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Economic arguments for shifting health dollars upstream

For several decades, researchers and policy-change advocates have offered economic evidence that the health sector would better serve the population – and at less cost – if more of its dollars were spent facilitating improvements in people’s living and working conditions.  This discussion paper calls for a re-invigoration of this discussion, fueled by contemporary pressures: our expanding medical technical capabilities, our aging population, rising incidences of chronic disease, the skyrocketing wealth gap, and slowing economies.

The discussion paper provides 1) an overview to health system spending; 2) a discussion of the current drivers for looking at the economics of how we spend health care dollars; 3) a synthesis of existing economic arguments for moving dollars upstream; 4) examples of effective economic arguments in the areas of early child development and food security; and 5) actions we can take moving forward, with discussion questions.

Use this resource to:

  • Facilitate discussion about how we spend health care dollars, nationally and provincially
  • Explore recent research that links socioeconomic status, social determinants, interventions, health outcomes and health costs
  • Discuss the status and value of using economic arguments with government decision-makers


National Collaborating Centre for Determinants of Health. (2016). Economic arguments for shifting health dollars upstream. Antigonish, NS: National Collaborating Centre for Determinants of Health, St. Francis Xavier University.

Tags: Evaluation, Healthy public policy, Leadership & capacity building, Assess and report, Participate in policy development