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Public preferences for reducing health inequality

Health Inequalities - Trade Offs from Centre for Health Economics on Vimeo.

Research in this area investigates the strength of public concern for reducing health inequality as opposed to improving total population health – sometimes known as “equity-efficiency trade-offs”. The aim is to provide economically meaningful estimates of the magnitude of inequality aversion in different contexts, to help inform policy decisions. The research is based on questionnaires that present respondents with hypothetical policy dilemmas involving equity-efficiency trade-offs, administered in both face-to-face and online settings. 

Contact: Richard CooksonShehzad Ali


Graham H, Bland JM, Cookson R, Kanaan M, White PCL. Do people favour policies that protect future generations? Evidence from a British survey of adults. Journal of Social Policy 2017;doi:10.1017/S0047279416000945. Download from Cambridge University Press

Robson M, Asaria M, Cookson R, Tsuchiya A, Ali S. Eliciting the level of health inequality aversion in England. Health Economics 2016;doi:10.1002/hec.3430. Download from Wiley

Materials from recent studies

To help other researchers who may be interested in following up some of our work, we include below links to the survey materials used in two studies conducted in 2013 and 2014. Both studies involved “Citizens’ Panel” meetings of members of the public, as well as on-line surveys, and hence we refer to them as the “CP1” and “CP2” studies respectively. The CP1 study helped to test the robustness of a standard survey instrument in this field to various cognitive biases. The original instrument was developed in the early 2000s by a research team at the University of York in a project funded by the ESRC (see CHE Occasional Paper 20, May 2001). The CP2 study helped to develop and validate new e-learning tools to help respondents consider their responses more carefully – a video animation setting out rival principles of justice, and an interactive spreadsheet version of the questionnaire providing feedback on the implied equity-efficiency trade-offs. These two studies were funded by the NIHR and the C2D2 programme (a virtual centre supported by the Wellcome Trust and the University of York).

These CP1 and CP2 survey and e-learning instruments were designed by Richard Cookson and Shehzad Ali, with advisory input from Miqdad Asaria and Aki Tsuchiya, and produced by Ruth Helstrip (all face-to-face and online questionnaires and the animated video) and Shehzad Ali (the interactive questionnaire produced in Excel). Anyone is free to re-use these survey materials in further research, and we would be happy to hear from you, but if you do so we would be grateful if you could let us know and acknowledge our original research design input appropriately.

All the content of this website, unless explicitly stated otherwise, is copyright of the University of York and may not be reproduced without prior permission. By accessing these web pages, you agree that any downloading of content is for personal, non-commercial reference only.

CP1 Materials (a study conducted in late 2013 and early 2014)

  1. Paper Questionnaire CP1 Paper Questionnaire (PDF , 1,291kb)

  2. Online Questionnnaire CP1 Online Questionnaire (PDF , 947kb)

CP2 Materials (a study conducted in mid to late 2014)

  1. Paper Questionnaire Group A (Paper First) CP2 Paper Questionnaire Group A (PDF , 1,027kb)

  2. Paper Questionnaire Goup B (Interactive First) CP2 Paper Questionnaire Group B (PDF , 934kb)

  3. Interactive Spreadsheet Questionnaire (“slider”) Interactive Questionnaire (MS Excel , 246kb)

  4. Video Animation (large file: 14MB) Video Animation ( 14,226kb download)

  5. Screen Shot of Online Questionnaire (originally hosted on Smart Survey) CP2 Online Questionnaire (PDF , 1,950kb)