IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v197y2018icp213-225.html
   My bibliography  Save this article

The impact of the Great Recession on health-related risk factors, behaviour and outcomes in England

Author

Listed:
  • Jofre-Bonet, Mireia
  • Serra-Sastre, Victoria
  • Vandoros, Sotiris

Abstract

This paper examines the impact that the Great Recession had on individuals’ health behaviours and risk factors such as diet choices, smoking, alcohol consumption, and Body Mass Index, as well as on intermediate health outcomes in England. We exploit data on about 9000 households from the Health Survey for England for the period 2001–2013 and capture the change in macroeconomic conditions using regional unemployment rates and an indicator variable for the onset of the recession. Our findings indicate that the recession is associated with a decrease in the number of cigarettes smoked - which translated into a moderation in smoking intensity - and a reduction in alcohol intake. The recession indicator itself is associated with a decrease in fruit intake, a shift of the BMI distribution towards obesity, an increase in medicines consumption, and the likelihood of suffering from diabetes and mental health problems. These associations are often stronger for the less educated and for women. When they exist, the associations with the unemployment rate (UR) are nevertheless similar before and after 2008. Our results suggest that some of the health risks and intermediate health outcomes changes may be due to mechanisms not captured by worsened URs. We hypothesize that the uncertainty and the negative expectations generated by the recession may have influenced individual health outcomes and behaviours beyond the adjustments induced by the worsened macroeconomic conditions. The net effect translated into the erosion of the propensity to undertake several health risky behaviours but an exacerbation of some morbidity indicators. Overall, we find that the recession led to a moderation in risky behaviours but also to worsening of some risk factors and health outcomes.

Suggested Citation

  • Jofre-Bonet, Mireia & Serra-Sastre, Victoria & Vandoros, Sotiris, 2018. "The impact of the Great Recession on health-related risk factors, behaviour and outcomes in England," Social Science & Medicine, Elsevier, vol. 197(C), pages 213-225.
  • Handle: RePEc:eee:socmed:v:197:y:2018:i:c:p:213-225
    DOI: 10.1016/j.socscimed.2017.12.010
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277953617307402
    Download Restriction: Full text for ScienceDirect subscribers only

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. repec:aph:ajpbhl:10.2105/ajph.2004.053678_1 is not listed on IDEAS
    2. Ferrie, Jane E. & Shipley, Martin J. & Marmot, Michael G. & Stansfeld, Stephen & Smith, George Davey, 1998. "The health effects of major organisational change and job insecurity," Social Science & Medicine, Elsevier, vol. 46(2), pages 243-254, January.
    3. Ruhm, Christopher J., 2005. "Healthy living in hard times," Journal of Health Economics, Elsevier, vol. 24(2), pages 341-363, March.
    4. Cutler, David M. & Huang, Wei & Lleras-Muney, Adriana, 2015. "When does education matter? The protective effect of education for cohorts graduating in bad times," Social Science & Medicine, Elsevier, vol. 127(C), pages 63-73.
    5. Ann H. Stevens & Douglas L. Miller & Marianne E. Page & Mateusz Filipski, 2015. "The Best of Times, the Worst of Times: Understanding Pro-cyclical Mortality," American Economic Journal: Economic Policy, American Economic Association, vol. 7(4), pages 279-311, November.
    6. Burgard, Sarah A. & Brand, Jennie E. & House, James S., 2009. "Perceived job insecurity and worker health in the United States," Social Science & Medicine, Elsevier, vol. 69(5), pages 777-785, September.
    7. repec:aph:ajpbhl:10.2105/ajph.2014.302219_7 is not listed on IDEAS
    8. Molloy, Gerard John & Stamatakis, Emmanuel & Randall, Gemma & Hamer, Mark, 2009. "Marital status, gender and cardiovascular mortality: Behavioural, psychological distress and metabolic explanations," Social Science & Medicine, Elsevier, vol. 69(2), pages 223-228, July.
    9. Gerdtham, Ulf-G. & Johannesson, Magnus, 2005. "Business cycles and mortality: results from Swedish microdata," Social Science & Medicine, Elsevier, vol. 60(1), pages 205-218, January.
    10. Pierre-Yves Crémieux & Marie-Claude Meilleur & Pierre Ouellette & Patrick Petit & Martin Zelder & Ken Potvin, 2005. "Public and private pharmaceutical spending as determinants of health outcomes in Canada," Health Economics, John Wiley & Sons, Ltd., vol. 14(2), pages 107-116.
    11. repec:aph:ajpbhl:1998:88:7:1030-1036_7 is not listed on IDEAS
    12. John Cawley & Asako S. Moriya & Kosali Simon, 2015. "The Impact of the Macroeconomy on Health Insurance Coverage: Evidence from the Great Recession," Health Economics, John Wiley & Sons, Ltd., vol. 24(2), pages 206-223, February.
    13. Elizabeth Brainerd & David M. Cutler, 2005. "Autopsy on an Empire: Understanding Mortality in Russia and the Former Soviet Union," Journal of Economic Perspectives, American Economic Association, vol. 19(1), pages 107-130, Winter.
    14. Kandrack, Mary-Anne & Grant, Karen R. & Segall, Alexander, 1991. "Gender differences in health related behaviour: Some unanswered questions," Social Science & Medicine, Elsevier, vol. 32(5), pages 579-590, January.
    15. Eve Caroli & Mathilde Godard, 2016. "Does job insecurity deteriorate health?," Health Economics, John Wiley & Sons, Ltd., vol. 25(2), pages 131-147, February.
    16. María E. Dávalos & Hai Fang & Michael T. French, 2012. "Easing The Pain Of An Economic Downturn: Macroeconomic Conditions And Excessive Alcohol Consumption," Health Economics, John Wiley & Sons, Ltd., vol. 21(11), pages 1318-1335, November.
    17. Gerdtham, Ulf-G. & Ruhm, Christopher J., 2006. "Deaths rise in good economic times: Evidence from the OECD," Economics & Human Biology, Elsevier, vol. 4(3), pages 298-316, December.
    18. Brenner, M. Harvey, 1987. "Relation of economic change to Swedish health and social well-being, 1950-1980," Social Science & Medicine, Elsevier, vol. 25(2), pages 183-195, January.
    19. Cutler, David M. & Lleras-Muney, Adriana, 2010. "Understanding differences in health behaviors by education," Journal of Health Economics, Elsevier, vol. 29(1), pages 1-28, January.
    20. Antonakakis, Nikolaos & Collins, Alan, 2015. "The impact of fiscal austerity on suicide mortality: Evidence across the ‘Eurozone periphery’," Social Science & Medicine, Elsevier, vol. 145(C), pages 63-78.
    21. Deaton, Angus S & Paxson, Christina H, 1998. "Aging and Inequality in Income and Health," American Economic Review, American Economic Association, vol. 88(2), pages 248-253, May.
    22. Ettner, Susan L., 1996. "New evidence on the relationship between income and health," Journal of Health Economics, Elsevier, vol. 15(1), pages 67-85, February.
    23. Svensson, Mikael, 2007. "Do not go breaking your heart: Do economic upturns really increase heart attack mortality?," Social Science & Medicine, Elsevier, vol. 65(4), pages 833-841, August.
    24. Ruhm, Christopher J. & Black, William E., 2002. "Does drinking really decrease in bad times?," Journal of Health Economics, Elsevier, vol. 21(4), pages 659-678, July.
    25. McInerney, Melissa & Mellor, Jennifer M., 2012. "Recessions and seniors’ health, health behaviors, and healthcare use: Analysis of the Medicare Current Beneficiary Survey," Journal of Health Economics, Elsevier, vol. 31(5), pages 744-751.
    26. Gabriella Conti & James Heckman & Sergio Urzua, 2010. "The Education-Health Gradient," American Economic Review, American Economic Association, vol. 100(2), pages 234-238, May.
    27. Christopher J. Ruhm, 2000. "Are Recessions Good for Your Health?," The Quarterly Journal of Economics, Oxford University Press, vol. 115(2), pages 617-650.
    28. Athina Economou & Agelike Nikolaou & Ioannis Theodossiou, 2008. "Are recessions harmful to health after all?: Evidence from the European Union," Journal of Economic Studies, Emerald Group Publishing, vol. 35(5), pages 368-384, September.
    29. Pierre-Yves Crémieux & Pierre Ouellette & Caroline Pilon, 1999. "Health care spending as determinants of health outcomes," Health Economics, John Wiley & Sons, Ltd., vol. 8(7), pages 627-639.
    30. Poterba, James M. & Samwick, Andrew A., 2003. "Taxation and household portfolio composition: US evidence from the 1980s and 1990s," Journal of Public Economics, Elsevier, vol. 87(1), pages 5-38, January.
    31. McInerney, Melissa & Mellor, Jennifer M. & Nicholas, Lauren Hersch, 2013. "Recession depression: Mental health effects of the 2008 stock market crash," Journal of Health Economics, Elsevier, vol. 32(6), pages 1090-1104.
    32. Haaland, Venke Furre & Telle, Kjetil, 2015. "Pro-cyclical mortality across socioeconomic groups and health status," Journal of Health Economics, Elsevier, vol. 39(C), pages 248-258.
    33. Simou, Effie & Koutsogeorgou, Eleni, 2014. "Effects of the economic crisis on health and healthcare in Greece in the literature from 2009 to 2013: A systematic review," Health Policy, Elsevier, vol. 115(2), pages 111-119.
    34. Cutler, David M. & Knaul, Felicia & Lozano, Rafael & Mendez, Oscar & Zurita, Beatriz, 2002. "Financial crisis, health outcomes and ageing: Mexico in the 1980s and 1990s," Journal of Public Economics, Elsevier, vol. 84(2), pages 279-303, May.
    35. Xu, Xin, 2013. "The business cycle and health behaviors," Social Science & Medicine, Elsevier, vol. 77(C), pages 126-136.
    36. McDonough, Peggy & Walters, Vivienne, 2001. "Gender and health: reassessing patterns and explanations," Social Science & Medicine, Elsevier, vol. 52(4), pages 547-559, February.
    37. Clayton, Maya & Liñares-Zegarra, José & Wilson, John O.S., 2015. "Does debt affect health? Cross country evidence on the debt-health nexus," Social Science & Medicine, Elsevier, vol. 130(C), pages 51-58.
    38. Ettner, Susan L., 1997. "Measuring the human cost of a weak economy: Does unemployment lead to alcohol abuse?," Social Science & Medicine, Elsevier, vol. 44(2), pages 251-260, January.
    39. Charles, Kerwin Kofi & DeCicca, Philip, 2008. "Local labor market fluctuations and health: Is there a connection and for whom?," Journal of Health Economics, Elsevier, vol. 27(6), pages 1532-1550, December.
    40. Neumayer, Eric, 2004. "Recessions lower (some) mortality rates:: evidence from Germany," Social Science & Medicine, Elsevier, vol. 58(6), pages 1037-1047, March.
    41. Hessel, Philipp & Vandoros, Sotiris & Avendano, Mauricio, 2014. "The differential impact of the financial crisis on health in Ireland and Greece: a quasi-experimental approach," LSE Research Online Documents on Economics 59610, London School of Economics and Political Science, LSE Library.
    42. repec:aph:ajpbhl:10.2105/ajph.2014.302219)_5 is not listed on IDEAS
    43. repec:wly:hlthec:v:26:y:2017:i:1:p:104-117 is not listed on IDEAS
    44. Ruhm, Christopher J., 2003. "Good times make you sick," Journal of Health Economics, Elsevier, vol. 22(4), pages 637-658, July.
    45. Ruhm, Christopher J., 2015. "Recessions, healthy no more?," Journal of Health Economics, Elsevier, vol. 42(C), pages 17-28.
    46. Moon, J. Robin & Glymour, M. Maria & Subramanian, S.V. & Avendaño, Mauricio & Kawachi, Ichiro, 2012. "Transition to retirement and risk of cardiovascular disease: Prospective analysis of the US health and retirement study," Social Science & Medicine, Elsevier, vol. 75(3), pages 526-530.
    47. Brenner, M. Harvey & Mooney, Anne, 1983. "Unemployment and health in the context of economic change," Social Science & Medicine, Elsevier, vol. 17(16), pages 1125-1138, January.
    48. Antonakakis, Nikolaos & Collins, Alan, 2014. "The impact of fiscal austerity on suicide: On the empirics of a modern Greek tragedy," Social Science & Medicine, Elsevier, vol. 112(C), pages 39-50.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. repec:eee:socmed:v:222:y:2019:i:c:p:274-284 is not listed on IDEAS
    2. repec:eee:socmed:v:225:y:2019:i:c:p:69-84 is not listed on IDEAS
    3. repec:eee:socmed:v:220:y:2019:i:c:p:403-410 is not listed on IDEAS
    4. Joana Cima & Alvaro S Almeida, 2018. "Health Expenditure, GDP Growth and the Financial Crisis: A Panel Data Analysis for OECD European Countries," FEP Working Papers 602, Universidade do Porto, Faculdade de Economia do Porto.
    5. repec:eee:socmed:v:220:y:2019:i:c:p:387-395 is not listed on IDEAS

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:197:y:2018:i:c:p:213-225. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Dana Niculescu). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.