Supriya Lahiri

Barriers to Implementation of Workplace Health Interventions: An Economic Perspective

Objective: To identify insurance related, structural, and workplace cultural barriers to the implementation of effective preventive and upstream clinical interventions in the working age adult population. Methods: Analysis of avoided costs from perspective of health economics theory and from empiric observations from large studies; presentation of data from our own cost-plus model on integrating health promotion and ergonomics. Results: We identify key avoided costs issues as a misalignment of interests between employers, insurers, service institutions, and government. Conceptual limitations of neoclassical economics are attributable to work culture and supply-driven nature of health care. Discussion: Effective valuation of avoided costs is a necessary condition for redirecting allocations and incentives. Key content for valuation models is discussed.

Cost-effectiveness of a workplace-based incentivized weight loss program.

Objective: To evaluate the cost-effectiveness ratios of a nursing home–based incentivized Behavioral Weight Management Program (BWMP) from the employers perspective. Methods: Seventy-two overweight and obese health care workers completed the BWMP (n = 35 incentivized; n = 37 nonincentivized). Weight change outcomes were compared for the pre- (0) and postintervention (28 weeks) follow-up periods within and between sites. Comprehensive estimates of BWMP direct program costs and avoided costs of absenteeism and productivity improvements were estimated to evaluate a business case. Results: There was a significant difference (P = 0.01) between the average per-participant weight change between incentivized sites (−7.4 lb) and nonincentivized sites (−2.2 lb). The cost-effectiveness ratios per pound of weight loss were

Short-run energy-economy interactions in Egypt

25.5 and

A Review of Employment Conditions as Social Determinants of Health Part II: The Workplace

58.1, respectively. Conclusions: In general, incentivized BWMPs were more cost effective. To generate a business case, enhancement in productivity becomes a critical factor and future research needs to investigate it further.

A business case evaluation of workplace engineering noise control: a net-cost model.

Abstract This paper discusses the short-run adjustment mechanism of the Egyptian economy to changes in the domestic price of oil. The effects of oil price increases have been analysed in the framework of a short-run macroeconomic model with an explicit treatment of energy. The results suggest that a reduction in petroleum use induced by a rise in the price of oil will impose difficult adjustment problems for the economy in the short run in terms of increase in inflation, fall in the share of wage income and sharp output losses. The analysis also indicates that energy demand management through appropriate petroleum pricing strategy cannot bring about desirable impacts on the economy unless efforts are made to reduce cost pressures originating from other energy sectors.

Is There an Economic Case for Training Intervention in the Manual Material Handling Sector of Developing Countries

This is the second part of an article on employment conditions as social determinants of health and health inequalities. In part I of this article, we explored structural (external) employment conditions that affect health inequalities and health gradients. In this article, we try to examine the internal aspects of employment conditions that affect the same variables. It is not our intention to “box” employment conditions in a rigid framework within an internal domain of person-hazard interaction. The objective of examining this variable is to scrutinize internal aspects of employment conditions at a comprehensive policy level in conjunction with external contextual variables. Major occupational health concerns are examined in relationship to globalization, child labor, and work in the formal and informal sectors. Interventions that can eliminate or greatly reduce these exposures as well as those that have been unsuccessful are reviewed. Innovative interventions including work organization change, cleaner production, control banding, national and international coalitions, participatory training, and participatory approaches to improving the work environment are reviewed.

Employment Conditions as Social Determinants of Health Part I: The External Domain

Objective: This article provides a convenient tool for companies to determine the costs and benefits of alternative interventions to prevent noise-induced hearing loss (NIHL). Methods: Contextualized for Singapore and in collaboration with Singapores Ministry of Manpower, the Net-Cost model evaluates costs of intervention for equipment and labor, avoided costs of productivity losses and medical care, and productivity gains from the employers economic perspective. Results: To pilot this approach, four case studies are presented, with varying degrees of economic benefits to the employer, including one in which multifactor productivity is the main driver. Conclusion: Although compliance agencies may not require economic analysis of NIHL, given scarce resources in a market-driven economy, this tool enables stakeholders to understand and compare the costs and benefits of NIHL interventions comprehensively and helps in determining risk management strategies.

An Economy-wide Energy Policy Model for Egypt

Objective: To estimate cost-effectiveness ratios and net costs of a training intervention to reduce morbidity among porters who carry loads without mechanical assistance in a developing country informal sector setting. Methods: Pre- and post-intervention survey data (n = 100) were collected in a prospective study: differences in physical/mental composite scores and pain scale scores were computed. Costs and economic benefits of the intervention were monetized with a net-cost model. Results: Significant changes in physical composite scores (2.5), mental composite scores (3.2), and pain scale scores (−1.0) led to cost-effectiveness ratios of

Planning for the Subernarekha river system in eastern India

6.97,

Cost–benefit analysis of overhead lift use peer coaching

5.41, and