TABLE 3.

Challenges in conducting economic studies on health emergencies and disasters

Challenges	Contents
Attributing consequences to interventions	It is difficult to precisely attribute an economic impact or health outcome to a specific cause, particularly if researchers cannot establish a clear counterfactual for comparison. Health emergencies and disasters can make this even more challenging, due to their complex and cascading impacts. 38
Measuring the economic value of consequences	It is difficult to measure and create a combined economic value to reflect people's preferences for both health and non‐health consequences. Some comparison measures exist, like willingness to pay or quality‐adjusted life years (see Table 5), but they offer imperfect reflections of a person's health and wellbeing. 39
Accounting for net impact over time	It is difficult to immediately account for potential indirect harms or negative spillover effects associated with a specific health emergency and the responses that are implemented under pressure to save lives. 30 Accounting for different impacts over time comes with challenges, such as how to deal with increasing levels of uncertainty or how to account for discounting, which reflects the difference in preferences for an immediate outcome versus one further in the future. 40

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