Investing in Health and Wellbeing

Overview & Synopsis

The proverbial benefits of prevention over cure are self-evident—and yet we are reluctant to invest in protecting or improving health. Resolution of this age-old dilemma begins with a timeless truth: the benefits of good health come at a cost; prevention is not better than cure at any price. Investment in health protection is more appealing when a high-risk, high-value hazard can be averted certainly, rapidly, and at a relatively low cost. Application of this idea helps to explain why prevention is neglected by health services, why the world was not ready for the COVID-19 pandemic, why the world’s most deadly infections are neglected, why cigarette smoking is still commonplace, why the idea of a ‘sin tax’ is misconceived, why billions still do not have access to safe sanitation, and why the response to climate change has been so slow. Although more money and effort are invested in health promotion and disease prevention today than is commonly thought, the enormous avoidable burden of ill-health is a reason to seek ways of investing still more. The search should begin, not with the usual expert prescriptions of how health choices ought to be made, but with investigations of how choices are made in practice. That depends on understanding, not only costs, hazards, and risks, but also the values, motives, and powers of all those who collectively make decisions about health.