Department of Public Health, University Medical Center Rotterdam, Rotterdam, The Netherlands.
J Epidemiol Community Health. 2011 May;65(5):412-9. doi: 10.1136/jech.2010.112680. Epub 2010 Dec 19.
In order to support the case for inter-sectoral policies to tackle health inequalities, the authors explored the economic costs of socioeconomic inequalities in health in the European Union (EU).
Using recent data on inequalities in self-assessed health and mortality covering most of the EU, health losses due to socioeconomic inequalities in health were calculated by applying a counterfactual scenario in which the health of those with lower secondary education or lower (roughly 50% of the population) would be improved to the average level of health of those with at least higher secondary education. We then calculated various economic effects of those health losses: healthcare costs, costs of social security schemes, losses to Gross Domestic Product (GDP) through reduced labour productivity and the monetary value of total losses in welfare.
Inequality related losses to health amount to more than 700 000 deaths per year and 33 million prevalent cases of ill health in the EU as a whole. These losses account for 20% of the total costs of healthcare and 15% of the total costs of social security benefits. Inequality related losses to health reduce labour productivity and take 1.4% off GDP each year. The monetary value of health inequality related welfare losses is estimated to be €980 billion per year or 9.4% of GDP.
Our results suggest that the economic costs of socioeconomic inequalities in health in Europe are substantial. As this is a first attempt at quantifying the economic implications of health inequalities, the estimates are surrounded by considerable uncertainty and further research is needed to reduce this. If our results are confirmed in further studies, the economic implications of health inequalities warrant significant investments in policies and interventions to reduce them.
为了支持通过跨部门政策解决健康不平等问题，作者探索了欧盟（EU）中健康方面的社会经济不平等造成的经济成本。
利用最新的关于自我评估健康和死亡率不平等的欧盟大部分地区的数据，通过应用反事实情景来计算健康不平等导致的健康损失，在这种情景下，接受过中等以下教育或以下教育的人的健康状况（大致占人口的 50%）将提高到接受过高等中等教育的人的平均健康水平。然后，我们计算了这些健康损失的各种经济影响：医疗保健成本、社会保障计划的成本、由于劳动生产力下降导致国内生产总值（GDP）的损失以及福利总损失的货币价值。
不平等导致的健康损失每年在欧盟造成超过 70 万人死亡和 3300 万例现有疾病。这些损失占医疗保健总费用的 20%和社会保障福利总费用的 15%。不平等导致的健康损失每年降低劳动生产力 1.4%。与健康不平等相关的福利损失的货币价值估计为每年 9800 亿欧元，占 GDP 的 9.4%。
我们的结果表明，欧洲健康方面的社会经济不平等造成的经济成本相当大。由于这是首次量化健康不平等对经济的影响，因此这些估计存在很大的不确定性，需要进一步研究以降低这种不确定性。如果我们的结果在进一步的研究中得到证实，那么健康不平等的经济影响就需要对政策和干预措施进行大量投资以减少不平等。
