从小病到大病: 在环境政策分析中评估发病率的实用框架
From Minor Ailments to Major Illnesses: A Practical Framework for Valuing Morbidity in Environmental Policy Analysis
NBER Working Papers · 2026 · [{"name": "Mark Dickie", "affiliation": []}, {"name": "Matthew J. Neidell", "affiliation": []}]
中文摘要
环境决策常常影响健康，但疾病负担的价值评估仍面临挑战：现有方法，如疾病成本（COI）度量和质量调整生命年，均未能反映个人为避免不良健康状态而愿意支付的费用（支付意愿）。本文提出一个用于对各类健康状况下的疾病负担进行估值的新框架，利用广泛可得的偏好权重，并结合一个具有已知支付意愿（WTP）的基准状况，推导出WTP估计值。我们的分析显示，所得WTP估计值显著高于常用的COI度量值，表明现有政策评估中对健康状态的价值存在低估。敏感性分析表明，其变化幅度与统计生命价值的相应变化一致，凸显了该方法的稳健性。该框架为将疾病负担纳入环境政策分析提供了一个实用工具。
Abstract
Environmental decisions often impact health, yet morbidity valuation remains challenging, with current approaches like cost-of-illness (COI) measures and Quality-Adjusted Life Years failing to reflect individuals’ willingness to pay to avoid adverse health states. This paper introduces a novel framework for valuing morbidity across health conditions, deriving willingness-to-pay (WTP) estimates using widely available preference weights and a baseline condition with known WTP. Our analysis reveals WTP estimates significantly exceeding commonly used COI measures, indicating undervaluation of health states in policy evaluations. Sensitivity analyses highlight variations consistent with those for the value of statistical life, underscoring the method's robustness. This framework offers a practical tool for integrating morbidity into analyses of environmental policy.