Individual Decisions for Health

By Björn Lindgren | Go to book overview
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Introduction

Björn Lindgren

Research on the determinants of (good) health belongs to several disciplines - biology, medicine, epidemiology, public health, psychology, and sociology to name some of the most important and influential ones with a long history in the field. Economics is a relative newcomer. On the public health policy scene, health economics has often been considered as the provider of costing exercises (if considered at all), while the answers to the challenges of high costs of illness are to be looked for elsewhere, to those disciplines that have traditionally provided the information for public health interventions. The presence of health economists in government committees on public health issues is an exception.

This is unfortunate, since economics has much more to offer. Other disciplines may contribute to an understanding of which factors are important and which biological or social mechanisms that may explain the role of these factors. The contribution of health economics, however, consists mainly of a better understanding of the causes of individual variation in health-related behaviour. To the economist, observed individual behaviour is explained by a process in which the individual makes trade-offs between current psychic, time, and financial costs on one hand and future health benefits in the form of reductions in the probability of morbidity and mortality on the other. The contributions of health economics are sometimes complementing the analyses of the traditional public health disciplines but from a different analytical angle, sometimes challenging prevailing public health truths and myths.

So, even though an individual’s health status is determined by the genes that the individual inherits at birth, by the environmental risk factors that the individual faces during his or her lifetime, by chance in the form of accidents and illness, and by the present state of health care technologies, the individual’s own behaviour is an essential determinant. The health-related behaviour of an individual is an integrated part of his or her life style and living habits. It is affected by family relations and income but also by the structure of society at large and the incentives for a more or less healthy living created by institutions and regulations. Individual behaviour and changes in behaviour as a response to changes in the incentives structure often have long-term consequences for the individual’s health status.

Individual health-related behaviour is also a challenge to the economist. Uncertainties in health abound, for instance. First, there is uncertainty about the

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