• Richard Cookson, Shehzad Ali, Aki Tsuchiya, and Miqdad Asaria.
• Centre for Health Economics, University of York, York, UK.
• Health Econ. 2018 Nov 1; 27 (11): 1754-1771.

AbstractIn principle, questionnaire data on public views about hypothetical trade-offs between improving total health and reducing health inequality can provide useful normative health inequality aversion parameter benchmarks for policymakers faced with real trade-offs of this kind. However, trade-off questions can be hard to understand, and one standard type of question finds that a high proportion of respondents-sometimes a majority-appear to give exclusive priority to reducing health inequality. We developed and tested two e-learning interventions designed to help respondents understand this question more completely. The interventions were a video animation, exposing respondents to rival points of view, and a spreadsheet-based questionnaire that provided feedback on implied trade-offs. We found large effects of both interventions in reducing the proportion of respondents giving exclusive priority to reducing health inequality, though the median responses still implied a high degree of health inequality aversion and-unlike the video-the spreadsheet-based intervention introduced a substantial new minority of non-egalitarian responses. E-learning may introduce as well as avoid biases but merits further research and may be useful in other questionnaire studies involving trade-offs between conflicting values.© 2018 The Authors. Health Economics Published by John Wiley & Sons Ltd.

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