Valuing health at different ages: Evidence from a nationally representative survey in the US

Background: Evidence about how people value health gains for different age groups is controversial and incomplete, despite the significance of this issue for priority setting in health policy. Objective: The aim of this study was to collect and analyse nationally representative data in the US regarding how people prioritize health programmes for children versus older adults. Methods: In January 2009, an online survey was administered to a nationally representative sample of US adults. Participants were asked for their preferences between health programmes benefiting 100 children aged 10 years versus health programmes benefiting a randomly varying number of adults aged 60 years. Participants were also asked about reasons for their choices. Results: The survey response rate was 64% (n = 2132). Most respondents favoured programmes for 100 children aged 10 years when compared with programmes benefiting as many as 1000 adults aged 60 years. This was true even for the respondent group least inclined to favour children - older adults without children aged <18 years. Conclusion: US adults, regardless of sociodemographic characteristics, report preferences for health gains for children that go well beyond differentials that can be explained by relative life expectancy. Further work is needed to understand the extent to which these findings accurately reflect societal preferences.