Welfarist and Non-Welfarist Conceptions of \"Health Promotion”

Although \"health promotion\" programs account for only a small proportion of health spending in OECD countries (OECD, 2000), their components (anti-smoking, pro-exercise and vaccination campaigns, for example) are often highly visible instruments of health policy. Furthermore, the case for increased spending on such programs is likely to intensify if evidence of (i) their effectiveness; and (ii) diminishing returns to spending on other categories of health services (e.g., curative and acute medical services), grows. Economists\' contributions to the literatures on, inter alia, (i) rational addiction; (ii) (licit and illicit) drug use; (iii) health production; and (iv) health sector economic evaluation; are pertinent to this health sub-sector. However, no integrated economic conception of the field of health promotion has been produced. This paper provides such an account: the instruments and targets of health promotion are analysed in an integrated framework by drawing on concepts from the public economics and health economics literatures. The analyses emphasise the material differences in welfare outcomes that can arise, depending on whether the objective of a health promotion program is to maximise welfare, or to pursue another, e.g. health-stock, objective.