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Reasons for distributional preferences for health outcomes: A mixed method interview study
Kyoko Shimamoto1, Aki Tsuchiya2
1School of Health Management and Keio Global Research Institute (KGRI), Keio University, Tokyo, Japan; Department of Health Sciences, University of York, York, United Kingdom.
Summary
Public health policy requires understanding how people balance health improvements against reducing socioeconomic health inequality. This study used mixed methods to explore Japanese public preferences and reasoning, finding complex and sometimes contradictory motivations.
Area of Science:
- Public Health
- Health Economics
- Social Determinants of Health
Background:
- Policymakers require data on public valuation of health equity versus efficiency.
- Existing quantitative Benefit Trade-Off (BTO) studies lack qualitative insights into public health preferences.
- Understanding public distributional preferences is crucial for health policy design.
Purpose of the Study:
- To elicit Japanese public preferences on socioeconomic inequality in lifetime health using BTO tasks.
- To qualitatively explore the reasoning behind these health equity and efficiency trade-offs.
- To provide mixed-method evidence on public health valuation.
Main Methods:
- A mixed-method study involving 50 individual online interviews in Japan (2022).
- Utilized Benefit Trade-Off (BTO) tasks to quantify preferences.
- Incorporated qualitative questions to understand participant reasoning and motivations.
Main Results:
- The median participant exhibited inequality aversion, favoring a prioritarian approach.
- Qualitative findings revealed non-health considerations (e.g., tax contributions) and self-interested motivations.
- Observed deviations from standard BTO assumptions, including indecisiveness and inconsistent reasoning.
Conclusions:
- This is the first mixed-method study combining BTO tasks with in-depth qualitative analysis of public health preferences.
- Participant reasoning showed similarities to previous studies but also unique aspects, including gender and regional variations.
- Identified coherent explanations for seemingly contradictory behaviors like 'inequality seeking'.
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