Systematic Review of the Relative Social Value of Child and Adult Health

Tessa Peasgood, Martin Howell*, Rakhee Raghunandan, Amber Salisbury, Marcus Sellars, Gang Chen, Joanna Coast, Jonathan C. Craig, Nancy Devlin, Kirsten Howard, Emily Lancsar, Stavros Petrou, Julie Ratcliffe, Rosalie Viney, Germaine Wong, Richard Norman, Cam Donaldson

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review


We aimed to synthesise knowledge on the relative social value of child and adult health.

Quantitative and qualitative studies that evaluated the willingness of the public to prioritise treatments for children over adults were included. A search to September 2023 was undertaken. Completeness of reporting was assessed using a checklist derived from Johnston et al. Findings were tabulated by study type (matching/person trade-off, discrete choice experiment, willingness to pay, opinion survey or qualitative). Evidence in favour of children was considered in total, by length or quality of life, methodology and respondent characteristics.

Eighty-eight studies were included; willingness to pay (n = 9), matching/person trade-off (n = 12), discrete choice experiments (n = 29), opinion surveys (n = 22) and qualitative (n = 16), with one study simultaneously included as an opinion survey. From 88 studies, 81 results could be ascertained. Across all studies irrespective of method or other characteristics, 42 findings supported prioritising children, while 12 provided evidence favouring adults in preference to children. The remainder supported equal prioritisation or found diverse or unclear views. Of those studies considering prioritisation within the under 18 years of age group, nine findings favoured older children over younger children (including for life saving interventions), six favoured younger children and five found diverse views.

The balance of evidence suggests the general public favours prioritising children over adults, but this view was not found across all studies. There are research gaps in understanding the public’s views on the value of health gains to very young children and the motivation behind the public’s views on the value of child relative to adult health gains.
Original languageEnglish
Pages (from-to)177-198
Number of pages12
Issue number2
Early online date9 Nov 2023
Publication statusPublished - 1 Feb 2024

Bibliographical note

Funding Information:
Open Access funding enabled and organized by CAUL and its Member Institutions. QUOKKA is funded through the Medical Future Research Fund (Grant number: APP1200816); TORCH is funded through the Medical Future Research Fund (Grant number: APP1199902).

Publisher Copyright:
© 2023, The Author(s).


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