Health and wellbeing : identifying causal effects

Abstract

Improving people’s health constitutes an important public-sector goal with hefty budgets in many countries of the world. This chapter assesses the evidence on the presence, direction, and magnitude of the effect of health on wellbeing. Health indicators are a ubiquitous feature of so-called objective measures of wellbeing and, by these accounts, improvements registered in health directly translate to improvements in wellbeing. But in assessing the impact of health on subjective wellbeing, it is necessary to rely on methods that allow for the identification of causal effects. The studies reviewed in this chapter provide evidence that better health and health interventions can lead to better wellbeing outcomes, but they also reveal disparities in these outcomes depending on the type of health issue, how health is measured, the type of intervention and the demographic targeted. The study concludes that policy-makers should seek to disentangle the wellbeing impacts of health interventions and to reflect on the relative importance of both health and wellbeing in assessing the cost effectiveness of interventions. In turn, impacts may be identified through carefully designed impact studies that overcome overlaps in the definitions of health and wellbeing, which account for both direct and indirect effects of health on wellbeing and that consider the reverse causality of wellbeing on health.