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The Limitations and Potentials of Evaluating Economic Aspects of Community-Based Health Promotion: A Critical Review

Author

Listed:
  • Philipp Weber

    (Friedrich-Alexander-Universität Erlangen-Nürnberg)

  • Leonie Birkholz

    (Friedrich-Alexander-Universität Erlangen-Nürnberg)

  • Riccarda Straub

    (Friedrich-Alexander-Universität Erlangen-Nürnberg)

  • Simone Kohler

    (Friedrich-Alexander-Universität Erlangen-Nürnberg)

  • Natalie Helsper

    (Friedrich-Alexander-Universität Erlangen-Nürnberg)

  • Lea Dippon

    (Friedrich-Alexander-Universität Erlangen-Nürnberg)

  • Klaus Pfeifer

    (Friedrich-Alexander-Universität Erlangen-Nürnberg)

  • Alfred Rütten

    (Friedrich-Alexander-Universität Erlangen-Nürnberg)

  • Jana Semrau

    (Friedrich-Alexander-Universität Erlangen-Nürnberg)

Abstract

Community-based health promotion (CBHP) interventions are promising approaches to address public health problems; however, their economic evaluation presents unique challenges. This review aims to explore the opportunities and limitations of evaluating economic aspects of CBHP, focusing on the assessment of intervention costs and outcomes, and the consideration of political-level changes and health equity. A systematic search of the PubMed, Web of Science and PsycInfo databases identified 24 CBHP interventions, the majority of which targeted disadvantaged communities. Only five interventions included a detailed cost/resource assessment. Outcomes at the operational level were mainly quantitative, related to sociodemographics and environment or health status, while outcomes at the political level were often qualitative, related to public policy, capacity building or networks/collaboration. The study highlights the limitations of traditional health economic evaluation methods in capturing the complexity of CBHP interventions. It proposes the use of cost-consequence analysis (CCA) as a more comprehensive approach, offering a flexible and multifaceted assessment of costs and outcomes. However, challenges remain in the measurement and valuation of outcomes, equity considerations, intersectoral costs and attribution of effects. While CCA is a promising starting point, further research and methodological advancements are needed to refine its application and improve decision making in CBHP.

Suggested Citation

  • Philipp Weber & Leonie Birkholz & Riccarda Straub & Simone Kohler & Natalie Helsper & Lea Dippon & Klaus Pfeifer & Alfred Rütten & Jana Semrau, 2024. "The Limitations and Potentials of Evaluating Economic Aspects of Community-Based Health Promotion: A Critical Review," Applied Health Economics and Health Policy, Springer, vol. 22(2), pages 165-179, March.
    • Handle: RePEc:spr:aphecp:v:22:y:2024:i:2:d:10.1007_s40258-023-00864-y
    DOI: 10.1007/s40258-023-00864-y
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    References listed on IDEAS

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    1. Cookson, Richard & Drummond, Mike & Weatherly, Helen, 2009. "Explicit incorporation of equity considerations into economic evaluation of public health interventions – reply to Richardson and Shiell," Health Economics, Policy and Law, Cambridge University Press, vol. 4(2), pages 261-263, April.
    2. Simon Eckermann, 2017. "Health Economics from Theory to Practice," Springer Books, Springer, number 978-3-319-50613-5, December.
    3. Cookson, Richard & Drummond, Mike & Weatherly, Helen, 2009. "Explicit incorporation of equity considerations into economic evaluation of public health interventions," Health Economics, Policy and Law, Cambridge University Press, vol. 4(2), pages 231-245, April.
    4. A. Shiell & P. Hawe, 1996. "Health promotion community development and the tyranny of individualism," Health Economics, John Wiley & Sons, Ltd., vol. 5(3), pages 241-247, May.
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