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◆ Social science & medicine (1982)2026-09-08

Safety prioritization beyond efficiency: The role of age, health status, and ingroup preferences.

Judith Covey, Danae Arroyos-Calvera, Rebecca McDonald

原始摘要(英文原文)· Original abstract
A key challenge for policymakers is allocating limited resources to improve safety. One approach is to compare the cost-per-life-saved against a metric such as the Value of Statistical Life (VSL), an approach that prioritizes efficiency - i.e., the number of lives saved. But public preferences may reflect concerns beyond efficiency. In two experiments conducted in May and June 2020, we examine how people trade efficiency against distributive principles (equity in distribution and saving those most at risk), and beneficiary characteristics (age and health status). Self-interest was also considered by randomly assigning respondents to adopt either an impartial or socially inclusive personal perspective. Across both experiments, efficiency was the dominant concern, with equity and self-interest also valued. In the experiment focused on age (N = 314), saving younger lives received greater weight than saving older lives, but the effect was small and heterogeneous. It was driven primarily by younger respondents - older respondents showed no comparable prioritization. In contrast, the experiment focused on health (N = 316) revealed no aggregate preference for prioritizing people in good health over those in poor health. Ingroup preferences among respondents in good or poor health offset one another. Self-interest framing did not amplify ingroup preferences. Overall, the findings indicate limited consensus for adjusting VSLs based on age or health status. Some age-related weighting emerges without cross-group agreement, and there is no overall support for health-based adjustment. Recognizing how ingroup preferences shape public views is important for informing safety policy.
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Safety prioritization beyond efficiency: The role of age, health status, and ingroup preferences. — 科研速览 Science Skim