IDEAS home Printed from https://ideas.repec.org/a/wly/hlthec/v27y2018i11p1754-1771.html
   My bibliography  Save this article

E‐learning and health inequality aversion: A questionnaire experiment

Author

Listed:
  • Richard Cookson
  • Shehzad Ali
  • Aki Tsuchiya
  • Miqdad Asaria

Abstract

In principle, questionnaire data on public views about hypothetical trade‐offs between improving total health and reducing health inequality can provide useful normative health inequality aversion parameter benchmarks for policymakers faced with real trade‐offs of this kind. However, trade‐off questions can be hard to understand, and one standard type of question finds that a high proportion of respondents—sometimes a majority—appear to give exclusive priority to reducing health inequality. We developed and tested two e‐learning interventions designed to help respondents understand this question more completely. The interventions were a video animation, exposing respondents to rival points of view, and a spreadsheet‐based questionnaire that provided feedback on implied trade‐offs. We found large effects of both interventions in reducing the proportion of respondents giving exclusive priority to reducing health inequality, though the median responses still implied a high degree of health inequality aversion and—unlike the video—the spreadsheet‐based intervention introduced a substantial new minority of non‐egalitarian responses. E‐learning may introduce as well as avoid biases but merits further research and may be useful in other questionnaire studies involving trade‐offs between conflicting values.

Suggested Citation

  • Richard Cookson & Shehzad Ali & Aki Tsuchiya & Miqdad Asaria, 2018. "E‐learning and health inequality aversion: A questionnaire experiment," Health Economics, John Wiley & Sons, Ltd., vol. 27(11), pages 1754-1771, November.
  • Handle: RePEc:wly:hlthec:v:27:y:2018:i:11:p:1754-1771
    DOI: 10.1002/hec.3799
    as

    Download full text from publisher

    File URL: https://doi.org/10.1002/hec.3799
    Download Restriction: no

    File URL: https://libkey.io/10.1002/hec.3799?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    Other versions of this item:

    References listed on IDEAS

    as
    1. Amiel,Yoram & Cowell,Frank, 1999. "Thinking about Inequality," Cambridge Books, Cambridge University Press, number 9780521466967.
    2. Ernst Fehr & Klaus M. Schmidt, 1999. "A Theory of Fairness, Competition, and Cooperation," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 114(3), pages 817-868.
    3. Dutta, Indranil, 2007. "Health inequality and non-monotonicity of the health related social welfare function," Journal of Health Economics, Elsevier, vol. 26(2), pages 414-421, March.
    4. Alberto Alesina & George-Marios Angeletos, 2005. "Fairness and Redistribution," American Economic Review, American Economic Association, vol. 95(4), pages 960-980, September.
    5. Clark, Andrew E. & D'Ambrosio, Conchita, 2014. "Attitudes to Income Inequality: Experimental and Survey Evidence," IZA Discussion Papers 8136, Institute of Labor Economics (IZA).
    6. Maureen Cropper & Alan Krupnick & William Raich, 2016. "Preferences for Equality in Environmental Outcomes," NBER Working Papers 22644, National Bureau of Economic Research, Inc.
    7. 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.
    8. Alesina, Alberto & La Ferrara, Eliana, 2005. "Preferences for redistribution in the land of opportunities," Journal of Public Economics, Elsevier, vol. 89(5-6), pages 897-931, June.
    9. 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.
    10. 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.
    11. 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.
    12. Miqdad Asaria & Susan Griffin & Richard Cookson & Sophie Whyte & Paul Tappenden, 2013. "Distributional Cost-Effectiveness Analysis of Health Care Programmes," Working Papers 091cherp, Centre for Health Economics, University of York.
    13. Dutta, Indranil, 2007. "Health inequality and non-monotonicity of the health related social welfare function: A rejoinder," Journal of Health Economics, Elsevier, vol. 26(2), pages 426-429, March.
    14. 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.
    15. Alberto F. Alesina & Paola Giuliano, 2009. "Preferences for Redistribution," NBER Working Papers 14825, National Bureau of Economic Research, Inc.
    16. Christopher T. Dawes & James H. Fowler & Tim Johnson & Richard McElreath & Oleg Smirnov, 2007. "Egalitarian motives in humans," Nature, Nature, vol. 446(7137), pages 794-796, April.
    17. James Konow, 2003. "Which Is the Fairest One of All? A Positive Analysis of Justice Theories," Journal of Economic Literature, American Economic Association, vol. 41(4), pages 1188-1239, December.
    18. 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.
    19. Binmore, Ken & Shaked, Avner, 2010. "Experimental Economics: Where Next? Rejoinder," Journal of Economic Behavior & Organization, Elsevier, vol. 73(1), pages 120-121, January.
    20. Binmore, Ken & Shaked, Avner, 2010. "Experimental economics: Where next?," Journal of Economic Behavior & Organization, Elsevier, vol. 73(1), pages 87-100, January.
    21. 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.
    22. Ernst Fehr & Urs Fischbacher, 2003. "The nature of human altruism," Nature, Nature, vol. 425(6960), pages 785-791, October.
    23. 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.
    24. 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.
    25. Atkinson, Anthony B., 1970. "On the measurement of inequality," Journal of Economic Theory, Elsevier, vol. 2(3), pages 244-263, September.
    26. Jeremiah Hurley & Neil Buckley & Katherine Cuff & Mita Giacomini & David Cameron, 2011. "Judgments regarding the fair division of goods: the impact of verbal versus quantitative descriptions of alternative divisions," Social Choice and Welfare, Springer;The Society for Social Choice and Welfare, vol. 37(2), pages 341-372, July.
    27. Binmore, Ken, 1999. "Why Experiment in Economics?," Economic Journal, Royal Economic Society, vol. 109(453), pages 16-24, February.
    28. 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.
    Full references (including those not matched with items on IDEAS)

    Citations

    Blog mentions

    As found by EconAcademics.org, the blog aggregator for Economics research:
    1. Simon McNamara’s journal round-up for 6th August 2018
      by sjmcnamara1 in The Academic Health Economists' Blog on 2018-08-06 11:00:29

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Erik Schokkaert & Benoît Tarroux, 2021. "Empirical research on ethical preferences: how popular is prioritarianism?," Working Papers halshs-03110312, HAL.
    2. Smeele, Nicholas V.R. & Chorus, Caspar G. & Schermer, Maartje H.N. & de Bekker-Grob, Esther W., 2023. "Towards machine learning for moral choice analysis in health economics: A literature review and research agenda," Social Science & Medicine, Elsevier, vol. 326(C).
    3. Susan Griffin & James Love-Koh & Becky Pennington & Lesley Owen, 2019. "Evaluation of Intervention Impact on Health Inequality for Resource Allocation," Medical Decision Making, , vol. 39(3), pages 171-182, April.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. 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.
    2. McNamara, Simon & Tsuchiya, Aki & Holmes, John, 2021. "Does the UK-public's aversion to inequalities in health differ by group-labelling and health-gain type? A choice-experiment," Social Science & Medicine, Elsevier, vol. 269(C).
    3. 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.
    4. Clark, Andrew E. & D'Ambrosio, Conchita, 2014. "Attitudes to Income Inequality: Experimental and Survey Evidence," IZA Discussion Papers 8136, Institute of Labor Economics (IZA).
    5. Hurley, Jeremiah & Mentzakis, Emmanouil & Walli-Attaei, Marjan, 2020. "Inequality aversion in income, health, and income-related health," Journal of Health Economics, Elsevier, vol. 70(C).
    6. 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.
    7. Erik Schokkaert & Benoît Tarroux, 2021. "Empirical research on ethical preferences: how popular is prioritarianism?," Working Papers 2104, Groupe d'Analyse et de Théorie Economique Lyon St-Étienne (GATE Lyon St-Étienne), Université de Lyon.
    8. 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.
    9. Sylvie Thoron, 2016. "Morality Beyond Social Preferences: Smithian Sympathy, Social Neuroscience and the Nature of Social Consciousness [La moralité au delà des préférences sociales. La sympathie Smithienne, les neurosc," Post-Print hal-01645043, HAL.
    10. Michele Bernasconi & Enrico Longo & Valeria Maggian, 2023. "When merit breeds luck (or not): an experimental study on distributive justice," Working Papers 2023:02, Department of Economics, University of Venice "Ca' Foscari".
    11. Lionel Page & Daniel G. Goldstein, 2016. "Subjective beliefs about the income distribution and preferences for redistribution," Social Choice and Welfare, Springer;The Society for Social Choice and Welfare, vol. 47(1), pages 25-61, June.
    12. Marcelo Bérgolo & Gabriel Burdín & Santiago Burone & Mauricio de Rosa & Matías Giaccobasso & Martín Leites, 2020. "Dissecting Inequality-Averse Preferences," Documentos de Trabajo (working papers) 20-19, Instituto de Economía - IECON.
    13. Joan Costa-i-Font & Frank Cowell, 2019. "Incorporating Inequality Aversion in Health-Care Priority Setting," CESifo Working Paper Series 7503, CESifo.
    14. Sophie Cetre & Max Lobeck & Claudia Senik & Thierry Verdier, 2018. "In search of unanimously preferred income distributions. Evidence from a choice experiment," Working Papers halshs-01863359, HAL.
    15. Guenther, Isabel & Tetteh-Baah, Samuel Kofi, 2019. "The impact of discrimination on redistributive preferences and productivity: experimental evidence from the United States," VfS Annual Conference 2019 (Leipzig): 30 Years after the Fall of the Berlin Wall - Democracy and Market Economy 203652, Verein für Socialpolitik / German Economic Association.
    16. Yamamura, Eiji, 2012. "Effects of siblings and birth order on income redistribution preferences," MPRA Paper 38658, University Library of Munich, Germany.
    17. Ľuboš Pástor & Pietro Veronesi, 2021. "Inequality Aversion, Populism, and the Backlash against Globalization," Journal of Finance, American Finance Association, vol. 76(6), pages 2857-2906, December.
    18. Yoram Amiel & Michele Bernasconi & Frank Cowell & Valentino Dardanoni, 2015. "Do we value mobility?," Social Choice and Welfare, Springer;The Society for Social Choice and Welfare, vol. 44(2), pages 231-255, February.
    19. Eisenkopf, Gerald & Fischbacher, Urs & Föllmi-Heusi, Franziska, 2013. "Unequal opportunities and distributive justice," Journal of Economic Behavior & Organization, Elsevier, vol. 93(C), pages 51-61.
    20. Bogliacino, Francesco & Codagnone, Cristiano, 2021. "Microfoundations, behaviour, and evolution: Evidence from experiments," Structural Change and Economic Dynamics, Elsevier, vol. 56(C), pages 372-385.

    More about this item

    JEL classification:

    • J1 - Labor and Demographic Economics - - Demographic Economics

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:wly:hlthec:v:27:y:2018:i:11:p:1754-1771. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Wiley Content Delivery (email available below). General contact details of provider: http://www3.interscience.wiley.com/cgi-bin/jhome/5749 .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.