Shining lights: studies that have most influenced the understanding of health promotion's financial impact.

Purpose: To examine the literature from the past 20 years and identify those studies that support the economic merit of health promotion.

Data Source: A panel of experts was used to identify the top studies supporting the purpose of this article.

Study Inclusion And Exclusion Criteria: Studies were chosen based on the following criteria: the study (1) examined the relationship between health risks and financial outcomes, or health promotion programs and financial outcomes; (2) provided strong and compelling financial data supporting the worth of health promotion; (3) had a high-quality methodology; (4) answered an important question or replicated important findings with superior methodology; and (5) represented U.S.-based initiatives published since 1980. After initially nominating a group of studies for consideration, panelists rated each on a scale from 1 to 3 representing their opinion of importance. Studies rating the highest were included for this discussion.

Data Extraction Methods: Studies were analyzed by population characteristics, design, statistical tests, limitations, and results. This information was summarized for each identified article.

Major Conclusions: A relationship between modifiable health risk factors and health care costs is supported by research. Health promotion interventions appear to provide positive financial returns, most notably for health care costs and absenteeism reduction. Private sector initiatives seem to be driving economic-based research. Overall, health promotion shows promising results for providing financial advantages for its sponsors; however, if this discipline is to show its true worth, considerable funding is needed from government or philanthropic sources to cover the substantial costs of quality research.