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 of 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 it deepens our understanding of public preferences when analysing different policy options.

SIPHER 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

Now the wellbeing of any person can be described as a combination of these seven indicators, which gives us rich information about how people are doing.  Furthermore, Workstrand 6 developed a formula to express the quality of each combination as a single numerical value.

To do this, we conducted a study to examine how people trade off between the seven indicators of wellbeing. Members of the general public helping us with this study were asked questions about their personal preferences (that is, thinking about themselves) for different combinations of the seven wellbeing indicators. We have also asked the general public about their social preferences, or how they think policy makers should weigh up the different wellbeing indicators that other people may experience. For example, if policy makers could bring about two different combinations of wellbeing indicators, 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 indicators into one number in a way that reflects the relative importance of each indicator.

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.

For this, we gathered data to better understand how people think about inequalities, and to develop a measure of “inequality aversion” to be included in SIPHER’s systems models.  This captures how much people dislike inequality by measuring what lower level of average wellbeing people would accept, if everybody was completely equal.

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.