Eliciting trade-offs between population health and environmental outcomes: A pilot study

Melissa Pegg; Chetan Mistry; Erin Barker; Matthew Taylor

doi:10.29333/ejeph/15212

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Melissa Pegg ¹ , Chetan Mistry ¹ , Erin Barker ¹ , Matthew Taylor ¹ ^*

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¹ York Health Economics Consortium, York, UK^* Corresponding Author

Abstract

Objectives: The aim of this study was to investigate whether it is possible to elicit how United Kingdom (UK) public citizens might trade off human health and environmental outcomes.
Methods: Using a representative adult population, a discrete choice experiment (DCE) was conducted on criteria impacting trade-off decisions between human health and environmental outcomes. Respondents were asked to make twelve choices that included four attributes: the impact on UK life expectancy, the impact on biodiversity, the impact on UK carbon emissions and location of environmental impacts. Data were analyzed using a conditional logit regression model.
Results: 508 respondents completed the survey. A DCE found UK public citizens are willing to forgo human health to reduce environmental harm.
Conclusions: This research demonstrated it is possible to elicit the public’s view about trade-offs between health and the environment. Moreover, the public is willing to forgo human health to reduce environmental impact, propounding the importance of healthcare sustainability.

Keywords

healthcare
environmental impact
public opinion
trade-off

License

This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Article Type: Research Article

EUR J ENV PUBLIC HLT, Volume 8, Issue 4, 2024, Article No: em0163

https://doi.org/10.29333/ejeph/15212

Publication date: 01 Oct 2024

Online publication date: 26 Sep 2024

Article Views: 1042

Article Downloads: 780

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References

Rockström J, Gupta J, Qin D, et al. Safe and just earth system boundaries. Nature. 2023;619:102-11. https://doi.org/10.1038/s41586-023-06083-8 PMid:37258676 PMCid:PMC10322705
January Climate Bulletins. Copernicus: In 2024, the world experienced the warmest January on record. Available at: https://climate.copernicus.eu/copernicus-2024-world-experienced-warmest-january-record (Accessed: 30 July 2024).
IPCC. Climate change 2023: Synthesis report. Summary for policymakers. Geneva (Switzerland): IPCC; 2023.
Keswani A, Akselrod H, Anenberg SC. Health and clinical impacts of air pollution and linkages with climate change. NEJM Evid. 2022;1(7):EVIDra2200068. https://doi.org/10.1056/EVIDra2200068 PMid:38319260
NHS England. Delivering a ‘net zero’ national health service. NHS England; 2022. Available at: https://www.england.nhs.uk/greenernhs/publication/delivering-a-net-zero-national-health-service/ (Accessed: 30 July 2024).
McAlister S, Morton RL, Barratt A. Incorporating carbon into health care: Adding carbon emissions to health technology assessments. Lancet Planet Health. 2022;6(12): e993-9. https://doi.org/10.1016/S2542-5196(22)00258-3 PMid:36495894
Tang LL, Furushima Y, Honda Y, Hasegawa T, Itsubo N. Estimating human health damage factors related to CO emissions by considering updated climate-related relative risks. Int J Life Cycle Assess. 2019;24(6):1118-28. https://doi.org/10.1007/s11367-018-1561-6
Harris H, Bhutta MF, Rizan C. A survey of UK and Irish surgeons’ attitudes, behaviours and barriers to change for environmental sustainability. Ann R Coll Surg Engl. 2021; 103(10):725-29. https://doi.org/10.1308/rcsann.2021.0271 PMid:34719956 PMCid:PMC10335270
Imaz-Iglesia I, Wild C. EUnetHTA’s contribution to the new legal framework for health technology assessment cooperation in Europe. Int J Technol Assess Health Care. 2022;38(1):e50. https://doi.org/10.1017/S026646232200037X PMid:35652661
NHS England. Suppliers. NHS England; 2023. Available at: https://www.england.nhs.uk/greenernhs/get-involved/suppliers/ (Accessed: 30 July 2024).
Government UK. Procurement policy note 06/20–Taking account of social value in the award of central government contracts. UK Government; 2020. Available at: https://www.gov.uk/government/publications/procurement-policy-note-0620-taking-account-of-social-value-in-the-award-of-central-government-contracts (Accessed: 30 July 2024).
Toolan M, Walpole S, Shah K, et al. Environmental impact assessment in health technology assessment: Principles, approaches, and challenges. Int J Technol Assess Health Care. 2023;39(1):e13. https://doi.org/10.1017/S0266462323000041 PMid:36815229
Halsby K, Langford B, Pagotto A, et al. PP299 a framework and analysis assessing the impact of patient-centered outcome evidence in HTA appraisals. Int J Technol Assess Health Care. 2021;37(S1):34. https://doi.org/10.1017/S0266462321001513
National Institute for Health and Care Excellence. Nice listens: Public dialogue on environmental sustainability. Final report. NICE; 2023. Available at: https://www.nice.org.uk/about/what-we-do/our-research-work/nice-listens (Accessed: 30 July 2024).
Belle N, Cantarelli P. Your money, your life, or your freedom? A discrete-choice experiment on trade-offs during a public health crisis. Public Admin Rev. 2022;82(1):59-68. https://doi.org/10.1111/puar.13429
de Bekker-Grob EW, Ryan M, Gerard K. Discrete choice experiments in health economics: A review of the literature. Health Econ. 2012;21(2):145-72. https://doi.org/10.1002/hec.1697 PMid:22223558
Soekhai V, de Bekker-Grob EW, Ellis AR, Vass CM. Discrete choice experiments in health economics: Past, present and future. Pharmacoeconomics. 2019;37(2):201-26. https://doi.org/10.1007/s40273-018-0734-2 PMid:30392040 PMCid:PMC6386055
Salloum RG, Shenkman EA, Louviere JJ, Chambers DA. Application of discrete choice experiments to enhance stakeholder engagement as a strategy for advancing implementation: A systematic review. Implement Sci. 2017;12:140. https://doi.org/10.1186/s13012-017-0675-8 PMid:29169397 PMCid:PMC5701380
Lancsar E, Louviere J. Conducting discrete choice experiments to inform healthcare decision making: A user’s guide. Pharmacoeconomics. 2008;26(8):661-77. https://doi.org/10.2165/00019053-200826080-00004 PMid:18620460
Vossler CA, Doyon M, Rondeau D. Truth in consequentiality: Theory and field evidence on discrete choice experiments. Am Econ J-Microecon. 2012;4(4):145-71. https://doi.org/10.1257/mic.4.4.145
Bridges JFP, Hauber AB, Marshall D, et al. Conjoint analysis applications in health–A checklist: A report of the ISPOR good research practices for conjoint analysis task force. Value Health. 2011;14(4):403-13. https://doi.org/10.1016/j.jval.2010.11.013 PMid:21669364
Mariel P, Hoyos D, Meyerhoff J, et al. Environmental valuation with discrete choice experiments: Guidance on design, implementation and data analysis. New York City (NY): Springer; 2021. https://doi.org/10.1007/978-3-030-62669-3 PMid:34843549 PMCid:PMC8629263
Bank TW. Life expectancy at birth, total (years)–United Kingdom. The World Bank; 2023. Available at: https://data.worldbank.org/indicator/SP.DYN.LE00.IN?end=2021&locations=GB&start=2000&view=chart (Accessed: 30 July 2024).
United Nations. Paris Agreement. United Nations; 2016. Available at: https://www.un.org/en/climatechange/paris-agreement (Accessed: 30 July 2024).
Climate Watch. Historical GHG emissions. Climate Watch; 2022. Available at: https://www.climatewatchdata.org/ghg-emissions?end_year=2020&regions=GBR&start_year=1990 (Accessed: 30 July 2024).
Hauber AB, González JM, Groothuis-Oudshoorn CGM, et al. Statistical methods for the analysis of discrete choice experiments: A report of the ISPOR conjoint analysis good research practices task force. Value Health. 2016; 19(4):300-15. https://doi.org/10.1016/j.jval.2016.04.004 PMid:27325321
Johnson R, Orme B. Getting the most from CBC. Sawtooth Software; 2003. Available at: http://www.sawtooth software.com/education/techpap.shtml (Accessed: 30 July 2024).
Zelezny LC, Schultz PW. Promoting environmentalism. J Soc Issues. 2000;56(3):365-71. https://doi.org/10.1111/0022-4537.00172
Chambon M, Elberse JE, Dalege J, Beijer NRM, van Harreveld F. Understanding public perceptions toward sustainable healthcare through psychological network analysis of material preference and attitudes toward plastic medical devices. Sci Rep. 2023;13(1):17938. https://doi.org/10.1038/s41598-023-45172-6 PMid:37864068 PMCid:PMC10589264
Obadha M, Barasa E, Kazungu J, Abiiro GA, Chuma J. Attribute development and level selection for a discrete choice experiment to elicit the preferences of health care providers for capitation payment mechanism in Kenya. Health Econ Rev. 2019;9(1):30. https://doi.org/10.1186/s13561-019-0247-5 PMid:31667632 PMCid:PMC6822414
Jennings N, Fecht D, De Matteis S. Mapping the co-benefits of climate change action to issues of public concern in the UK: A narrative review. Lancet Planet Health. 2020;4(9): e424-33. https://doi.org/10.1016/S2542-5196(20)30167-4 PMid:32918888
Romanello M, Di Napoli C, Drummond P, et al. The 2022 report of the Lancet Countdown on health and climate change: Health at the mercy of fossil fuels. Lancet. 2022;400(10363):1619-54. https://doi.org/10.1016/S0140-6736(22)01540-9 PMid:36306815
Masselot P, Mistry M, Vanoli J, et al. Excess mortality attributed to heat and cold: A health impact assessment study in 854 cities in Europe. Lancet Planet Health. 2023;7(4):e271-81.
Campbell D, Morkbak MR, Olsen SB. The link between response time and preference, variance and processing heterogeneity in stated choice experiments. J Environ Econ Manag. 2018;88:18-34. https://doi.org/10.1016/j.jeem.2017.10.003
Weber EU. What shapes perceptions of climate change? New research since 2010. Wiley Interdiscip Rev: Clim Change. 2016;7(1):125-34. https://doi.org/10.1002/wcc.377
Nomis. Census 2021 bulk data download. Office for National Statistics; 2021. Available at: https://www.nomisweb.co.uk/sources/census_2021_bulk (Accessed: 30 July 2024).

How to cite this article

Vancouver

Pegg M, Mistry C, Barker E, Taylor M. Eliciting trade-offs between population health and environmental outcomes: A pilot study. EUR J ENV PUBLIC HLT. 2024;8(4):em0163. https://doi.org/10.29333/ejeph/15212

APA

Pegg, M., Mistry, C., Barker, E., & Taylor, M. (2024). Eliciting trade-offs between population health and environmental outcomes: A pilot study. European Journal of Environment and Public Health, 8(4), em0163. https://doi.org/10.29333/ejeph/15212

AMA

Pegg M, Mistry C, Barker E, Taylor M. Eliciting trade-offs between population health and environmental outcomes: A pilot study. EUR J ENV PUBLIC HLT. 2024;8(4), em0163. https://doi.org/10.29333/ejeph/15212

Chicago

Pegg, Melissa, Chetan Mistry, Erin Barker, and Matthew Taylor. "Eliciting trade-offs between population health and environmental outcomes: A pilot study". European Journal of Environment and Public Health 2024 8 no. 4 (2024): em0163. https://doi.org/10.29333/ejeph/15212

Harvard

Pegg, M., Mistry, C., Barker, E., and Taylor, M. (2024). Eliciting trade-offs between population health and environmental outcomes: A pilot study. European Journal of Environment and Public Health, 8(4), em0163. https://doi.org/10.29333/ejeph/15212

MLA

Pegg, Melissa et al. "Eliciting trade-offs between population health and environmental outcomes: A pilot study". European Journal of Environment and Public Health, vol. 8, no. 4, 2024, em0163. https://doi.org/10.29333/ejeph/15212