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Gmeinder, Michael and Morgan, David and Mueller, Michael (2017) How much do OECD countries spend on prevention? Paris: OECD Publishing.

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OECD countries face the multiple challenges of rapidly ageing societies with the associated rise in chronic diseases and the ever-present threat from new or evolving communicable diseases. This is within the context of seeking better value for money from the health sector. While a growing body of evidence shows that many health promotion and disease prevention measures can improve health outcomes at relatively low cost, less has been documented – in an internationally comparable way – on how much countries actually invest in such activities and the drivers of prevention spending over the years. This is particularly pertinent in the context of fiscal sustainability and tight public budgets. Using newly available data from across OECD countries, this study examines the differences in spending on prevention both at an aggregate and detailed level.

This analysis brings a fresh perspective and raises questions as to the optimal resource allocations within the sector. Time series data is also scrutinised in conjunction with collated policy and public health developments from a number of countries to try to identify some of the drivers behind the observed prevention spending trends. In doing so, directions for further improvement in the underlying data as well as policy implications are discussed.

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6. Prevention policies have seen some success in reducing behavioural risk factors, such as smoking, harmful alcohol use, poor diet and physical inactivity, all contributing to a high burden of chronic diseases. Yet, while some of these risky behaviours have been in decline in many OECD countries in recent years, others have been on the rise (Figure 2). Daily smoking in adults has come down markedly in most OECD countries over the past decade (from 25.7% in 2000 to 18.4% in 2015), even if current rates continue to be a major contributor to mortality in OECD countries. Much of the fall is attributable to individual smoking cessation interventions as well as population-based measures aimed at reducing tobacco consumption, including public awareness campaigns, advertising bans, increased taxation and smoking bans in public spaces and restaurants (OECD, 2015a).

7. The consumption of alcohol in adults has on average decreased slightly in the past decade (from 9.5 litres per adult in 2000 to 9.0 litres in 2015), but while some OECD countries have seen gradual declines in alcohol consumption since 2000, others have experienced increases. Furthermore, hazardous individual drinking patterns have been on the rise, such as heavy episodic drinking in young people and women. Recent OECD work identified a number of policies that have proven effective in tackling harmful alcohol use, such as counselling of heavy drinkers, improving enforcement of drinking-and-driving laws, increasing taxes and prices as well as regulating the marketing of alcoholic drinks (OECD, 2015b)....


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