How do individuals value health states?

M. Karimi, J. Brazier, S. Paisley


To measure the benefits of health interventions, health economists ask members of the general public to value health states. These values are important in determining resource allocation in health care. Yet, there is arguably little known about how individuals value health. Previous studies have shown that a variety of non-health factors and beliefs are important in valuing health, but there is less evidence in the literature about how individuals’ beliefs affect their preferences or what role they play in the process of forming preferences. In this study, the thought processes of UK participants while valuing health states were investigated using semi-structured interviews and a think-aloud protocol, with the aim to better understanding of the relationship between the health state, the underlying beliefs, and the individual’s preferences.

Participants followed several stages in valuing health. First, participants interpreted the health states more concretely. Their interpretation relied on their imagination and experience of ill health. Participants judged how those concrete health problems combined with their personal interests, circumstances, and environment would affect them. Ultimately, participants valued health by judging the non-health consequences (such as enjoyment, independence, relationships, and dignity) of the health states.

This study highlights the importance and role of non-health factors in valuing health. The findings have implications for methods of describing health, for example, whether the focus should be on health or broader well-being and capability. This is because the consequences are similar to the domains of measures such as the ICECAP-A. A better understanding of how individuals value health provides important research directions about how to improve methods of valuing health and about how to test whether individuals are informed about the health states they are valuing.