Health, well-being, and equity

This research area does not represent a single research project, but rather a loose collection of work across five topics listed below.

1. Efficiency and equity

Health care resource allocation needs to be not only efficient but also equitable. This topic addresses the following three issues:

1. What are the situations in which QALY maximisation is not enough?
2. To what extent will people trade efficiency for equity?
3. What are the equity weights that should be attached to QALYs?

• Shaw, R., Dolan, P., Tsuchiya, A., Williams, A., Smith, P., Burrows, R., Development of a questionnaire to elicit people’s preferences regarding health inequalities, Occasional Paper, Centre for Health Economics, University of York (2001)
• Dolan, P., Tsuchiya, A., Smith, P., Shaw, R., Williams, A., Determining the parameters in a social welfare function using stated preference data: An application to health, Sheffield Health Economics Group Discussion Paper (2002) download
• Dolan, P. and Olsen, J. Distributing Health Care: Economic and Ethical Issues, Oxford University Press. (2002)
• Dolan P., Tsuchiya, A. The social welfare function and individual responsibility: Some theoretical issues and empirical evidence from health, Sheffield Health Economics Group Discussion Paper (2003) download
• Abásolo, I., Tsuchiya, A, Exploring Social Welfare Functions and violation of monotonicity: An example from inequalities in health. Journal of Health Economics 23(2): 313-329 (2004)
• Dolan, P., Tsuchiya, A., Health priorities and public preferences: The relative importance of past health experience and future health prospects, Journal of Health Economics, 24: 703-714 (2005)

2. Beyond consequentialism

Not all equity concerns are about the distribution of desiderata. In other words, procedural justice – that is, the way in which decisions are reached - is important as well as the outcome of those decisions. This topic addresses the following issues:

1. What are the characteristics of decision making that are important?
   
2. Are these characteristics important for “procedural” or “consequential” reasons?
3. What is the relative importance of each characteristic?
   
4. Are the general public prepared to trade procedure for outcome?

• Anand, P., Wailoo, A., Utilities versus Rights for Publicly Provided Goods: Arguments and Evidence from Health Care Rationing. Economica, 67:543-577 (2000)
• Wailoo, A., Anand, P., The nature of procedural preferences for health-care rationing decisions, Social Science and Medicine (published)
• Dolan, P., Edlin, R., Tsuchiya, A., Wailoo, A., It ain’t what you do, it’s the way that you do it: Characteristics of procedural justice and their importance in social decision-making, in submission

3. Health and Well-being

Happiness and/or wellbeing are related to life events, individual characteristics, and economic issues. There are currently two PhD studentships studying this topic. This topic explores issues such as:

1. To what extent does “health” impact on wellbeing?
2. How does this compare to other domains?
3. How do specific health problems/conditions impact wellbeing?
4. How does self reported wellbeing relate to outcome measures used in health services research?
5. What is the impact of choice versus achievement on wellbeing?

• Tsuchiya, A., Williams, A., A "Fair Innings" Between the Sexes: Are Men Being Treated Inequitably?, Social Science & Medicine, 60: 277-286 (2004)
• Brazier, J., Akehurst, R., Brennan, A., Dolan, P., Claxton, K., McCabe, C., O'Hagan, A., Sculpher, M., Tsuchiya, A. Should patients have a greater role in valuing health states: whose well-being is it anyway? HEDS Discussion Paper 3/04, University of Sheffield (2004)

4. Impact of crime on well-being

Intangible costs of crime are in effect pain and suffering caused by crime; if they can be captured as health impact, then existing measures of health can be used to quantify the intangible cost of crime. This topic addresses the following issues:

1. Is there something special about health impacts caused by crime, compared to health impact due to diseases?
2. Can we measure the outcomes of crime (eg. injury, psychological damage), purely in terms of outcomes, without referring to the process of the offence?
3. Is it possible to capture the indirect effect of crime, beyond its direct victims, such as "fear" of crime?

• Dolan, P., Peasgood, T., Estimating the economic and social costs of the fear of crime, paper presented at the ESRC Seminar on Crime, insecurity, and well-being: an economic approach, Sheffield, September 2004
• Dolan, P., Loomes, G., Pesasgood, T., Tsuchiya, A., Estimating the intangible victim costs of violent crime, British Journal of Criminology (forthcoming)

5. Well-being in public policy

Policy makers are showing increasing interest in using measures of well-being to inform policy. The topics addressed include:

1. Why should policy-makers be concerned about well-being?
2. What criteria should a measure of well-being for policy satisfy?
3. What things have the biggest effect on well-being and should policy-makers respond to this information?

• Dolan P, White M, Dynamic well-being: connecting what we anticipate with what we experience, Social Indicators Research (forthcoming)
• Dolan P, Peasgood T, Are measures of subjective well-being useful for policy purposes? Paper presented at the conference on “Capability and happiness”, Milano-Bicocca, June 2005

Also visit the webpage for the Centre for Well-Being in Public Policy. http://www.shef.ac.uk/cwipp/