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How averse are the UK general public to inequalities in health between socioeconomic groups? A systematic review

Author

Listed:
  • Simon McNamara

    (University of Sheffield)

  • John Holmes

    (University of Sheffield)

  • Abigail K. Stevely

    (University of Sheffield)

  • Aki Tsuchiya

    (University of Sheffield
    University of Sheffield)

Abstract

There is growing interest in the use of “distributionally-sensitive” forms of economic evaluation that capture both the impact of an intervention upon average population health and the distribution of that health amongst the population. This review aims to inform the conduct of distributionally sensitive evaluations in the UK by answering three questions: (1) How averse are the UK public towards inequalities in lifetime health between socioeconomic groups? (2) Does this aversion differ depending upon the type of health under consideration? (3) Are the UK public as averse to inequalities in health between socioeconomic groups as they are to inequalities in health between neutrally framed groups? EMBASE, MEDLINE, EconLit, and SSCI were searched for stated preference studies relevant to these questions in October 2017. Of the 2155 potentially relevant papers identified, 15 met the predefined hierarchical eligibility criteria. Seven elicited aversion to inequalities in health between socioeconomic groups, and eight elicited aversion between neutrally labelled groups. We find general, although not universal, evidence for aversion to inequalities in lifetime health between socioeconomic groups, albeit with significant variation in the strength of that preference across studies. Second, limited evidence regarding the impact of the type of health upon aversion. Third, some evidence that the UK public are more averse to inequalities in lifetime health when those inequalities are presented in the context of socioeconomic inequality than when presented in isolation.

Suggested Citation

  • Simon McNamara & John Holmes & Abigail K. Stevely & Aki Tsuchiya, 2020. "How averse are the UK general public to inequalities in health between socioeconomic groups? A systematic review," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(2), pages 275-285, March.
  • Handle: RePEc:spr:eujhec:v:21:y:2020:i:2:d:10.1007_s10198-019-01126-2
    DOI: 10.1007/s10198-019-01126-2
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    1. Cookson, Richard & Drummond, Mike & Weatherly, Helen, 2009. "Explicit incorporation of equity considerations into economic evaluation of public health interventions – reply to Richardson and Shiell," Health Economics, Policy and Law, Cambridge University Press, vol. 4(2), pages 261-263, April.
    2. Shah, Koonal K., 2009. "Severity of illness and priority setting in healthcare: A review of the literature," Health Policy, Elsevier, vol. 93(2-3), pages 77-84, December.
    3. Paul Anand & Allan Wailoo, 2000. "Utilities vs. Rights to Publicly Provided Goods: Arguments and Evidence from Health-Care Rationing," Open Discussion Papers in Economics 14, The Open University, Faculty of Social Sciences, Department of Economics.
    4. Donna Rowen & John Brazier & Anju Keetharuth & Aki Tsuchiya & Clara Mukuria, 2016. "Comparison of Modes of Administration and Alternative Formats for Eliciting Societal Preferences for Burden of Illness," Applied Health Economics and Health Policy, Springer, vol. 14(1), pages 89-104, February.
    5. Miqdad Asaria & Susan Griffin & Richard Cookson, 2016. "Distributional Cost-Effectiveness Analysis," Medical Decision Making, , vol. 36(1), pages 8-19, January.
    6. Costa-Font, J.; & Cowell, F.;, 2019. "Incorporating Inequality Aversion in Health-Care Priority Setting," Health, Econometrics and Data Group (HEDG) Working Papers 19/04, HEDG, c/o Department of Economics, University of York.
    7. Tsuchiya, Aki & Dolan, Paul & Shaw, Rebecca, 2003. "Measuring people's preferences regarding ageism in health: some methodological issues and some fresh evidence," Social Science & Medicine, Elsevier, vol. 57(4), pages 687-696, August.
    8. Wagstaff, Adam, 1991. "QALYs and the equity-efficiency trade-off," Journal of Health Economics, Elsevier, vol. 10(1), pages 21-41, May.
    9. 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.
    10. 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.
    11. Alan Williams, 1997. "Intergenerational Equity: An Exploration of the ‘Fair Innings’ Argument," Health Economics, John Wiley & Sons, Ltd., vol. 6(2), pages 117-132, March.
    12. 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.
    13. Miqdad Asaria & Susan Griffin & Richard Cookson, 2013. "Distributional cost-effectiveness analysis: a tutorial," Working Papers 092cherp, Centre for Health Economics, University of York.
    14. Stéphane Mussard & Maria Noel Pi Alperin & Véronique Thireau, 2018. "Health inequality indices and exogenous risk factors: an illustration on Luxembourgish workers," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 19(9), pages 1285-1301, December.
    15. Rebecca Shaw & Paul Dolan & Aki Tsuchiya & Alan Williams & Peter Smith & Roger Burrows, 2001. "Development of a questionnaire to elicit public preferences regarding health inequalities," Working Papers 040cheop, Centre for Health Economics, University of York.
    16. Lancsar, Emily & Wildman, John & Donaldson, Cam & Ryan, Mandy & Baker, Rachel, 2011. "Deriving distributional weights for QALYs through discrete choice experiments," Journal of Health Economics, Elsevier, vol. 30(2), pages 466-478, March.
    17. Dolan, Paul & Tsuchiya, Aki, 2005. "Health priorities and public preferences: the relative importance of past health experience and future health prospects," Journal of Health Economics, Elsevier, vol. 24(4), pages 703-714, July.
    18. Wagstaff, Adam, 2002. "Inequality aversion, health inequalities and health achievement," Journal of Health Economics, Elsevier, vol. 21(4), pages 627-641, July.
    19. Donna Rowen & John Brazier & Clara Mukuria & Anju Keetharuth & Arne Risa Hole & Aki Tsuchiya & Sophie Whyte & Phil Shackley, 2016. "Eliciting Societal Preferences for Weighting QALYs for Burden of Illness and End of Life," Medical Decision Making, , vol. 36(2), pages 210-222, February.
    20. Dolan, Paul & Robinson, Angela, 2001. "The measurement of preferences over the distribution of benefits: The importance of the reference point," European Economic Review, Elsevier, vol. 45(9), pages 1697-1709, October.
    21. Matthew Robson & Miqdad Asaria & Richard Cookson & Aki Tsuchiya & Shehzad Ali, 2017. "Eliciting the Level of Health Inequality Aversion in England," Health Economics, John Wiley & Sons, Ltd., vol. 26(10), pages 1328-1334, October.
    22. Cookson, Richard & Drummond, Mike & Weatherly, Helen, 2009. "Explicit incorporation of equity considerations into economic evaluation of public health interventions," Health Economics, Policy and Law, Cambridge University Press, vol. 4(2), pages 231-245, April.
    23. Tsuchiya, Aki & Dolan, Paul, 2007. "Do NHS clinicians and members of the public share the same views about reducing inequalities in health?," Social Science & Medicine, Elsevier, vol. 64(12), pages 2499-2503, June.
    24. Véronique Thireau & Stephane Mussard & Maria Noel Pi Alperin, 2018. "Health Inequality Indices and Exogeneous Risk Factors : An illustration luxembourgish workers," Post-Print hal-01987468, HAL.
    25. Richard Norman & Jane Hall & Deborah Street & Rosalie Viney, 2013. "Efficiency And Equity: A Stated Preference Approach," Health Economics, John Wiley & Sons, Ltd., vol. 22(5), pages 568-581, May.
    26. 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.
    27. Stavros Petrou & Ngianga-Bakwin Kandala & Angela Robinson & Rachel Baker, 2013. "A Person Trade-Off Study to Estimate Age-Related Weights for Health Gains in Economic Evaluation," PharmacoEconomics, Springer, vol. 31(10), pages 893-907, October.
    28. Shah, Koonal K. & Tsuchiya, Aki & Wailoo, Allan J., 2018. "Valuing health at the end of life: A review of stated preference studies in the social sciences literature," Social Science & Medicine, Elsevier, vol. 204(C), pages 39-50.
    29. Aki Tsuchiya & Paul Dolan, 2009. "Equality of what in health? Distinguishing between outcome egalitarianism and gain egalitarianism," Health Economics, John Wiley & Sons, Ltd., vol. 18(2), pages 147-159, February.
    30. Odejar, Maria & Baker, Rachel & Ryan, Mandy & Donalson, Cam & Bateman, Ian J. & Jones-Lee, M & Lancsar, Emily & Mason, Helen & Pinto Paredes, JL & Robinson, A & Shackley, P & Smith, R & Sugdem, R & Wi, 2010. "Weighting and valuing quality-adjusted life-years using stated preference methods: preliminary results from the Social Value of a QALY Project," MPRA Paper 108869, University Library of Munich, Germany.
    31. 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.
    32. Nord, Erik & Johansen, Rune, 2014. "Concerns for severity in priority setting in health care: A review of trade-off data in preference studies and implications for societal willingness to pay for a QALY," Health Policy, Elsevier, vol. 116(2), pages 281-288.
    33. Cookson, Richard & Mirelman, Andrew J. & Griffin, Susan & Asaria, Miqdad & Dawkins, Bryony & Norheim, Ole Frithjof & Verguet, Stéphane & J. Culyer, Anthony, 2017. "Using cost-effectiveness analysis to address health equity concerns," LSE Research Online Documents on Economics 101230, London School of Economics and Political Science, LSE Library.
    34. 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.
    35. Gu, Yuanyuan & Lancsar, Emily & Ghijben, Peter & Butler, James RG & Donaldson, Cam, 2015. "Attributes and weights in health care priority setting: A systematic review of what counts and to what extent," Social Science & Medicine, Elsevier, vol. 146(C), pages 41-52.
    36. Shehzad Ali & Aki Tsuchiya & Miqdad Asaria & Richard Cookson, 2017. "How Robust Are Value Judgments of Health Inequality Aversion? Testing for Framing and Cognitive Effects," Medical Decision Making, , vol. 37(6), pages 635-646, August.
    37. Weinstein, Milton C., 1988. "A QALY is a QALY is a QALY -- Or is it?," Journal of Health Economics, Elsevier, vol. 7(3), pages 289-290, September.
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    More about this item

    Keywords

    Health inequality aversion; Social preferences; Equity weighting; Fair innings; Systematic review;
    All these keywords.

    JEL classification:

    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality
    • D04 - Microeconomics - - General - - - Microeconomic Policy: Formulation; Implementation; Evaluation

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