What are the co-benefits of prevention?

What are co-benefits?

The ‘co-benefits of prevention’ refers to the multiple benefits across different policy or program areas that can arise from a preventive health strategy or initiative. For example, action that aims to prevent chronic disease is also likely to improve productivity, reduce absenteeism and achieve economic benefits for Australia. 1

In the same way, action in other sectors can affect health. For example, promoting active transport to reduce traffic emissions and traffic congestion will also increase levels of physical activity and reduce air pollution, benefitting health.

Addressing the root causes of chronic disease benefits other sectors as well

Many of the root causes of chronic disease – and some of the most effective strategies to prevent chronic disease – lie outside the health sector.

That is because the causes of chronic disease are linked to socio-ecological and commercial factors such as: 2

  • The natural and built environment

  • Community infrastructure and services

  • Marketing and advertising of unhealthy products

  • Income and wealth inequality

  • Education

  • Housing

  • Employment

  • Family situation

Many of these wider determinants of health are influenced by government policies, regulations and laws that sit within other sectors and affect many aspects of people’s lives, including their health.

For example, Australians who live in rural and remote areas with limited access to services and healthy affordable food outlets, or those who experience socioeconomic disadvantage, are at significantly greater risk of chronic disease, as well as poorer educational, professional and social outcomes. 3

Addressing the systemic causes of chronic disease is likely to have benefits in other areas, including social and economic benefits.

Similarly, interventions in other sectors will have benefits for the health of individuals and communities.

Why use a co-benefits approach in policy making?

The promotion and measurement of co-benefits has been championed by the environment movement since the 1990s. The health sector also has a long track record of promoting Health in All Policies. However, the language of co-benefits, and research that simultaneously measures health and other outcomes, are relatively new in the prevention of chronic disease.

Considering the co-benefits of preventive health policies can break down silos and create opportunities for sectors to work together on addressing common causes of a problem. 4 It can help us jointly build the case for investment through articulating shared or aligned goals and supporting strategic alliances.

A co-benefits approach helps policy makers to prioritise action by incorporating multiple benefits in economic analyses of policy interventions. 5,6 It could also help reduce the risk of unintended negative consequences by more systematically considering other effects that may result.

Because a co-benefits approach often addresses systemic causes of health and other outcomes, it can also contribute to reducing inequities in health as well as other social, environmental, economic, cultural and commercial areas of life.

Public policies need to be developed and implemented across sectors by examining issues and outcomes through multiple lenses, with the co-benefits for all engaged partners considered during the process.

– National Preventive Health Strategy 2021–2030

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Examples of the co-benefits of prevention

Example 1: Creating liveable cities and neighbourhoods 7

Measures to create a more liveable built environment result in improved health through increased physical activity, reduced pollution and better social connection. Liveable cities provide people with better access to healthy options (food, health care, including mental health care) and reduced exposure to factors that hamper health (alcohol, illicit drugs, unhealthy foods and drinks), violence and crime.

Creating liveable cities also has the potential to strengthen the economy and enhance environmental sustainability.

For example, increasing active travel reduces costs and greenhouse gas emissions related to vehicle usage. It results in less traffic congestion and reduces reliance on cars. Addressing liveability leads to better planned and more sustainable cities.

Example 2: Mitigating climate change 8

Bushfires, air pollution, heat and extreme weather events all impact our lives, livelihoods, and mental and physical health and wellbeing.

Addressing climate change through interventions such as encouraging use of renewable energy and energy efficiency, eating locally-produced food and reducing consumption of animals may also result in improved mental health, lower rates of cancer, fewer deaths from extreme heat, lower rates of obesity, less cardiovascular disease and less respiratory disease.

These interventions will also have co-benefits for the environment:

  • Less fossil fuel use
  • Reduced damp and humidity
  • Increased thermal comfort
  • Less noise pollution
  • Improved air quality
  • Reduced heat in urban areas
  • Lower CO2 and other greenhouse gas emissions
  • Less deforestation
  • Reduced livestock production
  • Fewer methane emissions.

Example 3: Co-benefits of preventing alcohol-related harm 9

Evidence shows we can effectively reduce alcohol-related harm, especially through multiple strategies that target different parts of the health system as well as the drivers of alcohol use.

These strategies are also likely to have positive benefits on non-healthcare costs incurred by, for example, road crashes, police, criminal courts, prisons, child protection and out-of-home community services.

The National Drug Research Institute has assessed that preventing alcohol-related harm could increase workplace productivity by $4 billion in Australia. 10

Effective strategies include reducing alcohol availability (for example, reducing the number of licensed retail outlets, bars and pubs, and restricting the trading hours of licensed venues), settings-based programs (for example, in sports clubs), and actions aimed at priority populations. Combinations of interventions are more likely to be effective.

Example 4: Settings-based health promotion and interventions

Settings-based health promotion and interventions can incur co-benefits for other sectors.

For example, physical activity and nutrition interventions in schools have been shown to improve: 11,12

  • academic performance
  • behaviour
  • concentration and focus
  • interaction and play during recess
  • equity.

Interventions in the workplace that benefit the health of individuals can also result in co-benefits for business and the economy, such as improved productivity. Workplace interventions have been shown to improve the health and wellbeing of all employees as well as those living with chronic disease.

Preventing chronic disease in the workplace can lead to: 12

  • Reduced absenteeism
  • Reduced presenteeism (people working at less than their full capacity due to disease or illness)
  • More years spent at work
  • Less income lost due to disease and premature death.

Multi-duty actions

Multi-duty actions is another way of talking about interventions that are likely to create co-benefits for health and wellbeing as well as the economy, environment and other areas of our lives.

The Lancet suggests policy makers adopt ‘triple-duty’ actions that have potential to impact on three global problems of obesity, undernutrition and climate change as a way to reorient human systems to achieve better human and planetary health. 4

A planning meeting in a bright modern office.

An example of a triple-duty action is shifting to active transport modes. This can:

  • Lower obesity and chronic disease through increased physical activity

  • Provide cheaper transport and support access to local, healthy food to reduce undernutrition

  • Address climate change through reduced greenhouse gas emissions.

Demonstrating the value of prevention through measuring co-benefits

To support decision making and make the case for investment in prevention, researchers and policymakers need to report and measure the full range of outcomes and co-benefits of policies, including health and non-health benefits.

Most evaluations, reviews and syntheses of health prevention do not currently identify co-benefits or measure them as primary or secondary outcomes. Similarly, most evaluations and reviews of interventions initiated and/or led by other sectors do not identify health or wellness outcomes. This makes it difficult for health researchers and governments to quantify and measure these health-related and other co-benefits.

To improve the evidence base and make a more compelling case for prevention, we should include health co-benefits as outcomes when designing, implementing and evaluating non-health sector initiatives. 12  We should also include other co-benefits as outcomes when designing, implementing and evaluating preventive health interventions.

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Find out more

The following framework documents may help you identify and measure co-benefits.

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  1. Productivity Commission. 2017. Shifting the Dial: 5 Year Productivity Review. Report No. 84. Canberra.
  2. Commonwealth of Australia. 2021.National Preventive Health Strategy 2021–2030.
  3. NHPS, Australian Institute of Health and Welfare. 2021. Australia’s welfare 2021 data insights. Australia’s welfare series no. 15. Canberra: AIHW; Lewis M, McNaughton SA, Rychetnik L, Chatfield MD, Lee AJ. Dietary Intake, Cost, and Affordability by Socioeconomic Group in Australia. Int J Environ Res Public Health. 2021 Dec 17;18(24):13315. doi: 10.3390/ijerph182413315
  4. Swinburn BA, Kraak VI, Allender S, Atkins VJ, Baker PI, Bogard JR, Brinsden H, Calvillo A, De Schutter O, Devarajan R, Ezzati M, Friel S, Goenka S, Hammond RA, Hastings G, Hawkes C, Herrero M, Hovmand PS, Howden M, Jaacks LM, Kapetanaki AB, Kasman M, Kuhnlein HV, Kumanyika SK, Larijani B, Lobstein T, Long MW, Matsudo VKR, Mills SDH, Morgan G, Morshed A, Nece PM, Pan A, Patterson DW, Sacks G, Shekar M, Simmons GL, Smit W, Tootee A, Vandevijvere S, Waterlander WE, Wolfenden L, Dietz WH. The Global Syndemic of Obesity, Undernutrition, and Climate Change: The Lancet Commission report. Lancet. 2019 Feb 23;393(10173):791-846. doi: 10.1016/S0140-6736(18)32822-8. Epub 2019 Jan 27. Erratum in: Lancet. 2019 Feb 23;393(10173):746.
  5. Giles-Corti B, Foster S, Shilton T, Falconer R. The co-benefits for health of investing in active transportation. NSW Public Health Bull. 2010 May-Jun;21(5-6):122-7. doi: 10.1071/NB10027. PMID: 20637168.
  6. Ananthapavan J, Moodie M, Milat A, Veerman L, Whittaker E, Carter R. A cost-benefit analysis framework for preventive health interventions to aid decision-making in Australian governments. Health Res Policy Syst. 2021 Dec 19;19(1):147.
  7. The importance of healthy liveable cities. Web page.
  8. Victoria Department of Health. 2020. Tackling climate change and its impacts on health through MPHWP – Guidance for local government 2020.
  9. Crosland P, Howse E, Heenan M, Mohamad Asfia SKB, Dona SWA, Angeles MR, West R, Rychetnik L. 2022. The value of primary prevention to reduce alcohol consumption, an evidence check rapid review. The Australian Prevention Partnership Centre, Sydney.
  10. Whetton S, Tait RJ, Gilmore W, Dey T, Agramunt S, Abdul Halim S, McEntee A, Mukhtar A, Roche A, Allsop S, Chikritzhs T. Examining the Social and Economic Costs of Alcohol Use in Australia: 2017/18, Perth, WA, National Drug Research Institute, Curtin University 2021.
  11. Howse, E, Crosland, P, Rychetnik, L, Wilson, A. The value of prevention: An evidence check rapid review. Brokered by the Sax Institute for the Centre for Population Health, NSW Ministry of Health. Sydney, Australia: The Australian Prevention Partnership Centre, 2021.
  12. Bellew B, Nau T, Smith B, Bauman A (Eds.). Getting Australia Active III: A systems approach to physical activity for policy makers. Sydney, Australia. The Australian Prevention Partnership Centre and The University of Sydney. April 2020.

Page header photo creative credit: Claudine Thornton Creative, using eucalyptus blooms on the shorelines of Minjerribah (North Stradbroke island)