studies (SAIS) The Johns Hopkins University - Carey Business School Johns Hopkins Bloomberg School of Public Health

We spend more on health care than any other country, yet our macroeconomic indices of health system efficiency, population health outcomes, and value delivery do not justify that investment. That gap challenges the assumption that higher spending automatically translates into better results. Resources continue to flow toward advanced interventions, late-stage care, and increasingly complex systems—after risk has already accumulated—while overall outcomes remain stubbornly flat. Return on investment in health care should not be measured by utilization, scale, or sophistication. It should be measured by earlier detection, fewer emergencies, improved population-level outcomes, and lower downstream cost burden. If we want better results, we must be far more intentional about where and how capital is deployed, prioritizing prevention and care delivery models that perform in the real world—not just on balance sheets. The real question is not whether we are investing enough, but why, as a nation, have we refused to embrace and act on the reality that we should course-correct? #FoodForThought