Research units A-Z

Workstrand 6 provides insights into how the general public value different policy outcomes.

For example, if you had to choose between a ‘Policy A’ that leads to greater income and a ‘Policy B’ that leads to better health, which would you pick?  Or, between a ‘Policy C’ that leads to greater average population health but with greater health inequality and a ‘Policy D’ that leads to lower average population health but with less health inequality?

These are difficult choices and can invoke emotive reactions. It would be nice if we could increase income, increase health, and reduce inequalities. But in reality, we often cannot achieve everything we would like to, and policy makers have to decide between a range policy options.

The balance between different outcomes is known as a trade-off – in these examples, better health versus higher income; or improving the average level of health versus reducing inequality in health. Understanding how people think policies should trade-off between different outcomes is important for SIPHER because deepens our understanding of public preferences when analysing different policy options.

Workstrand 6 has identified seven key domains of wellbeing which we describe as the ‘SIPHER 7 Wellbeing Indicators’

• How physical health affects daily activities
• How emotional problems affect daily activities
• Feeling lonely and left out from others
• Household spending money
• Employment situation
• Concern about the safety of the neighbourhood
• Quality of the housing

We developed a methodology where the wellbeing of any person can be described as a combination of these seven domains, this gives us rich information about how people are doing.

To do this, we conducted a study to examine how people trade off between the seven domains of wellbeing. Members of the general public helping us with this study were asked questions about their personal preferences (that is, talking about themselves) for different combinations of the seven wellbeing domains. We have also asked the general public about their social preferences, or how they think policy makers should weigh up the different wellbeing domains that other people may experience. For example, if policy makers could bring about two different combinations of wellbeing domains, which one should they go for?

We used these results to build a single wellbeing index (Equivalent Income) that summarises any combination of the seven wellbeing domains in a single number in a way that reflects the relative importance of each domain.

As well as concern for different outcomes (e.g. greater income, better health and safer neighbourhoods), we are also interested in how different outcomes are spread across society, and whether people regard that spread as fair.

We are also in the process of gathering data to better understand how people think about inequalities. By doing this, we will develop a measure of “inequality aversion” to be included in SIPHER’s systems models– this will capture how much people dislike inequality. It works by measuring what lower level of average wellbeing people would accept, if it was combined with complete equality.

This inequality aversion measure will provide additional insight when comparing policy options that may improve overall wellbeing but make inequalities worse, and policies that are good at tackling inequalities but may result in lower average wellbeing.