The impact of economic shocks on health and health inequalities

My research is focused on the health effects of economic shocks, in particular in the mental and physical health of children, young people and older population. I am also focused on socioeconomic status related health inequalities.

My first chapter explores the effects of retirement on both physical and mental ill-health and whether these change in the presence of economic shocks. Inverse probability weighting regression adjustment is used to examine the mechanisms influencing the relationship between retirement and health and a difference-in-differences approach combined with matching to investigate whether the health effects of retirement are affected by the Great Recession. Models are estimated on data from the English Longitudinal Study of Ageing (ELSA) and find that in general retirement leads to a deterioration in both mental and physical health.  However, retiring shortly after the Great Recession appears to improve mental and physical health in the short-term, although only among individuals working in the most affected regions. Overall, results indicate that the health effects of retirement could be influenced by the presence of economic shocks. This might have implications for policies aimed at retaining older workers in the labour market, especially during periods of economic shocks.

My second chapter focuses on the long-term effects of parental unemployment spells experienced during different stages of childhood and early adolescence on their children’s mental and physical health. The analysis exploits data drawn from the British Household Panel Survey (BHPS) and the UK Household Longitudinal Study (UKHLS), linking detailed parental socioeconomic information with their children. A Correlated Random Effects (CRE) probit model that accounts for unobserved heterogeneity is used, as well as a non-linear Generalized Estimating Equations (GEE) random effects estimator to account for the dependency structure of the data. Results indicate that experiencing parental unemployment during early childhood and early adolescence has a negative effect on the children’s likelihood of suffering from long-standing illnesses later in life, while experiencing parental unemployment during middle childhood may affect mental health. Moreover, parental unemployment during early adolescence increases the probability of both reporting poor or fair self-assessed health and the likelihood of consuming prescribed medicines in young adulthood. However, there seems to be considerable effect heterogeneity with children in low–socioeconomic status families, whereas higher frequencies of parental unemployment spells lead to larger negative long-term health effects. These findings may help policymakers shape appropriate policy responses to mitigate the psychological and physical burden derived from parental unemployment, for example by targeting those children in already disadvantaged households.

My third chapter aims to explore potential associations between adolescents’ health inequalities related to socioeconomic deprivation at the household income and the small area deprivation level in England. We use a unique health-focused administrative data drawn from the Health Episode Statistics (HES) linked to a survey data from a cohort of adolescents so-called Next Steps, a longitudinal study regarding children born in 1990. We use total household income (including children benefits) and the Income Deprivation Affecting Children Index (IDACI) to measure income-related and small area deprivation related inequalities in psychological distress and disability/long-term illness among adolescents aged 15 and 17. We further analyse the evolution of unmet need and assess how the English health care system performed against the norm of horizontal equity in health care access during the years of the Great Recession. We employ Erreygers’ corrected concentration index (CCI) and decomposition of concentration indices. Our preliminary results suggest that small area deprivation and household income both yield inequalities in health among adolescents favouring the better-off. These findings have important implications for the measurement of socio-economic inequalities in health and healthcare access among adolescents.