Measuring the Health of Young Children

Health economists have been developing measures of children's health such as the EQ-5D-Y and the EQ-TIPS. Because it is infeasible to assign values to the health states of children, especially very young children, by eliciting their preferences, economists have elicited adult preferences among the health states of children as proxies for children's preferences. This essay argues that those efforts are misconceived. Infants and toddlers do not have preferences among most health states, and whatever preferences they may have should not determine the values of their health states. There is even less justification for allowing adult imagining of children's preferences to determine the value of children's health states. Fortunately, the precision of the values assigned to the health states of young children is of little importance and does not justify an investment of significant resources. Despite their inaccuracy, adaptations of the values of the health states of adults or older children are adequate for the purposes of determining cost-effectiveness of health policies.