Valuing Mortality Risk Reductions from Environmental, Transport, and Health Policies: A Global Meta‐Analysis of Stated Preference Studies

Abstract

We conduct, to our knowledge, the first global meta-analysis (MA) of stated preference (SP) surveys of mortality risk valuation. The surveys ask adults their willingness to pay (WTP) for small reductions in mortality risks, deriving estimates of the sample mean value of statistical life (VSL) for environmental, health, and transport policies. We explain the variation in VSL estimates by differences in the characteristics of the SP methodologies applied, the population affected, and the characteristics of the mortality risks valued, including the magnitude of the risk change. The mean (median) VSL in our full data set of VSL sample means was found to be around $7.4 million (2.4 million) (2005 U.S. dollars). The most important variables explaining the variation in VSL are gross domestic product (GDP) per capita and the magnitude of the risk change valued. According to theory, however, VSL should be independent of the risk change. We discuss and test a range of quality screening criteria in order to investigate the effect of limiting the MA to high-quality studies. When limiting the MA to studies that find statistically significant differences in WTP using external or internal scope tests (without requiring strict proportionality), we find that mean VSL from studies that pass both tests tend to be less sensitive to the magnitude of the risk change. Mean VSL also tends to decrease when stricter screening criteria are applied. For many of our screened models, we find a VSL income elasticity of 0.7-0.9, which is reduced to 0.3-0.4 for some subsets of the data that satisfy scope tests or use the same high-quality survey.

Analysis and valuation of the health and climate change cobenefits of dietary change

“…First, using "cost-of-illness" techniques (23, 25), we calculated the direct health-care costs and the indirect costs of informal care and lost work days that are associated with deaths from specific diseases. Second, we used region-specific data on the willingness of individuals to pay for incremental mortality reductions, the "value of statistical life" (VSL) (21,22), to obtain an estimate of the cost of the lives (and life-years) saved under each dietary scenario. The two approaches span the range of potential valuation methods (33,34); the VSL approach is commonly used in cost-benefit analysis (22) to indicate societal preferences whereas the cost-of-illness approach, in particular its direct cost component, highlights the economic impact on the health-care sector and on patients (23,25).…”

“…Ideally, we would have used values that were specifically estimated for the regions used. However, such data do not exist for all of the regions included in this study, so instead we used a comprehensive and quality-screened database of VSL estimates (21,22) and a regional set of comparable CoI estimates (23)(24)(25). The valuation based on CoI estimates might be further improved by the inclusion of comorbidities that can affect the costs attributable to specific disease, and by breaking down aggregate cancer costs into site-specific costs.…”

“…We based our VSL valuation on a comprehensive global metaanalysis of stated preference surveys of mortality risk valuation undertaken for the Organization for Economic Co-operation and Development (OECD) (21). Following OECD recommendations, we adopted a VSL base value for the European Union (EU) of 3.5 million US dollars (1.75-5.25 million US dollars) and used the benefittransfer method to calculate VSLs in other regions (22), taking into account differences in income expressed as GDP per capita adjusted for purchasing power parity (PPP) and projected to 2050 (SI Appendix, section SI.4).…”

“…In the economic analysis, we placed a monetary value on changes in GHG emissions by using estimates of the social cost of carbon (20) and explored monetizing the health consequences using the value of statistical life (21,22) and projections of health-care expenditure by cause of death (23)(24)(25). We stress from the outset that we consider the economic valuation to be a first step and that the estimates are not exactly comparable nor do they include all consequences of dietary changes.…”

The benefits of avoiding cancer (or dying from cancer): Evidence from a four- country study

“…We are looking for factors that systematically affect the magnitude of the cancer VSL and VSCC within a cancer context, and we are not seeking to estimate the so-called cancer premium, which has been investigated, with mixed results, in earlier studies (Jones-Lee et al, 1985;Hammitt and Haninger, 2010;Adamowicz et al, 2011;Lindhjem et al, 2011;OECD, 2012). Moreover, in past research we have found that cancer values trump those for any other cause of death Ščasný, 2011, 2013) making it difficult to investigate issues of scope and attributes associated with illness and death.…”