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Eliciting the level of health inequality aversion in England

Author

Listed:
  • Matthew Robson

    (Department of Economics and Related Studies, University of York, UK.)

  • Miqdad Asaria

    (Centre for Health Economics, University of York, UK.)

  • Richard Cookson

    (Centre for Health Economics, University of York, UK.)

  • Aki Tsuchiya

    (Department of Economics and School of Health and Related Research, University of Sheffield, UK.)

  • Shehzad Ali

    (Centre for Health Economics and Department of Health Sciences, University of York, UK.)

Abstract

Policy makers faced with equality-efficiency trade-offs can articulate the nature and extent of their health inequality aversion using social welfare functions. In this study we use data from an online survey of the general public in England (n=246) to elicit health inequality aversion parameters by numerically solving Atkinson and Kolm social welfare functions. We elicit median inequality aversion parameters of 10.95 for Atkinson and 0.15 for Kolm. These values suggest substantial concern for health inequality among the English general public which, at current levels of quality adjusted life expectancy, implies weighting health gains to the poorest fifth of people in society six to seven times as highly as health gains to the richest fifth.

Suggested Citation

  • Matthew Robson & Miqdad Asaria & Richard Cookson & Aki Tsuchiya & Shehzad Ali, 2016. "Eliciting the level of health inequality aversion in England," Working Papers 125cherp, Centre for Health Economics, University of York.
  • Handle: RePEc:chy:respap:125cherp
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    References listed on IDEAS

    as
    1. Abasolo, Ignacio & Tsuchiya, Aki, 2004. "Exploring social welfare functions and violation of monotonicity: an example from inequalities in health," Journal of Health Economics, Elsevier, vol. 23(2), pages 313-329, March.
    2. Kolm, Serge-Christophe, 1976. "Unequal inequalities. II," Journal of Economic Theory, Elsevier, vol. 13(1), pages 82-111, August.
    3. Stanislav Kolenikov, 2010. "Resampling variance estimation for complex survey data," Stata Journal, StataCorp LP, vol. 10(2), pages 165-199, June.
    4. Wagstaff, Adam, 1991. "QALYs and the equity-efficiency trade-off," Journal of Health Economics, Elsevier, vol. 10(1), pages 21-41, May.
    5. Ignacio Abásolo & Aki Tsuchiya, 2013. "Is more health always better for society? Exploring public preferences that violate monotonicity," Theory and Decision, Springer, vol. 74(4), pages 539-563, April.
    6. Abasolo, Ignacio & Tsuchiya, Aki, 2004. "Exploring social welfare functions and violation of monotonicity: an example from inequalities in health--a reply to Jan Abel Olsen," Journal of Health Economics, Elsevier, vol. 23(2), pages 333-334, March.
    7. Miqdad Asaria & Susan Griffin & Richard Cookson & Sophie Whyte & Paul Tappenden, 2015. "Distributional Cost‐Effectiveness Analysis of Health Care Programmes – A Methodological Case Study of the UK Bowel Cancer Screening Programme," Health Economics, John Wiley & Sons, Ltd., vol. 24(6), pages 742-754, June.
    8. Miqdad Asaria & Susan Griffin & Richard Cookson, 2013. "Distributional cost-effectiveness analysis: a tutorial," Working Papers 092cherp, Centre for Health Economics, University of York.
    9. Dolan, Paul & Tsuchiya, Aki, 2009. "The social welfare function and individual responsibility: Some theoretical issues and empirical evidence," Journal of Health Economics, Elsevier, vol. 28(1), pages 210-220, January.
    10. Attema, Arthur E. & Brouwer, Werner B.F. & l’Haridon, Olivier & Pinto, Jose Luis, 2015. "Estimating sign-dependent societal preferences for quality of life," Journal of Health Economics, Elsevier, vol. 43(C), pages 229-243.
    11. Richard Edlin & Aki Tsuchiya & Paul Dolan, 2012. "Public Preferences For Responsibility Versus Public Preferences For Reducing Inequalities," Health Economics, John Wiley & Sons, Ltd., vol. 21(12), pages 1416-1426, December.
    12. Kolm, Serge-Christophe, 1976. "Unequal inequalities. I," Journal of Economic Theory, Elsevier, vol. 12(3), pages 416-442, June.
    13. Ignacio Abasolo & Aki Tsuchiya, 2008. "Understanding preference for egalitarian policies in health: are age and sex determinants?," Applied Economics, Taylor & Francis Journals, vol. 40(19), pages 2451-2461.
    14. Paul Dolan & Aki Tsuchiya, 2011. "Determining the parameters in a social welfare function using stated preference data: an application to health," Applied Economics, Taylor & Francis Journals, vol. 43(18), pages 2241-2250.
    15. Atkinson, Anthony B., 1970. "On the measurement of inequality," Journal of Economic Theory, Elsevier, vol. 2(3), pages 244-263, September.
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    Blog mentions

    As found by EconAcademics.org, the blog aggregator for Economics research:
    1. Method of the month: Distributional cost effectiveness analysis
      by miqedup in The Academic Health Economists' Blog on 2018-09-12 06:00:57

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    9. Micaela Pinho & Anabela Botelho, 2018. "Inference Procedures to Quantify the Efficiency–Equality Trade-Off in Health from Stated Preferences: A Case Study in Portugal," Applied Health Economics and Health Policy, Springer, vol. 16(4), pages 503-513, August.
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    More about this item

    Keywords

    health inequality; inequality aversion; social preferences; survey; welfare function;
    All these keywords.

    JEL classification:

    • N0 - Economic History - - General

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