Author:

Keywords:

DALYs, environmental health

Abstract:

Aggregated health metrics, such as disability adjusted life years (DALYs) and willigness to pay (WTP) are useful in environmental health policy to value the changes in public health caused by environmental pollution. Because of the different application areas and methodological approaches - DALYs are based on experts' assessment instead of the citizens' point of view in WTP - a fixed WTP/DALY ratio does not exist. In this paper, the relationship between these two aggregated environmental health indicators is studied for air pollution and noise in Flanders. The environmental burden of disease methodology without age adjustment or time discounting and the Dutch disability weights have been applied. The external cost values are consistent with those used in the European ExternE and CAFE Programmes. Calculating a euro per DALY, a difference is made between mortality and morbidity due to short-term or chronic exposure. The external cost per DALY due to acute and chronic mortality corresponds respectively to € 75,000 and € 52,000. In the case of severe morbidity health effects a € 82,300/DALY conversion factor was calculated. However, for smaller symptoms, medical experts and citizens do not value at equal. Expert weighting schemes (DALYs) give much lower values compared to the individuals'willigness to pay. It is concluded that nowadays, the individuals'willigness to pay may be a better value for small health effects. After all, the severity weights, traditionally used to disability effects, are not yet sufficient developed for diminished well-being.