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Macroeconomic Conditions and Health in Britain: Aggregation, Dynamics and Local Area Heterogeneity

Author

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  • Janke, Katharina
  • Lee, Kevin
  • Propper, Carol
  • Shields, Kalvinder K
  • Shields, Michael

Abstract

We estimate a model that allows for dynamic and interdependent responses of morbidity in different local areas to economic conditions at the local and national level, with statistical selection of optimal local area. We apply this approach to quarterly British data on chronic health conditions for those of working age over the period 2002-2016. We find strong and robust counter-cyclical relationships for overall chronic health, and for five broad types of health conditions. Chronic health conditions therefore increase in poor economic times. There is considerable spatial heterogeneity across local areas, with the counter-cyclical relationship being strongest in poorer local areas with more traditional industrial structures. We find that feedback effects are quantitatively important across local areas, and dynamic effects that differ by health condition. Consequently, the standard panel data model commonly used in the literature considerably under-estimates the extent of the counter-cyclical relationship in our context.

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  • Janke, Katharina & Lee, Kevin & Propper, Carol & Shields, Kalvinder K & Shields, Michael, 2020. "Macroeconomic Conditions and Health in Britain: Aggregation, Dynamics and Local Area Heterogeneity," CEPR Discussion Papers 14507, C.E.P.R. Discussion Papers.
  • Handle: RePEc:cpr:ceprdp:14507
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    1. Rajeev Dehejia & Adriana Lleras-Muney, 2004. "Booms, Busts, and Babies' Health," The Quarterly Journal of Economics, Oxford University Press, vol. 119(3), pages 1091-1130.
    2. Cotti Chad & Tefft Nathan, 2011. "Decomposing the Relationship between Macroeconomic Conditions and Fatal Car Crashes during the Great Recession: Alcohol- and Non-Alcohol-Related Accidents," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 11(1), pages 1-24, August.
    3. Ruhm, Christopher J., 2005. "Healthy living in hard times," Journal of Health Economics, Elsevier, vol. 24(2), pages 341-363, March.
    4. Hollingsworth, Alex & Ruhm, Christopher J. & Simon, Kosali, 2017. "Macroeconomic conditions and opioid abuse," Journal of Health Economics, Elsevier, vol. 56(C), pages 222-233.
    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. Crost, Benjamin & Friedson, Andrew, 2017. "Recessions and health revisited: New findings for working age adults," Economics & Human Biology, Elsevier, vol. 27(PA), pages 241-247.
    7. Halliday, Timothy J., 2014. "Unemployment and mortality: Evidence from the PSID," Social Science & Medicine, Elsevier, vol. 113(C), pages 15-22.
    8. Strumpf, Erin C. & Charters, Thomas J. & Harper, Sam & Nandi, Arijit, 2017. "Did the Great Recession affect mortality rates in the metropolitan United States? Effects on mortality by age, gender and cause of death," Social Science & Medicine, Elsevier, vol. 189(C), pages 11-16.
    9. repec:pri:cheawb:adriana_booms.pdf is not listed on IDEAS
    10. van den Berg, Gerard J. & Gerdtham, Ulf-G. & von Hinke, Stephanie & Lindeboom, Maarten & Lissdaniels, Johannes & Sundquist, Jan & Sundquist, Kristina, 2017. "Mortality and the business cycle: Evidence from individual and aggregated data," Journal of Health Economics, Elsevier, vol. 56(C), pages 61-70.
    11. Antonova, Liudmila & Bucher-Koenen, Tabea & Mazzonna, Fabrizio, 2017. "Long-term health consequences of recessions during working years," Social Science & Medicine, Elsevier, vol. 187(C), pages 134-143.
    12. Christopher Ruhm, 2007. "A healthy economy can break your heart," Demography, Springer;Population Association of America (PAA), vol. 44(4), pages 829-848, November.
    13. Pesaran, M. Hashem & Smith, Ron, 1995. "Estimating long-run relationships from dynamic heterogeneous panels," Journal of Econometrics, Elsevier, vol. 68(1), pages 79-113, July.
    14. Colombo, Emilio & Rotondi, Valentina & Stanca, Luca, 2018. "Macroeconomic conditions and health: Inspecting the transmission mechanism," Economics & Human Biology, Elsevier, vol. 28(C), pages 29-37.
    15. Carpenter, Christopher S. & McClellan, Chandler B. & Rees, Daniel I., 2017. "Economic conditions, illicit drug use, and substance use disorders in the United States," Journal of Health Economics, Elsevier, vol. 52(C), pages 63-73.
    16. Brenner, M.H., 1971. "Economic changes and heart disease mortality," American Journal of Public Health, American Public Health Association, vol. 61(3), pages 606-611.
    17. Sarah H. Gordon & Benjamin D. Sommers, 2016. "Recessions, Poverty, and Mortality in the United States: 1993–2012," American Journal of Health Economics, MIT Press, vol. 2(4), pages 489-510, Fall.
    18. 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.
    19. Erzo F. P. Luttmer, 2005. "Neighbors as Negatives: Relative Earnings and Well-Being," The Quarterly Journal of Economics, Oxford University Press, vol. 120(3), pages 963-1002.
    20. 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.
    21. Toffolutti, Veronica & Suhrcke, Marc, 2019. "Does austerity really kill?," Economics & Human Biology, Elsevier, vol. 33(C), pages 211-223.
    22. Jean‐Paul Lam & Emmanuelle Piérard, 2017. "The Time‐Varying Relationship between Mortality and Business Cycles in the USA," Health Economics, John Wiley & Sons, Ltd., vol. 26(2), pages 164-183, February.
    23. Christopher J. Ruhm, 2000. "Are Recessions Good for Your Health?," The Quarterly Journal of Economics, Oxford University Press, vol. 115(2), pages 617-650.
    24. 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.
    25. Wang, Huixia & Wang, Chenggang & Halliday, Timothy J., 2018. "Health and health inequality during the great recession: Evidence from the PSID," Economics & Human Biology, Elsevier, vol. 29(C), pages 17-30.
    26. He, Monica M., 2016. "Driving through the Great Recession: Why does motor vehicle fatality decrease when the economy slows down?," Social Science & Medicine, Elsevier, vol. 155(C), pages 1-11.
    27. repec:wly:hlthec:v:25:y:2016:i::p:6-24 is not listed on IDEAS
    28. Hilary Hoynes & Douglas L. Miller & Jessamyn Schaller, 2012. "Who Suffers during Recessions?," Journal of Economic Perspectives, American Economic Association, vol. 26(3), pages 27-48, Summer.
    29. Laliotis, Ioannis & Stavropoulou, Charitini, 2018. "Crises and mortality: Does the level of unemployment matter?," Social Science & Medicine, Elsevier, vol. 214(C), pages 99-109.
    30. Dave, Dhaval M. & Kelly, Inas Rashad, 2012. "How does the business cycle affect eating habits?," Social Science & Medicine, Elsevier, vol. 74(2), pages 254-262.
    31. Max Brüning & Josselin Thuilliez, 2019. "Mortality and Macroeconomic Conditions: What Can We Learn From France?," Demography, Springer;Population Association of America (PAA), vol. 56(5), pages 1747-1764, October.
    32. Lee, Kevin C & Pesaran, M Hashem, 1993. "The Role of Sectoral Interactions in Wage Determination in the UK Economy," Economic Journal, Royal Economic Society, vol. 103(416), pages 21-55, January.
    33. Ruhm, Christopher J., 2003. "Good times make you sick," Journal of Health Economics, Elsevier, vol. 22(4), pages 637-658, July.
    34. Erdal Tekin & Chandler McClellan & Karen Jean Minyard, 2018. "Health and health behaviors during the great recession: a note on drinking, smoking, obesity, and physical activity," Review of Economics of the Household, Springer, vol. 16(4), pages 1017-1026, December.
    35. van Garderen, Kees Jan & Lee, Kevin & Pesaran, M. Hashem, 2000. "Cross-sectional aggregation of non-linear models," Journal of Econometrics, Elsevier, vol. 95(2), pages 285-331, April.
    36. Sarafidis, Vasilis & Yamagata, Takashi & Robertson, Donald, 2009. "A test of cross section dependence for a linear dynamic panel model with regressors," Journal of Econometrics, Elsevier, vol. 148(2), pages 149-161, February.
    37. Lee, Kevin C & Pesaran, M Hashem & Pierse, Richard G, 1990. "Testing for Aggregation Bias in Linear Models," Economic Journal, Royal Economic Society, vol. 100(400), pages 137-150, Supplemen.
    38. Sarah H. Gordon & Benjamin D. Sommers, 2016. "Recessions, Poverty, and Mortality in the United States: 1993–2012," American Journal of Health Economics, University of Chicago Press, vol. 2(4), pages 489-510, Fall.
    39. Marianne Page & Jessamyn Schaller & David Simon, 2019. "The Effects of Aggregate and Gender-Specific Labor Demand Shocks on Child Health," Journal of Human Resources, University of Wisconsin Press, vol. 54(1), pages 37-78.
    40. Michael P. Clements & David F. Hendry, 2005. "Guest Editors’ Introduction: Information in Economic Forecasting," Oxford Bulletin of Economics and Statistics, Department of Economics, University of Oxford, vol. 67(s1), pages 713-753, December.
    41. 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.
    42. 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.
    43. Robyn Swift, 2011. "The relationship between health and GDP in OECD countries in the very long run," Health Economics, John Wiley & Sons, Ltd., vol. 20(3), pages 306-322, March.
    44. repec:pri:cheawb:adriana_booms is not listed on IDEAS
    45. Kaplan, Erin K. & Collins, Courtney A. & Tylavsky, Frances A., 2017. "Cyclical unemployment and infant health," Economics & Human Biology, Elsevier, vol. 27(PA), pages 281-288.
    46. Sameem, Sediq & Sylwester, Kevin, 2017. "The business cycle and mortality: Urban versus rural counties," Social Science & Medicine, Elsevier, vol. 175(C), pages 28-35.
    47. José Tapia granados, 2008. "Macroeconomic fluctuations and mortality in postwar Japan," Demography, Springer;Population Association of America (PAA), vol. 45(2), pages 323-343, May.
    48. 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.
    49. 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.
    50. Paling, Thomas & Vall Castello, Judit, 2017. "Business cycle impacts on substance use of adolescents: A multi-country analysis," Economics & Human Biology, Elsevier, vol. 27(PA), pages 1-11.
    51. Tapia Granados, José A. & Ionides, Edward L., 2008. "The reversal of the relation between economic growth and health progress: Sweden in the 19th and 20th centuries," Journal of Health Economics, Elsevier, vol. 27(3), pages 544-563, May.
    52. Ruhm, Christopher J., 2019. "Drivers of the fatal drug epidemic," Journal of Health Economics, Elsevier, vol. 64(C), pages 25-42.
    53. Mikael Svensson & Curt Hagquist, 2010. "Adolescents alcohol-use and economic conditions: a multilevel analysis of data from a period with big economic changes," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 11(6), pages 533-541, December.
    54. Vandoros, Sotiris & Avendano, Mauricio & Kawachi, Ichiro, 2019. "The association between economic uncertainty and suicide in the short-run," Social Science & Medicine, Elsevier, vol. 220(C), pages 403-410.
    55. Neumayer, Eric, 2004. "Recessions lower (some) mortality rates:: evidence from Germany," Social Science & Medicine, Elsevier, vol. 58(6), pages 1037-1047, March.
    56. Tefft, Nathan, 2011. "Insights on unemployment, unemployment insurance, and mental health," Journal of Health Economics, Elsevier, vol. 30(2), pages 258-264, March.
    57. Christopher J. Ruhm, 2016. "Health Effects of Economic Crises," Health Economics, John Wiley & Sons, Ltd., vol. 25(S2), pages 6-24, November.
    58. Wagstaff, Adam, 1985. "Time series analysis of the relationship between unemployment and mortality: A survey of econometric critiques and replications of Brenner's studies," Social Science & Medicine, Elsevier, vol. 21(9), pages 985-996, January.
    59. Audrey Laporte, 2004. "Do economic cycles have a permanent effect on population health? Revisiting the Brenner hypothesis," Health Economics, John Wiley & Sons, Ltd., vol. 13(8), pages 767-779, August.
    60. Ezra Golberstein & Gilbert Gonzales & Ellen Meara, 2019. "How do economic downturns affect the mental health of children? Evidence from the National Health Interview Survey," Health Economics, John Wiley & Sons, Ltd., vol. 28(8), pages 955-970, August.
    61. Ruhm, Christopher J., 2015. "Recessions, healthy no more?," Journal of Health Economics, Elsevier, vol. 42(C), pages 17-28.
    62. Lindo, Jason M., 2015. "Aggregation and the estimated effects of economic conditions on health," Journal of Health Economics, Elsevier, vol. 40(C), pages 83-96.
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    More about this item

    Keywords

    aggregation; dynamics; health; Heterogeneity; macroeconomic conditions; Morbidity;
    All these keywords.

    JEL classification:

    • C33 - Mathematical and Quantitative Methods - - Multiple or Simultaneous Equation Models; Multiple Variables - - - Models with Panel Data; Spatio-temporal Models
    • E32 - Macroeconomics and Monetary Economics - - Prices, Business Fluctuations, and Cycles - - - Business Fluctuations; Cycles
    • J10 - Labor and Demographic Economics - - Demographic Economics - - - General
    • J21 - Labor and Demographic Economics - - Demand and Supply of Labor - - - Labor Force and Employment, Size, and Structure

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