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Public Perceptions of Inequalities in Health and Income

This project aims to assess and critically inform the public's perception of health inequalities in the UK, thus informing one of society’s most important policy debates. 

Health inequality large

Researchers

Research background

The term “health inequality” refers to the systematic differences in the health of individuals who occupy different socioeconomic positions in society. Although the UK is an international leader in health inequality research and policy, a recent report indicated that since a landmark review on the issue exactly 10 years, health inequalities in England have worsened (Marmot, 2020).

In line with the concerted media focus on this, it is often assumed by public health researchers and advocates alike that the public is both aware of health inequalities and desire to see them reduced. However, there is no robust evidence to demonstrate whether this is, in fact, the case.

Research aims 

In this project we developed a novel approach to assessing public awareness of and ‘preferences’ for inequalities in health outcomes, by asking UK and US samples what they thought the typical life expectancy of people occupying different socioeconomic positions are (e.g. richest 20% vs. poorest 20%). We could then compare people’s perceptions of existing health inequalities in the UK and US with actual health inequality in the UK. We were also interested in how these responses compared with comparable measures on income inequality, given evidence of a universal desire for some level of income inequality (Kiatpongson & Norton, 2014).

Research methods

This is principally a quantitative survey project in which data was collected using the online survey software, Qualtrics. Participants were recruited using Prolific (UK) and MTurk (US) marketplace platforms. Along with the principal questions designed to assess perceptions of health inequalities we also collected data on participants’ own socioeconomic circumstances as well as their attitudes towards health and income inequality and political ideology.

Projected outcomes

Across nationalities and measures, we observed that members of both the UK and US public were correct in perceiving that higher SEE groups outlive lower SES groups. There was also consistent evidence of a universal desire for differences in life expectancy to be eliminated (i.e. no evidence of a desire for health inequality). We have therefore presented a novel and versatile approach that can be used to inform one of society’s most important policy debates.

Additional links: British Medical Journal (2020) article on health equity in England can be found here: https://www.bmj.com/content/368/bmj.m693