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Every £1 spent on public health in UK saves average of £14

Cuts to public health budgets are likely to cost the NHS and wider economy ‘billions’

Ingrid Torjesen

Thursday, 30 March 2017

Every £1.00 spent on public health returns an extra £14 on the original investment, and in some cases significantly, says a systematic review* published online in the Journal of Epidemiology & Community Health.

Recent cuts made to public health budgets in the UK are therefore a “false economy” and are set to cost an already overstretched NHS and the wider economy “billions,” warn the researchers.

Public health is often perceived as a ‘soft target’ for cuts, so the researchers decided to look at the average return on investment (ROI) for a range of public health interventions.

They identified 52 suitable studies published over four decades that had calculated an ROI for local and national public health initiatives and/or had worked out the overall value for money of a project or proposal—otherwise known as the cost-benefit ratio, or CBR for short. These had looked at use of 29 different types of intervention in the UK, Western Europe, the USA, Canada, Japan, Australia and New Zealand.

Critical analysis of the data from these studies showed that the average ROI for a public health initiative was 14.3 for every unit cost spent on it, while the average CBR was 8.3.

When the overall impact of all 29 interventions was assessed, the ROI on local initiatives was 4.1, meaning that every £1 spent returns £4 plus the original £1 investment, while the average CBR was 10.3.

Even larger benefits accrued for national policies. Analysis of the data from these showed that the average ROI was 27.2 while the average CBR was 17.2.

The researchers said that their results “clearly demonstrate that public health interventions are cost-saving, both to health services as well as the wider economy,” who point out that some interventions, such as falls prevention, can produce substantial returns within 6 to 12 months.

Furthermore, they calculate that the recent £200 million cuts to public health funding in the UK will cost more like eight times as much – £1.6 billion. “The UK government’s ‘efficiency savings’ thus represent a false economy which will generate many billions in additional future costs to the ailing NHS and wider UK economy,” they said.

“The recent UK increases in (avoidable) teen pregnancies, sexually transmitted infections, homelessness and suicides are thus predictable and worrying. Do they represent harbingers of worse to come?”


* Masters R, Anwar E, Collins B, et al Return on investment of public health interventions: a systematic review J Epidemiol Community Health, published online first: 29 March 2017. DOI: 10.1136/jech-2016-208141

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