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Undertaking economic evaluations of workplace-based occupational health and safety interventions can be difficult, reflected by the significant lack of literature, evidence and guidance on the subject. Particular difficulties include: complex labour legislation; differences in the perception of health risks associated with work experiences amongst workplace parties and policy makers; the burden of costs and consequences being borne by different stakeholders in the system; conflicting incentives and priorities between the multiple stakeholders; lack of consensus about what ought to count as a benefit or cost of intervening or not intervening; multiple providers of indemnity and medical care coverage; and industry-specific human resources practices making it difficult to identify all work-related illnesses and injuries. In addition, most health economics methods books are designed for use in a clinical setting, which cannot be adapted for the workplace setting. In the face of such barriers, it is not surprising that few studies of occupational health and safety interventions contain an economic evaluation. This book aims to lay the foundations for a systematic methodology of economic evaluation of workplace interventions, by identifying the main barriers to research of high quality and practical relevance, and proposing a research strategy to remedy these weaknesses. Context chapters provide a wealth of background material ranging from a presentation of the broad conceptualization of work and health, to suggestions for strategies in confronting the dearth of data often experienced by occupational health and safety researchers. They take into account the varying institutional and regulatory approaches in different international jurisdictions. Specific topic chapters delve into the principles and application of economic evaluation methods relevant to this setting: study design, type of analysis, costs, consequences, uncertainty, and equity are all covered, providing guidance on analytical and decision making challenges. The concluding chapter synthesizes the summaries, conclusions, challenges and recommendations from across the book, presenting these in a reference case.
Undertaking economic evaluations of occupational health and safety interventions can be difficult for a number of reasons. This is reflected by the significant lack of evidence on their cost-effectiveness. Particular challenges include: complex labour legislation, differences in the perception of health risks associated with work experiences amongst workplace parties and policy makers, costs and consequences being borne by different stakeholders in the system, conflicting incentives and priorities between the multiple stakeholders, lack of consensus about what ought to count as a benefit or cost of intervening or not intervening, multiple providers of indemnity and medical care coverage, and industry-specific human resources practices that make it difficult to identify all work-related illnesses and injuries. Advancement of the application of economic evaluation methods in this literature is further hindered by the fact that most methods books are designed for use in a clinical setting and cannot be easily applied to the workplaces. In the face of such barriers, it is not surprising that few studies of occupational health and safety interventions contain an economic evaluation. This book aims to lay the foundations for a systematic methodology of economic evaluation of workplace interventions, by identifying the main barriers to research of high quality and practical relevance, and proposing a research strategy to overcome them. Context chapters provide a wealth of background material ranging from a presentation of the broad conceptualization of work and health, to suggestions for strategies in confronting the dearth of data often experienced by occupational health and safety researchers. The institutional and regulatory approaches in different international jurisdictions are covered in one of the context chapters. Specific topic chapters delve into the principles and application of economic evaluation methods relevant to workplaces and system level interventions. Study design, type of analysis, costs, consequences, uncertainty, and equity are all covered, providing guidance on meeting many analytical and decision-making challenges. The final chapter synthesizes the summaries, conclusions, challenges and recommendations from across the book, presenting the synthesis as a reference case.
In today's world of scare resources, determining the optimal allocation of funds to preventive health care interventions (PHIs) is a challenge. The upfront investments needed must be viewed as long term projects, the benefits of which we will experience in the future. The long term positive change to PHIs from economic investment can be seen across multiple sectors such as health care, education, employment and beyond. Applied Health Economics for Public Health Practice and Research is the fifth in the series of Handbooks in Health Economic Evaluation. It presents new research on health economics methodology and application to the evaluation of public health interventions. Looking at traditional as well as novel methods of economic evaluation, the book covers the history of economics of public health and the economic rationale for government investment in prevention. In addition, it looks at principles of health economics, evidence synthesis, key methods of economic evaluation with accompanying case studies, and much more. Looking to the future, Applied Health Economics for Public Health Practice and Research presents priorities for research in the field of public health economics. It acknowledges the role played by natural environment in promoting better health, and the place of genetics, environment and socioeconomic status in determining population health. Ideal for health economists, public health researchers, local government workers, health care professionals, and those responsible for health policy development. Applied Health Economics for Public Health Practice and Research is an important contribution to the economic discussion of public health and resource allocation.
This anthology provides readers of scientific literature on socioeconomic factors and working conditions with the newest knowledge in this field. Since our world is subjected to constant change in accelerating speed, scientific reviews and updates are needed. Fortunately, research methodology in epidemiology, physiology, psychology and sociology is also developing rapidly and therefore the scientific community can provide politicians and policy makers with increasingly sophisticated and exact descriptions of societal factors in relation to work. The anthology starts in the macro level sphere – with international perspectives and reviews related to working conditions in relation to political change (the fall of the Soviet Union) gender, age, precarious employment, national economy and retirement. Two chapters relate to national policies and activities in international organizations. The second part of the book relates to the meso level sphere – with reviews on social patterns in distributions of psychosocial and physical risks at work in general as well as reviews on noise, shift work, under/overemployment, occupational physical activity, job intensity (which may be a particularly important problem in low income countries), digitization in modern work, climate change, childhood determinants of occupational health in adult years and theoretical models currently used in occupational epidemiology - demand/control, effort/reward, organizational justice, psychosocial safety climate, conflicts, bullying/harassment. This part of the book ends with two chapters on interventions (one chapter on the use of cultural interventions and one on interventions and their evaluation in general) and two chapters on financial aspects of poor/good work environments and evaluations of interventions. In the third part of the book the micro level is addressed. Here mechanisms translating working conditions into physiology are discussed. This starts in general theory relating basic theories regarding energy storage and release to psychosocial theory (extension of demand control theory). It also includes regeneration physiology, autonomic nervous system function, immunology and adverse behaviour. Sections in the Handbook: Macro-level determinants of occupational health: Akizumi Tsutsumi, Meso-level determinants of occupational health: Morten Wahrendorf and Jian Li, Micro-level determinants of occupational health: Bradley J. Wright
A growing body of evidence from economic studies shows areas where appropriate policies can generate health and other benefits at an affordable cost, sometimes reducing health expenditure and helping to redress health inequalities at the same time.
As the debate over health care reform continues, costs have become a critical measure in the many plans and proposals to come before us. Knowing costs is important because it allows comparisons across such disparate health conditions as AIDS, Alzheimer's disease, heart disease, and cancer. This book presents the results of a major study estimating the large and largely overlooked costs of occupational injury and illness--costs as large as those for cancer and over four times the costs of AIDS. The incidence and mortality of occupational injury and illness were assessed by reviewing data from national surveys and applied an attributable-risk-proportion method. Costs were assessed using the human capital method that decomposes costs into direct categories such as medical costs and insurance administration expenses, as well as indirect categories such as lost earnings and lost fringe benefits. The total is estimated to be $155 billion and is likely to be low as it does not include costs associated with pain and suffering or of home care provided by family members. Invaluable as an aid in the analysis of policy issues, Costs of Occupational Injuryand Illness will serve as a resource and reference for economists, policy analysts, public health researchers, insurance administrators, labor unions and labor lawyers, benefits managers, and environmental scientists, among others. J. Paul Leigh is Professor in the School of Medicine, Department of Epidemiology and Preventive Medicine, University of California, Davis. Stephen Markowitz, M.D., is Professor in the Department of Community Health and Social Medicine, City University of New York Medical School. Marianne Fahs is Director of the Health Policy Research Center, Milano Graduate School of Management and Urban Policy, New School University. Philip Landrigan, M.D., is Wise Professor and Chair of the Department of Community Medicine, Mount Sinai Medical Center, New York.
Every year workers' low-back, hand, and arm problems lead to time away from jobs and reduce the nation's economic productivity. The connection of these problems to workplace activities-from carrying boxes to lifting patients to pounding computer keyboards-is the subject of major disagreements among workers, employers, advocacy groups, and researchers. Musculoskeletal Disorders and the Workplace examines the scientific basis for connecting musculoskeletal disorders with the workplace, considering people, job tasks, and work environments. A multidisciplinary panel draws conclusions about the likelihood of causal links and the effectiveness of various intervention strategies. The panel also offers recommendations for what actions can be considered on the basis of current information and for closing information gaps. This book presents the latest information on the prevalence, incidence, and costs of musculoskeletal disorders and identifies factors that influence injury reporting. It reviews the broad scope of evidence: epidemiological studies of physical and psychosocial variables, basic biology, biomechanics, and physical and behavioral responses to stress. Given the magnitude of the problem-approximately 1 million people miss some work each year-and the current trends in workplace practices, this volume will be a must for advocates for workplace health, policy makers, employers, employees, medical professionals, engineers, lawyers, and labor officials.
This book provides an introduction to decision analytic cost-effectiveness modelling, giving the theoretical and practical knowledge required to design and implement analyses that meet the methodological standards of health technology assessment organisations. The book guides you through building a decision tree and Markov model and, importantly, shows how the results of cost-effectiveness analyses are interpreted. Given the complex nature of cost-effectiveness modelling and the often unfamiliar language that runs alongside it, we wanted to make this book as accessible as possible whilst still providing a comprehensive, in-depth, practical guide that reflects the state of the art – that includes the most recent developments in cost-effectiveness modelling. Although the nature of cost effectiveness modelling means that some parts are inevitably quite technical, across the 13 chapters we have broken down explanations of theory and methods into bite-sized pieces that you can work through at your own pace; we have provided explanations of terms and methods as we use them. Importantly, the exercises and online workbooks allow you to test your skills and understanding as you go along.
Mirroring a worldwide phenomenon in industrialized nations, the U.S. is experiencing a change in its demographic structure known as population aging. Concern about the aging population tends to focus on the adequacy of Medicare and Social Security, retirement of older Americans, and the need to identify policies, programs, and strategies that address the health and safety needs of older workers. Older workers differ from their younger counterparts in a variety of physical, psychological, and social factors. Evaluating the extent, causes, and effects of these factors and improving the research and data systems necessary to address the health and safety needs of older workers may significantly impact both their ability to remain in the workforce and their well being in retirement. Health and Safety Needs of Older Workers provides an image of what is currently known about the health and safety needs of older workers and the research needed to encourage social polices that guarantee older workers a meaningful share of the nation's work opportunities.