The UK-public's aversion to inequalities in health between socioeconomic groups

Public health policy has two primary aims: promoting population health and reducing health inequalities. When these aims conflict, policy-makers must determine the relative importance to place on each in decision-making. This thesis explores the UK-public's views on how government should act in these situations, and in particular, whether their "health inequality-aversion" differs depending on the groups between which a health inequality exists and the type of health an intervention provides. These issues are directly relevant to the conduct of "distributionally sensitive" forms of economic evaluation: methods that capture improvements in population health and reductions in inequalities in health. A systematic review, and three de novo person-trade-off choice experiments are reported. Over 1,600 members of the UK-public participated. I find evidence consistent with the idea that the UK-public are more averse to inequalities in lifetime health between socioeconomic groups than they are to inequalities in lifetime health between groups of unknown socioeconomic status. This motivates a normative debate about whether distributionally sensitive economic evaluations should apply estimates of the public's aversion between socioeconomic groups, or between neutrally labelled groups. In addition, I find evidence broadly consistent with the idea that UK-public are more willing to prioritise disadvantaged socioeconomic groups with lower lifetime health over advantaged socioeconomic groups with higher lifetime health if an intervention improves life-expectancy than they are if it improves quality-of-life. Further research on this issue is warranted. If confirmed in future, this finding would would motivate the development of forms of distributionally sensitive economic evaluation that can reflect differences in the public's willingness to prioritise disadvantaged socioeconomic groups for different health-gain types.