Academic journal article Canadian Journal of Public Health

Public Investment in Providing Information for Chronic Disease Prevention for Adults in Alberta

Academic journal article Canadian Journal of Public Health

Public Investment in Providing Information for Chronic Disease Prevention for Adults in Alberta

Article excerpt

ABSTRACT

Background: The World Health Organization in 2000 cited specific chronic diseases (chronic obstructive pulmonary disease, heart disease, diabetes and certain cancers) as major and preventable health hazards. There have subsequently been calls for increased investment in prevention activities. Currently there is no information on the economic magnitude of these promotion activities. In this study, we present an estimate of the investment in Alberta, by public organization, for chronic disease prevention activities which provide information that promotes behaviour changes in adults at risk.

Methods: We surveyed board members of the Alberta Healthy Living Network (AHLN) to obtain economic data and information on activities related to chronic disease (primary) prevention. We also asked for further contacts on programs in other agencies. We continued the ("snowball") process until no new agencies were identified. Agencies provided the information on a survey form.

Results: In 2003 in Alberta, the cost of publicly provided information to change risk behaviours related to chronic diseases for persons over 20 was $24.9 million. This investment was diffused over a large number of bodies. Anti-smoking programs used the largest proportion of the money. The total cost per person at risk was about $15. Regional Health Authorities spend about 1/10th of 1% of their budget on these activities.

Discussion: There are difficulties in collecting and organizing society-level data on chronic disease prevention. Nevertheless, all indications are that the amount of resources devoted in this area is small, and much smaller than has been suggested.

MeSH terms: Health promotion; chronic disease prevention and control; economics, medical; health care costs

The burden of chronic diseases is a large and growing problem in developed countries.1 Two recent studies have identified a substantial economic burden in Nova Scotia2 and Alberta.3 Several chronic diseases - heart disease, diabetes, chronic obstructive lung disease (COPD), and lung cancer - have been linked to the following modifiable risk factors: smoking, physical inactivity, and unhealthy eating habits. In light of these linkages, the World Health Organization (WHO) recommended a combined inter-sector approach to risk modification.4

There is a wide variety of chronic disease prevention strategies to modify these risk factors.5 Information, provided both personally (through counselling) and perhaps more importantly, through media mechanisms (thereby building enabling environments), is a key resource that is used in these strategies.6 Currently, estimates of overall disease prevention costs focus exclusively on immunizations7 and there are almost no data on the cost of providing health promotion information. We address this gap by estimating the dollar value of investment in chronic disease prevention information for the abovementioned diseases in Alberta.

METHODS

We conducted an analysis of expenditures on providing chronic disease prevention information that was undertaken by community and public bodies.

We focussed on those "primary prevention" activities8 that resulted from the provision of information in a public setting to any adult >20 years who engages, or might potentially engage, in the targeted risk behaviours. Cohen5 has devised a classification of health-influencing activities that include: 1) the availability of protective or harmful consumer goods and services; 2) physical characteristics of products; 3) social structures and policies; and 4) media and cultural messages. In terms of this classification, our focus is on direct person-to-person (or -group) information (e.g., counselling) which falls in category 1 and general information in category 4. We excluded those programs that target persons with existing chronic disease, such as cardiac and COPD rehabilitation and diabetes education, as these are secondary or tertiary prevention programs. …

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