Are We Willing to Trade Off Our Own Health to Save the Planet? Results From an Exploratory Discrete Choice Experiment

OBJECTIVES: Modifying the delivery of healthcare in order to reduce environmental will come at some cost, whether that cost is monetary (i.e. expenditure to reduce harmful effects) or via health (patients switching to less harmful, but less cost-effective treatments). This study aimed to estimate the public’s views about such trade-offs.

METHODS: 508 members of the public completed a discrete choice experiment (DCE), which asked them to state their preferences between different health system outcomes, measured by (i) life expectancy, (ii) carbon emissions and (iii) impact on biodiversity. Two alternative sets of questions were presented. The first reported that the environmental effects would be felt within the respondent’s own country of residence, and the second reported that the effects would occur elsewhere in the world.

RESULTS: People were willing to lose an average of 0.75 years of life expectancy in order to see a 5% reduction in carbon emissions. They were willing to lose 1.59 years of life expectancy to save 100 species from becoming extinct. Conversely, people would require an increase of 1.55 years of life expectancy to see carbon emissions increase by 5% and would require 2.88 additional years of life expectancy if 100 more species were to become extinct. When the environmental impact was described as occurring outside the respondent’s own country, the strength of preference was reduced by approximately 50%

CONCLUSIONS: Whilst this study was exploratory and should not be used for policy making, it demonstrates that it is feasible to elicit opinions from the public around trade-offs between health outcomes and environmental outcomes.