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ELW

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I have a query regarding DALYs which I've been unable to find an answer too, but suspect there is literature on were I more familiar with econ/global health:

By my understanding one of the main advantages of DALYs is that they capture the intuition action in cases like "You may extend either person As life by 5 healthy years or extend person Bs life by 5 mediocre years (lets say they go blind due to the treatment)."

However, there seems to be no way of distinguishing the case where person A and B start of as perfectly healthy and we may help the former more and the cases where B is already blind and we may add "five years at their current state of well-being". This seems to not be ideal.

Is there any talk or use of "marginal DALYs" for want of a better term, where the intervention is considered relative to the previous level of wellbeing? Alternatively, is it simply common practise to use QALYs in the kind of case I am concerned with?

I wondered if the oddly high portion of refusal to answer was ideological, too. I hope this isn't the case and inclined to think it's unlikely; though there seem to be some EAs who are wary of questions regarding this kind of diversity, as they reject it is something to be tackled within the movement, I would not have thought that proportion (or rather the proportion who hold the view to the point of refusing the data altogether) would be as large as this.

It feels rather optimistic to suggest this is an issue of categorisation e.g. though the answers on race were not exclusive, which would be obviously problematic, most race sections on this type of survey that I'm used to have a more fine-grained response options. However, it seems even if this were an issue it ought not cause problems for such a large proportion of respondents.

It's maybe worth noting the comparative proportion of respondents who did not answer political leanings (42.7%). If nothing else I think the number of people who refused response on race would be more bizarre/worrying if there was a very high response rate on everything else. My first thought was that refusal to answer on political leanings is likely idealogical (wariness of EA being especially associated with any specific political position) but on second thoughts I wonder if this is more likely to be a category problem? (It may be that people are reluctant to select "other" because their political stance is subsumed within left/right/centre etc, but they feel it is not well described by these options...? However, I'm not confident how likely this is and do not have a background in the intricacies of data gathering - unlike, I assume, those and ReThink who put this together.)