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Shiell will combine economics and health care with help from his new grant.
the Gauntlet

Health care gets another boost

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Canadians generally don't think of their health in terms of economic value, but a University of Calgary researcher is proposing that it might be time.

Population Health Intervention Research Centre chair Dr. Alan Shiell recently received one of 14 Canadian Institutes of Health Research national grants to further his research in the economics of public health care.

"I'm an economist and I've always done health economics," he said. "In the past 15 years or so I've specialized in public health--so prevention, health promotion and the like."

Shiell's grant will total $925,000 over the next five years and will primarily fund his salary. Unlike some researchers at the university, Shiell does not receive income from the school. This grant will free him from teaching and give him an office to work on other research proposals. CIHR's total grant announcement of $298 million was broken up into 764 health research projects across Canada.

Shiell's recent work includes a chapter in Canada West Foundation's Alberta's Energy Legacy: Ideas for the Future titled "An Apple a Day." It was written with colleague Dr. Penny Hawe.

"They asked 11 people to come up with big ideas for how to invest Alberta's energy legacy--the revenue Alberta is generating from its oil resources," said Shiell.

The foundation would use the money to improve the quality of life for Albertans. While Shiell and Hawe focused on public health, other chapters made recommendations for transportation, cultural innovations and a transfer to green energy.

"Canadians, in general, have a very strong sense of entitlement to health care," explained Shiell. "We're very concerned and we make sure that we get the best quality and the best health care that's available. But there isn't the same kind of drive for health promotion, for preventative services. The suggestion was that we should invest in a system for health promotion much like our system of health care."

Shiell argues that once Albertans compare the care they currently receive with what can be done, there will be a new sense of entitlement for an improved health care system and the government will be forced into action. Shiell hopes to examine which health programs are less effective and determine the effect of transferring the funding to more effective programs. He will make computer models to determine the impact on the incidences of disease, life expectancy and quality of life.

"A lot of economics is doing cost-benefit studies--what do particular things cost and what benefits do we get back out in terms of health improvements," said Shiell. "Which things are more worthwhile doing? Should we be investing in hip replacements or heart surgery?"

Shiell explained people are healthy because of different daily routines, not what happens in hospitals. Work, education and community all affect the standard of living and, therefore, quality of health.

"We know very little about the cost of improving these social conditions or the impact changing them has on peoples' health," said Shiell. "The flagship project is work where we're looking at peoples' neighborhoods and how the characteristics of where you live affect whether you walk or are active or not."

He hypothesizes the presence of parks, cafes and sidewalks will improve general health and reduce the need for doctors and emergency procedures. He is hoping the Calgary Health Region and city will work together on these goals.

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