Measuring the Societal Impact of Behavior Choices

Social marketing has a key role to play in helping to shape the choices people make and supporting the decisions and actions that determine their health and well-being. These choices have a broad impact on society, affecting not only the quality of life of individuals and communities and the cost of public services, but also the performance of business and the economy. In this article we discuss how the impact of behavior choices and the interventions that support them can be evaluated. We briefly set out the problems of measuring the cost effectiveness of behavior choice interventions and propose an approach to these challenges. The article illustrates how a pragmatic, layered framework for evaluating cost effectiveness can be developed and applied in five fields in which positive behavior choices can prevent illness (alcohol misuse, smoking, obesity, coronary vascular disease, and mental health). The review identifies the value of a quality adjusted life year in each of these fields and uses these estimates to generate “return on investment” for typical projects, at different levels in society (individual and family, health and care services, other public sector, private sector, and wider society). Finally we propose a consensus conference to develop and apply such a framework.