Underlying Principles of Different Schools of Economic Thought: Consequences for Health Promotion Research

Can health economics be both more conservative and more radical than it seems at first sight? The answer is yes, once one recognises how diverse the discipline really is. Rational choice tends to dominate economic thinking, but there are alternative schools of thought, as well as differences in perspective even among economists who identify with the mainstream. Different schools of thought adhere to different sets of principles. These shape the economist's view of the value of health promotion, determine what costs and benefits will be included in an evaluation and influence the conclusions that will be drawn and the advice that will be passed on to decision-makers. The differences and debates among the various schools of economic thought may appear rather abstract at times, but if health economists are to be held to account for the results of their work, then it is essential that health promotion practitioners and researchers are familiar with the arguments. To that end, we describe four contested views, summarising the essential principles on which each is based, and discussing the impact these principles have on each perspective's appreciation of the role and value of health promotion.