Economic appraisal of public health interventions

Over a long period, there has been an overall improvement in the aggregate health of the population. However, at the heart of public health is a conundrum – as the overall health of the population has improved, in the most recent past, inequalities in health have worsened. Despite a vast literature on the determinants of health, specific analysis of the determinants of inequalities in health is underdeveloped. And there is relatively little evidence of what interventions will work to reduce inequalities in health. Consequently the baseline for analysis of effectiveness is limited. The most comprehensive analysis is in the HDA’s Evidence Briefings (Kelly, 2004; www.hda-online.org.uk/evidence). Relationship between upstream and downstream interventions