Finance and Economics

Description

Financial health can be defined as an individual’s ability to manage expenses, cope with financial shocks, have minimal debt, and build wealth [Weida 2020]. Financial health is a major determinant of other socio-economic measures, including food, housing, energy and security. Empirical evidence has linked worsening economic outcomes to population health [Venkataramani 2020]. Indeed, financial crises can have a significant impact on mortality [Zilidis 2022].

In a model to assess the impact of city-level investment on health, the authors acknowledged that several variables were involved in the interplay between city-level investment, the environment, lifestyle choices, CVD risk profile and the number of people who experience heart attacks or strokes annually [Whitfield 2013].

Impact 

Economic and financial interventions can have profound effects on the health of populations.

Results

Five reviews comprising 340 primary articles were identified. One review assessed the impact of national urban regeneration investment on socioeconomic status or health outcomes [Thomson 2006]. A second review explored the barriers and facilitators to extended working lives in Europe, with a focus on gender [Edge 2017]. A third review assessed the impact, economic evaluation and sustainability of integrated vector management in urban settings to prevent vector-borne diseases [Marcos-Marcos 2018]. A fourth examined the global, regional, and national interventions that could help promote economic recovery following the COVID-19 pandemic [Mawani 2021]. The fifth review examined the relationship between income inequality and population health [Wilkinson and Pickett 2006].

Urban regeneration investments

• Impacts on self-reported health and mortality rates were inconsistent [Thomson 2006].
• There were overall improvements in employment and unemployment rates and in educational attainments [Thomson 2006].
• Limited evidence showed improvements in household income and housing quality [Thomson 2006].

Extension of work life

• Health was found to be the most frequently cited barrier to extended working lives in Europe [Edge 2017]
• The gender pay gap can have a negative impact on health [Edge 2017].

Infection rates

• IVM approaches resulted in reductions in breeding sites, the entomology index, and parasite rates of vector-borne diseases [Marcos-Marcos 2018].

Economic recovery

• Cash transfers, employment programmes and sick leave can help promote economic recovery following a pandemic [Mawani 2021].

Income and inequality

• The evidence from the majority of studies (70%) suggests that health is “less good” in communities where income differences are wider [Wilkinson and Pickett 2006].

Strength of the evidence

None of the included reviews reported on the reporting quality of the included primary studies. The overall quality of the evidence was rated as very low.

Resource implications 

In integrated vector management (IVM), interventions that involve a combination of different stakeholders are more cost-effective than those performed by only one stakeholder. The resources required are dependent on contextual factors, but with private/public funding initiatives, they are considered moderate investments to resources given the potential returns.

Recommendations

• Future evaluations of urban regeneration investments should incorporate clear theories of change informed by existing research evidence.
• Address the gender pay gap.
• Mixed methods research (which involves a multi-disease approach) could be a good way of taking into account all sectors involved and analyzing the harms of IVM strategies.
• Protecting jobs, protecting SMEs and protecting workers should be the cornerstone of interventions to promote socioeconomic recovery from pandemics.
• Investing in the health workforce should be a key intervention during economic crises because of its impact on economic growth and development.

Related Resources

• Financial health as a measurable social determinant of health.” PloS one vol. 15,5 e0233359. 18 May. 2020,
• Economic influences on population health in the United States: Toward policymaking driven by data and evidence.” PLoS medicine vol. 17,9 e1003319. 2 Sep. 2020, 
• The impact of economic crisis on mortality due to mental health illnesses.” Journal of public health (Oxford, England) vol. 44,1 (2022): 92-99. 
• Developing a model to estimate the potential impact of municipal investment on city health.” Journal of urban health : bulletin of the New York Academy of Medicine vol. 90 Suppl 1,Suppl 1 (2013): 62-73.

Reference to Reviews

Edge 2017. “Barriers and facilitators to extended working lives in Europe: a gender focus.” Public health reviews vol. 38 2. 31 Jan. 2017, doi:10.1186/s40985-017-0053-8

Marcos-Marcos 2018. “Impact, economic evaluation, and sustainability of integrated vector management in urban settings to prevent vector-borne diseases: a scoping review.” Infectious diseases of poverty vol. 7,1 83. 3 Sep. 2018, doi:10.1186/s40249-018-0464-x

Mawani 2021. “COVID-19 Economic Response and Recovery: A Rapid Scoping Review.” International journal of health services : planning, administration, evaluation vol. 51,2 (2021): 247-260. doi:10.1177/00207314211002785

Thomson 2006. “Do urban regeneration programmes improve public health and reduce health inequalities? A synthesis of the evidence from UK policy and practice (1980-2004).” Journal of epidemiology and community health vol. 60,2 (2006): 108-15. doi:10.1136/jech.2005.038885.

Wilkinson 2006. “Income inequality and population health: a review and explanation of the evidence.” Social science & medicine (1982) vol. 62,7 (2006): 1768-84. doi:10.1016/j.socscimed.2005.08.036