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Using interactions of area dose and individual exposure to estimate effects of population health interventions

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  • Sutton, Matt
  • Hugh-Jones, Samuel
  • Wilding, Anna

Abstract

Evaluations of natural experiments in population health studies typically construct and compare exposed and unnexposed populations classified by area or individual exposure. Populations are often dichotomised on one of these dimensions, even if the underlying dose of exposure is graded. We propose that effects of population health interventions can be estimated more accurately by using both dimensions, using an interaction of a continuous measure of dose at area level and the probability of exposure at the individual level. This is particularly useful when receipt of treatment by individuals is either unknown or endogenous. This dose-exposure interaction can be integrated into many common natural experiment designs and we propose it as a verification test. Furthermore, this interaction term can be calibrated to be a predicted probability of exposure and then used to ensure the magnitude of the estimated treatment effect is plausible. We describe how to use this approach and demonstrate its application in two examples: the effects of introducing social prescribing link workers on whether people feel supported by local services; and the effects of a welfare reform on the mental health of benefit claimants. In both cases and in a simulation study, the interactions approach produces more specific, precise and interpretable estimates of intervention effects. We suggest that researchers evaluating population health interventions that are expected to impact on some populations more than others should consider using a dose-exposure interaction design.

Suggested Citation

  • Sutton, Matt & Hugh-Jones, Samuel & Wilding, Anna, 2025. "Using interactions of area dose and individual exposure to estimate effects of population health interventions," Social Science & Medicine, Elsevier, vol. 372(C).
  • Handle: RePEc:eee:socmed:v:372:y:2025:i:c:s0277953625002825
    DOI: 10.1016/j.socscimed.2025.117952
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    1. David Card, 1992. "Using Regional Variation in Wages to Measure the Effects of the Federal Minimum Wage," ILR Review, Cornell University, ILR School, vol. 46(1), pages 22-37, October.
    2. Joshua D. Angrist & Jörn-Steffen Pischke, 2009. "Mostly Harmless Econometrics: An Empiricist's Companion," Economics Books, Princeton University Press, edition 1, number 8769.
    3. David Card, 1992. "Using Regional Variation in Wages to Measure the Effects of the Federal Minimum Wage," Working Papers 680, Princeton University, Department of Economics, Industrial Relations Section..
    4. Martin Gaynor & Rodrigo Moreno-Serra & Carol Propper, 2013. "Death by Market Power: Reform, Competition, and Patient Outcomes in the National Health Service," American Economic Journal: Economic Policy, American Economic Association, vol. 5(4), pages 134-166, November.
    5. repec:fth:prinin:300 is not listed on IDEAS
    6. Meyer, Bruce D, 1995. "Natural and Quasi-experiments in Economics," Journal of Business & Economic Statistics, American Statistical Association, vol. 13(2), pages 151-161, April.
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