Investing in Prevention = Investing in our Future

By Dr. Victoria Lee

Dr. Hancock outlined that increasing our investment in prevention translates into a better health bang for the buck.  This requires us to collectively shift the current paradigm from illness to wellness.  Approximately 78% of illness care costs in acute care are from life-sustaining measures in the final year of life[1].  However, consider that the benefit of every dollar invested in early learning for children far outweighs the costs at 1.5 to 10 times with long lasting social and economic benefits[2].  Children in early childhood education programs are less likely to smoke, drink alcohol and use drugs.  Access to high quality and affordable childcare provides increased family income, and better educated children lead to a more educated workforce for the province2.  However, we dedicate less than 1.5% of the total provincial budget to early childhood education.  BC and Canada are lagging behind other high income jurisdictions in supporting our children.  By increasing our investment in early childhood education and development, we can effectively get “a better health bang for the buck”.

Another shared solution was highlighted by Professor Friel at the recent BC Population Health Network meeting.  Intricate linkages exist between social and economic determinants of health with the physical environment.  Mitigation and adaptation to climate change therefore is not only an environmental issue, but also a significant socioeconomic concern.  Climate change will cost roughly $5 billion per year in 2020 and up to $44 billion per year by 2050[3].  Those in poor housing and working conditions will suffer most in terms of socioeconomic and health impacts (e.g. injury, heat stress, and food insecurity).

“The rich will find their world to be more expensive, inconvenient, uncomfortable, disrupted and colourless – in general, more unpleasant and unpredictable, perhaps greatly so.  The poor will die.”  (Kirk R. Smith, 2008.  Professor, Environmental Health Sciences.  University of California, Berkely)

On the other hand, over consumption and globesity are not only significant health concerns, but are “major drivers of environmental degradation”[4].

Complex health challenges of the 21st century (globesity, climate change and health inequities) require investments upstream that prevent disease, protect health and promote wellness.  Certainly, co-benefits exist for BC, its citizens and all stakeholders to develop a robust provincial poverty reduction plan, to support early childhood education, to reduce environmental impacts within the food system and to create sustainable communities.  Investing in prevention = investing in our future.

– Dr. Victoria Lee is the Co-chair of the Population Health Committee, Health Officers’ Council.

[1] Zhang, B. et al. Health Care Costs in the Last Week of Life Associations with End-of-Life Conversations.  Arch Intern Med. 2009;169(5):480-488. doi:10.1001/archinternmed.2008.587.

[2] TD Economics (2012).  Special Report: Early Childhood Education has Widespread and Long Lasting Benefits.  Available at

[3] National Round Table on the Environment and the Economy (2011).  Paying the Price: the Economic Impacts of Climate Change for Canada.  Available at

[4] Friel, S. Presentation at BCPHN Meeting.  March 19, 2013.  Vancouver, BC.