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E‐learning and health inequality aversion: A questionnaire experiment
Authors:Richard Cookson  Shehzad Ali  Aki Tsuchiya  Miqdad Asaria
Affiliation:1. Centre for Health Economics, University of York, York, UK;2. Centre for Health Economics and Department of Health Sciences, University of York, York, UK;3. School of Health and Related Research (ScHARR), and Department of Economics, University of Sheffield, Sheffield, UK;4. LSE Health, London School of Economics and Political Science (LSE), London, UK
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.
Keywords:distributional cost‐effectiveness analysis  empirical ethics  empirical social choice  health inequality  inequality aversion
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