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Too poor to say no? Health incentives for disadvantaged populations
  1. Kristin Voigt1,2
  1. 1Nuffield Department of Population Health, Ethox Centre, Oxford University, Oxford, UK
  2. 2Department of Philosophy & Institute for Health and Social Policy, McGill University, Montreal, Canada
  1. Correspondence to Dr Kristin Voigt, Nuffield Department of Population Health, Ethox Centre, Oxford University, Old Road Campus, Oxford OX3 7LF, UK; kristin.voigt{at}


Incentive schemes, which offer recipients benefits if they meet particular requirements, are being used across the world to encourage healthier behaviours. From the perspective of equality, an important concern about such schemes is that since people often do not have equal opportunity to fulfil the stipulated conditions, incentives create opportunity for further unfair advantage. Are incentive schemes that are available only to disadvantaged groups less susceptible to such egalitarian concerns? While targeted schemes may at first glance seem well placed to help improve outcomes among disadvantaged groups and thus reduce inequalities, I argue in this paper that they are susceptible to significant problems. At the same time, incentive schemes may be less problematic when they operate in ways that differ from the ‘standard’ incentive mechanism; I discuss three such mechanisms.

  • Distributive Justice
  • Health Promotion
  • Public Health Ethics
  • Public Policy

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  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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