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The impact of the great economic crisis on mental health care in Italy


  • Yuxi Wang

    (Bocconi University)

  • Giovanni Fattore

    (Bocconi University)


The great economic crisis in 2008 has affected the welfare of the population in countries such as Italy. Although there is abundant literature on the impact of the crisis on physical health, very few studies have focused on the causal implications for mental health and health care. This paper, therefore, investigates the impact of the recent economic crisis on hospital admissions for severe mental disorder at small geographic levels in Italy and assesses whether there are heterogeneous effects across areas with distinct levels of income. We exploit 9-year (2007–2015) panel data on hospital discharges, which is merged with employment and income composition at the geographic units that share similar labour market structures. Linear and dynamic panel analysis are used to identify the causal effect of rising unemployment rate on severe mental illness admissions per 100,000 residents to account for time-invariant heterogeneity. We further create discrete income levels to identify the potential socioeconomic gradients behind this effect across areas with different economic characteristics. The results show a significant impact of higher unemployment rates on admissions for severe mental disorders after controlling for relevant economic factors, and the effects are concentrated on the most economically disadvantaged areas. The results contribute to the literature of spatio-temporal variation in the broader determinants of mental health and health care utilisation and shed light on the populations that are most susceptible to the effects of the economic crisis.

Suggested Citation

  • Yuxi Wang & Giovanni Fattore, 2020. "The impact of the great economic crisis on mental health care in Italy," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(8), pages 1259-1272, November.
  • Handle: RePEc:spr:eujhec:v:21:y:2020:i:8:d:10.1007_s10198-020-01204-w
    DOI: 10.1007/s10198-020-01204-w

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    Blog mentions

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    1. Chris Sampson’s journal round-up for 26th October 2020
      by Chris Sampson in The Academic Health Economists' Blog on 2020-10-26 12:00:03


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    3. Aretz, Benjamin, 2022. "The short- and long-term effects of the Great Recession on late-life depression in Europe: The role of area deprivation," Social Science & Medicine, Elsevier, vol. 294(C).
    4. Kergall, Pauline & Guillon, Marlène, 2022. "Lockdown support, trust and COVID-19 conspiracy beliefs: Insights from the second national lockdown in France," Health Policy, Elsevier, vol. 126(11), pages 1103-1109.

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    More about this item


    Mental illness; Mental health care; Economic crisis; Unemployment;
    All these keywords.

    JEL classification:

    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality
    • I15 - Health, Education, and Welfare - - Health - - - Health and Economic Development
    • E24 - Macroeconomics and Monetary Economics - - Consumption, Saving, Production, Employment, and Investment - - - Employment; Unemployment; Wages; Intergenerational Income Distribution; Aggregate Human Capital; Aggregate Labor Productivity


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