Arroyos-Calvera, D., Covey, J., Loomes, Graham and McDonald, R. (2019) The efficiency-equity trade-off, self-interest, and moral principles in health and safety valuation. Social Science and Medicine, 238 . 112477. doi:10.1016/j.socscimed.2019.112477

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Abstract

Policy makers try to take account of public preferences when making trade-offs between policy options. Yet most estimates of the value of health and safety reflect only individuals’ self-interested preferences, neglecting their preferences over the distribution of public resources. We conduct an experiment in which participants choose between policy options that differ in their efficiency (expected number of fatalities or cases of ill health they would prevent) and their equity (defined in terms of the balance of risk reductions for different sections of the population). The policy options were framed as interventions to improve a hypothetical city’s water supply that would reduce the risk of death or ill health for people in different areas of the city to varying degrees. In order to examine whether self-interest would affect the trade-offs, we asked half of the sample about scenarios where they would personally benefit from some options. Our results suggest that efficiency is the most important single factor determining preferences between policy options, but decisions were influenced almost as much by equity as by efficiency. The effect of self-interest was smaller than that of the general concern for efficiency. We also elicited participants’ stated moral principles regarding trade-offs between equity, efficiency and self-interest, and found that their expressed principles were well-aligned with their choices. Our findings contribute to the growing evidence that distributional concerns matter when evaluating health interventions.

Item Type:	Journal Article
Divisions:	Faculty of Social Sciences > Warwick Business School > Behavioural Science Faculty of Social Sciences > Warwick Business School
Journal or Publication Title:	Social Science and Medicine
Publisher:	Pergamon-Elsevier Science Ltd
ISSN:	0277-9536
Official Date:	October 2019
Dates:	Date Event October 2019 Published 2019 Available 2 August 2019 Accepted
Date of first compliant deposit:	8 August 2019
Volume:	238
Article Number:	112477
DOI:	10.1016/j.socscimed.2019.112477
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Restricted or Subscription Access
RIOXX Funder/Project Grant:	Project/Grant ID RIOXX Funder Name Funder ID RP2012-V-022 Leverhulme Trust http://dx.doi.org/10.13039/501100000275 ES/K002201/1 [ESRC] Economic and Social Research Council http://dx.doi.org/10.13039/501100000269 ES/P008976/1 [ESRC] Economic and Social Research Council http://dx.doi.org/10.13039/501100000269
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