The efficiency-equity trade-off, self-interest, and moral principles in health and safety valuation

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The efficiency-equity trade-off, self-interest, and moral principles in health and safety valuation. / Arroyos Calvera, Danae; Covey, Judith; Loomes, Graham; McDonald, Rebecca.

In: Social Science and Medicine, Vol. 238, 112477, 10.2019.

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@article{5b4a67eee18740b5aaaf6a6557b757e6,
title = "The efficiency-equity trade-off, self-interest, and moral principles in health and safety valuation",
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{\textquoteright} 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{\textquoteright}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{\textquoteright} 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.",
keywords = "efficiency, equity, self-interest, moral principles",
author = "{Arroyos Calvera}, Danae and Judith Covey and Graham Loomes and Rebecca McDonald",
year = "2019",
month = oct,
doi = "10.1016/j.socscimed.2019.112477",
language = "English",
volume = "238",
journal = "Social Science and Medicine",
issn = "0277-9536",
publisher = "Reed-Elsevier (India) Private Limited",

}

RIS

TY - JOUR

T1 - The efficiency-equity trade-off, self-interest, and moral principles in health and safety valuation

AU - Arroyos Calvera, Danae

AU - Covey, Judith

AU - Loomes, Graham

AU - McDonald, Rebecca

PY - 2019/10

Y1 - 2019/10

N2 - 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.

AB - 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.

KW - efficiency

KW - equity

KW - self-interest

KW - moral principles

U2 - 10.1016/j.socscimed.2019.112477

DO - 10.1016/j.socscimed.2019.112477

M3 - Article

VL - 238

JO - Social Science and Medicine

JF - Social Science and Medicine

SN - 0277-9536

M1 - 112477

ER -