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Responsibility-sensitive welfare weights for health.

Matthew Robson1, Owen O'Donnell2, Tom Van Ourti3

  • 1Erasmus School of Economics, Erasmus University Rotterdam, Tinbergen Institute, The Netherlands.

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|June 23, 2025
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This study quantifies public health preferences, revealing a strong preference for non-smokers' health and moderate support for poorer individuals. Aversion to health inequality influences these welfare weights.

Keywords:
Cost-effectiveness analysisEquityEthical preferencesExperimentInequality aversionPrioritisation

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Area of Science:

  • Health Economics
  • Public Health Policy
  • Social Welfare Analysis

Background:

  • Evaluating health programs requires understanding societal preferences for health outcomes.
  • Societal values regarding health equity and inequality are crucial for resource allocation.
  • Existing research often lacks responsibility-sensitive weighting for health.

Purpose of the Study:

  • To estimate welfare weights for health, incorporating aversion to health inequality and inequity.
  • To assess how societal preferences vary based on non-health characteristics like sex, income, and smoking status.
  • To investigate the influence of perceived responsibility on health-related welfare weights.

Main Methods:

  • An online experiment with 569 UK participants distributing constrained resources.
  • Assessing health outcomes for hypothetical individuals with varying productivity, sex, income, and smoking habits.
  • Eliciting beliefs about responsibility for income and smoking to inform responsibility-sensitive health weights.

Main Results:

  • Weak prioritization of females' health, moderate prioritization of poorer individuals' health.
  • Strong prioritization of non-smokers' health over smokers' health.
  • Health inequality aversion reduced weights for females and non-smokers, while increasing weights for the poor.

Conclusions:

  • Societal preferences for health are influenced by inequality aversion and perceived responsibility.
  • Beliefs about responsibility significantly alter health welfare weights, particularly for smokers and the poor.
  • Findings inform health program evaluation and resource allocation, emphasizing equity and individual responsibility.