A Normative Foundation for Equity-sensitive Health Evaluation: The Role of Relative Comparisons of Health Gains

We explore in this paper the relationship between equity-sensitive population health evaluation measures and normative concerns for relative comparisons of health gains. Such a relationship allows us to characterize focal equity-sensitive models for the evaluation of population health. Instances are the so-called multiplicative Quality Adjusted Life Years (QALYs) and multiplicative Healthy Years Equivalents (HYEs), as well as generalizations of the two. Our axiomatic approach assumes social preferences over distributions of individual health states experienced in a given period of time. It conveys informational simplicity, as it does not require information about individual preferences on health.