An economic evaluation of the expanded food and nutrition education program.
OBJECTIVE
To evaluate the New York State Expanded Food and Nutrition Education Program using economic methodology.


METHODS
Data were collected by nutrition educators in a pretest, posttest design with an epidemiological modeling approach to assess costs and estimate potential health benefits of the state program.


METHODS
Cooperative Extension, 35 counties.


METHODS
5730 low-income participants.


METHODS
Series of 6 or more food and nutrition lessons.


METHODS
Cost (program and participant); health benefits in quality adjusted life years (QALYs); and monetized benefits: society's willingness to pay for QALYs, and benefits of avoiding or delaying health care costs and loss of productivity.


METHODS
Cost-effectiveness estimated from behavior change and QALY weights. Cost-benefit ratios estimated from costs and monetized benefits. Sensitivity analyses provided ranges where lack of agreement exists around parameters' values.


RESULTS
Cost was $892/graduate. Cost-effectiveness was 245 QALYs saved, at $20863/QALY (sensitivity 42-935 QALYs, $5467-$130311 per QALY). Societal willingness to pay benefit-to-cost ratio was $9.58:$1.00 (sensitivity $1.44-$41.92:$1:00); narrow governmental benefit-to-cost ratio was $0.82:$1.00 (sensitivity $0.08-$4.33:$1:00).


CONCLUSIONS
Outcome data indicate that food and nutrition behavior changes resulting from the Program are likely to improve future health and reduce health care costs. Cost-effectiveness is estimated to be as great as for many current health interventions.
Dollahite
Jamie
J
Division of Nutritional Sciences, Cornell University, Ithaca, New York 14853, USA. jsd13@cornell.edu
Kenkel
Donald
D
Thompson
C Scott
CS
D003362:Cost-Benefit Analysis; D017048:Health Care Costs; D006266:Health Education / Q000191:economics*; D009518:New York; D052756:Nutritional Sciences / Q000191:economics* / Q000193:education*; D011203:Poverty; D015397:Program Evaluation; D011788:Quality of Life