Communicating Health Through Health Footprints

Abstract

The depth and scale of challenges posed by noncommunicable diseases such as diabetes mellitus and cardiovascular disease are now well known and clearly documented. Reducing the 4 key risk factors has been shown to reduce premature mortality and morbidity by 70% globally. The authors consider how affirmative action can be driven to reduce these risk factors through Health Footprints, targeted interventions within specific domains of consumption, on the basis of an assessment of the negative health effect of specific choices, with the goal of driving healthy choices and improving health. In this article, the authors propose a methodology that ties together insight from public health, behavioral economics, marketing, and health communication. They offer 3 specific examples for affirmative action: a Pigovian tax on unhealthy foods, group-level interventions on the basis of sharing key health data, and personalized prevention tailored to specific individuals. In addition, they discuss the approach to implementation, including the role of an apex coordinating organization in setting standards for data and ethics, and evaluation of the effect of interventions to drive continuous improvement.

Acknowledgments

The opinions expressed and the data communicated in this article are those of the authors only and do not necessarily reflect the views of the World Economic Forum or of all the members of the Global Agenda Council on Non-Communicable Diseases.

The authors thank the members of the World Economic Forum Global Agenda Council for Chronic Diseases and Wellbeing for providing a platform for discussing the concepts developed in this article. In particular, the authors acknowledge the leadership of the Chairmen from 2009–2010 (Prof. Cary Cooper) and 2010–2011 (Dr. Mirta Roses Periago) and the support provided by the World Economic Forum representative, Eva Jané-Llopis. In addition, the authors acknowledge the support of Prof. Paul Dolan from the London School of Economics who provided significant support for this article on economics and behavioral economics.

Notes

¹“Calories for Nutrients (CFN) provides an index of how many calories are required to obtain an additional 1% of the recommended daily values of 13 key nutrients. Low scores correspond to relatively healthy items, as fewer calories are needed to obtain key nutrients; high scores indicate less healthy items, as more calories are needed to obtain these nutrients.” Epstein LH, Dearing KK, Roba LG and Finkelstein E (2010). The Influence of Taxes and Subsidies on Energy Purchased in an Experimental Purchasing Study. Psychological Science; published online February 5, 2010.

²Kahneman D. Two big things happening in psychology today. 2008.

³Hippocrates, Hippocratic writings. Edited, with introduction by GER Lloyd. Harmondsworth (Penguin), 1978, 168.

⁴According to the OECD, externalities refers to situations when the effect of production or consumption of goods and services imposes costs or benefits on others which are not reflected in the prices charged for the goods and services being provided (see http://stats.oecd.org/glossary/detail.asp?ID=3215).

⁵See http://www.financenews.co.ukfnews/fat-tax-could-sting-the-uk-as-early-as-2012.

⁶According to Wikipedia, a Pigovian tax (also called a Pigouvian tax) is a tax levied on a market activity that generates negative externalities. The tax is intended to correct the market outcome. In the presence of negative externalities, the social cost of a market activity is not covered by the private cost of the activity. In such a case, the market outcome is not efficient and may lead to over-consumption of the product. A Pigovian tax equal to the negative externality is thought to correct the market outcome back to efficiency (see http://en.wikipedia.org/wiki/Pigovian_tax.).

⁷World Trade Organisation's General Agreement on Tariffs and Trade, Article XX (see http://www.gatt.org)

⁸See http://www.quitext.com/Default.aspx.

⁹See http://www.healthvault.com/personal/index.aspx.

¹⁰See http://www.google.com/health.

¹¹See http://www.patientsknowbest.com.

¹²See http://www.datadyne.org.

¹³See http://en.wikipedia.org/wiki/World_Wide_Web_Consortium.

¹⁴See http://en.wikipedia.org/wiki/Hipaa.

¹⁵See http://en.wikipedia.org/wiki/Caldicott_principles#Caldicott_principles.

¹⁶See http://en.wikipedia.org/wiki/Helsinki_Accords.

¹⁷See http://en.wikipedia.org/wiki/Nuremberg_Code.