Economic Arguments for Shifting Health Dollars Upstream


In this discussion paper, evidence is presented supporting the position that greater investment in upstream action from within the health sector is both socially just and economically sound. Specifically, the evidence base suggests that the healthcare sector can achieve better health outcomes for less money by spending more of its dollars on public health and primary care work that builds healthier communities, social supports, and environments: what is called both upstream and equity work. 


  • Key messages
  • The purpose of this resource
  • An overview of our health system spending
  • Drivers for a renewed call for upstream investment within health budgets
  • A synthesis of key economic arguments for shifting healthcare dollars upstream
    • Focus on the impact of poverty and income inequality
    • Focus on high-cost users of illness care
    • Focus on other social determinants of health
  • Examples of the effective use of economic arguments to move resources upstream
    • Economic arguments for early childhood interventions
    • Economic arguments for food security interventions
  • Moving forward
  • Conclusion and discussion questions
  • Appendix 1: Glossary
  • Appendix 2: Economic analysis methods
  • References

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NCCDH Webinar: Inequalities cost. How can economic analysis help us find solutions?

NCCDH Webinar: How can we contain health costs and improve health equity?