Understanding the health and economic impact of behavioural risk factors for chronic disease

By Nirmali Sivapragasam, AusHSI PhD Scholar

My journey into the field of health economics and health services research started in 2013 after completing my master’s degree in public policy from the National University of Singapore and bachelor’s degree in economics and management from the London School of Economics (International Programs). Over the last 12 years, I have worked on projects in Singapore, Sri Lanka, Cambodia and Australia, in the areas of health financing, health services research and global health.

Before joining AusHSI, I was a senior research associate and project manager at Duke-NUS Medical School’s Signature Program in Health Services and Systems Research in Singapore. I led and contributed to projects in the areas of economic evaluation, data linkages with electronic medical records, implementation science and global health. This diverse experience in health services and systems research reinforced my decision to pursue postgraduate training in the field.

I am particularly interested in research exploring preventive healthcare services as a way of improving population health and reducing healthcare costs. By identifying and addressing health risks early through initiatives including risk screenings, health education, and lifestyle interventions, preventive care can help delay and prevent the onset of chronic conditions such as cardiovascular disease.

With support from my supervisors at AusHSI, I am fortunate to have received industry funding from Queensland Public Health and Scientific Services at Queensland Health to carry out my PhD research project. My research explores relationships between modifiable and behavioural risk factors for chronic disease, health-related quality of life (HRQoL) and healthcare costs.

My first study was a review to understand how three major risk factors for chronic diseases—body weight, smoking, and alcohol use—are associated with people’s quality of life. To the best of our knowledge, this is the first study of its kind to pool estimates on HRQoL across these three modifiable risk factors. The study results can be applied to health economic evaluation models, especially those that focus on preventing illness.

The next stage of my research focuses on helping make sure that health programs are not only good for people, but also a smart use of public money. I am creating a way to translate results between two popular tools that measure quality of life, which helps make different health studies easier to compare. I will then explore how lifestyle choices—like smoking, drinking, or being inactive—affect people’s health and healthcare costs over time, using real data from adults in Australia. I will use all these findings to evaluate a government program in Queensland that encourages healthier living in groups of people at higher risk of chronic disease.

My overall aim is to improve how we measure and understand the impact of chronic disease risk factors on people’s health, and the costs of keeping them healthy. By developing tools to compare different ways of measuring quality of life, and by studying how lifestyle factors like smoking, harmful drinking, and obesity affect both health and costs over time, my research helps ensure that health interventions are evaluated fairly and accurately. This is important for policymakers and clinicians, who rely on this information to decide which programs are worth funding and implementing. Most importantly, this work benefits patients by supporting the design of more effective health programs, especially for those at higher risk. Better decisions lead to better care, better use of resources and improved quality of life, ensuring that patients receive the right support at the right time.