Inequality Aversion in Health: Eliciting Aversion to Univariate Health Inequalities Across Different Health Distributions

Objectives Health inequality aversion parameters can be used to inform health-related social welfare functions when trade-offs between maximizing and equalizing health arise in health policy. Empirical estimates of inequality aversion among the public can be valuable to ensure that approaches to the trade-off reflect public preferences. We aimed to elicit inequality aversion parameters in a large population sample across different health distributions to inform health-related social welfare functions of the Atkinson and Kolm-Pollak type and compare responses from different distributions. Methods We recruited a representative population sample to complete 2 sets of benefit trade-off tasks with different degrees of baseline health inequality. This allows to test for intraindividual concurrence between elicited inequality aversion parameters across 2 different distributions. Elicited parameters from each task set are reported and compared across the 2 task sets. Our study used univariate health distributions. Results A total of 946 responses were retained after application of exclusion criteria. In our sample from Norway, we found that the median Atkinson and Kolm-Pollak inequality aversion parameters are 3.52 and 0.05, respectively, when pooling all responses. However, we did not find a convincing concurrence between elicited inequality aversion parameters from the 2 task sets. Conclusions Our results indicate that most respondents are willing to trade-off at least some total health gains to favor the worse off. We did not find a general concurrence between individuals’ inequality aversion parameters when presented with distributions with unequal baseline inequalities, which suggests that our sample’s distributional preferences may not satisfy the assumption of constant relative or absolute inequality aversion.