It has long been accepted that
greater wealth allows people to make better health choices, but does the
reverse apply? Does greater health lead to greater wealth, both on a personal
and a national level?
This week (25-27 June), ministers of health, international experts, and
over 500 delegates from the 53 countries (1) of the WHO European Region will
meet in Tallinn - at the WHO European Ministerial Conference on Health
Systems: "Health Systems, Health and Wealth" - to discuss a new paradigm for
health systems. They will examine the existing evidence on the relationship between health and wealth.
Studies in the WHO European Region show that rises in life expectancy are
clearly matched by improvements in economic performance. Between 1970 and
2003 in the western part of the Region, increases in life expectancy were
"worth" 29-38% of gross domestic product (GDP) and far exceeded each
country's health expenditures. In the eastern part of the Region, the
relationship is even clearer: between 1990 and 2003, countries that
experienced a reduction in life expectancy incurred welfare losses of 16-31%, while those that saw life expectancy rise realized benefits of 12-31% of GDP.
A German study, covering 1995-2005, found that a 10% increase in health
satisfaction enhanced women's hourly wages by about 0.14-0.47% and men's by
about 0.09-0.88%. A 2006 survey of 26 affluent countries, covering 1960-2000,
found that a 10% reduction in cardiovascular mortality was associated with a
one percentage point increase in the annual growth of per capita income. In a
recent study of the Russian Federation, good health (compared to less good health) was found to increase wages by 22% for women and 18% for men.
"Health is a robust predictor of economic growth owing to increased
savings, investment in human capital, labour-market participation,
productivity growth and so on, which makes a strong case for investing in
health systems," says Dr Marc Danzon, WHO Regional Director for Europe.
"However, if health ministers are to win the argument on investment they
need to demonstrate that the health system is really using the resources it
is given effectively and efficiently. Governments have to face difficult
choices when deciding how to allocate resources. Yet they often seem willing
to invest in some elements of their national physical and human
infrastructure, for example in transport systems and education, but less
willing to invest in their most important resource, the health of their people," he adds.
New WHO european charter on health systems expected to be signed on Friday 27 June.
The wider recognition that health systems are directly related to
economic performance, both at the individual level and at the national level,
puts health status among the key indicators of a country's economic
potential. To capitalize on that understanding, all 53 WHO European Member
States gathered in Tallinn are expected to sign a new charter on health
systems. The charter aims to reinforce the position that spending on health
systems, when it is cost-effective and appropriate, is a good investment and can benefit the health, wealth and well-being of populations.
* Three reports on how ill health can be an economic burden and how
well-run health systems can contribute to wealthier societies will be
discussed at the Tallinn Conference:
- The economic costs of ill health in the European Region;
- Performance measurement for health system improvement: experiences,
challenges and prospects; and
- Health systems, health and wealth: assessing the case for investing in
These reports are available on the Conference web site (http://www.euro.who.int/healthsystems2008).
* 1) The Member States of the WHO European Region are: Albania, Andorra,
Armenia, Austria, Azerbaijan, Belarus, Belgium, Bosnia and Herzegovina,
Bulgaria, Croatia, Cyprus, the Czech Republic, Denmark, Estonia, Finland,
France, Georgia, Germany, Greece, Hungary, Iceland, Ireland, Israel, Italy,
Kazakhstan, Kyrgyzstan, Latvia, Lithuania, Luxembourg, Malta, Moldova,
Monaco, Montenegro, the Netherlands, Norway, Poland, Portugal, Romania, the
Russian Federation, San Marino, Serbia, Slovakia, Slovenia, Spain, Sweden,
Switzerland, Tajikistan, The former Yugoslav Republic of Macedonia, Turkmenistan, Turkey, Ukraine, the United Kingdom and Uzbekistan.