Duke University, United States.
Harvard T.H. Chan School of Public Health, Harvard University, United States.
J Health Econ. 2021 Jan;75:102412. doi: 10.1016/j.jhealeco.2020.102412. Epub 2020 Nov 30.
The social value of risk reduction (SVRR) is the marginal social value of reducing an individual's fatality risk, as measured by some social welfare function (SWF). This Article investigates SVRR, using a lifetime utility model in which individuals are differentiated by age, lifetime income profile, and lifetime risk profile. We consider both the utilitarian SWF and a "prioritarian" SWF, which applies a strictly increasing and strictly concave transformation to individual utility. We show that the prioritarian SVRR provides a rigorous basis in economic theory for the "fair innings" concept, proposed in the public health literature: as between an older individual and a similarly situated younger individual (one with the same income and risk profile), a risk reduction for the younger individual is accorded greater social weight even if the gains to expected lifetime utility are equal. The comparative statics of prioritarian and utilitarian SVRRs with respect to age, and to (past, present, and future) income and baseline survival probability, are significantly different from the conventional value per statistical life (VSL). Our empirical simulation based upon the U.S. population survival curve and income distribution shows that prioritarian SVRRs with a moderate degree of concavity in the transformation function conform to widely held views regarding lifesaving policies: the young should take priority but income should make no difference.
风险降低的社会价值(SVRR)是指通过某种社会福利函数(SWF)衡量的降低个体死亡率的边际社会价值。本文使用了一个终身效用模型来研究 SVRR,该模型根据年龄、终身收入状况和终身风险状况对个体进行区分。我们考虑了功利主义 SWF 和“优先主义”SWF,后者对个体效用进行了严格递增和严格凹的转换。我们表明,优先主义 SVRR 在经济理论中为公共卫生文献中提出的“公平竞争”概念提供了严格的基础:在年龄较大的个体和情况类似的年轻个体(具有相同收入和风险状况的个体)之间,即使预期终身效用的收益相等,降低年轻个体的风险也会赋予更大的社会权重。优先主义和功利主义 SVRR 相对于年龄以及(过去、现在和未来)收入和基本生存概率的静态比较,与传统的每统计生命价值(VSL)有显著差异。我们基于美国人口生存曲线和收入分布的实证模拟表明,具有适度凹度的转换函数的优先主义 SVRR 符合广泛持有的救生政策观点:年轻人应优先考虑,但收入不应有所不同。