Many important opportunities to improve health lie outside the health sector and involve improving the conditions in which we live and work: safe design and maintenance of roads, bridges, train tracks, and airports; control of environmental pollutants; occupational safety; healthy buildings; a safe and healthy food supply; safe manufacture of consumer products; a healthy social environment; and others.
Faced with the overwhelming array of possibilities, U.S. decision makers need help identifying those that can contribute the most to health. Cost-effectiveness analysis is designed to serve that purpose, but has mainly been used to assess interventions within the health sector. This paper briefly reviews cost-effectiveness analysis and its methodologic evolution and discusses the issues that arise when it is used to evaluate interventions that fall outside the health sector under three headings: structuring the analysis, quantifying/measuring benefits and costs, and valuing benefits and costs.
Russell LB, Sinha A. Strengthening Cost-Effectiveness Analysis for Public Health Policy. American Journal of Preventive Medicine 2016; 50 (5): S6-S12. https://doi.org/10.1016/j.amepre.2015.11.007