The Impact of Economic Shocks on Health and Health Inequalities

Martinez Jimenez, Mario and Hollingsworth, Bruce and Zucchelli, Eugenio (2025) The Impact of Economic Shocks on Health and Health Inequalities. PhD thesis, Lancaster University.

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Abstract

This thesis explores the effects of economic shocks on health and health inequalities using multiple datasets from the United Kingdom. The second chapter studies 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 the English Longitudinal Study of Ageing (ELSA) dataset. The third chapter focuses on the effects of parental unemployment spells experienced during early, mid and late childhood on long-term child mental and physical health. This chapter exploits merged data drawn from the British Household Panel Survey (BHPS) and the UK Household Longitudinal Study (UKHLS), linking detailed parental socioeconomic information with key health variables on their children. In this analysis, a Correlated Random Effects (CRE) probit model accounts for unobserved heterogeneity while a non-linear Generalized Estimating Equations (GEE) random effects estimator for the dependency structure of the data. The fourth chapter explores associations between adolescent health and socioeconomic deprivation by income and small-area levels in England. This study uses administrative data drawn from the Health Episode Statistics (HES) linked to Next Steps, a longitudinal survey including a cohort of adolescents born in 1990. Erreygers’ corrected concentration index and Shapley-Shorrocks decomposition techniques are employed to measure and explore the relative contributions of a set of childhood circumstances in the adolescent health and health care utilisation inequalities. In addition, an Interrupted Time-Series (ITS) analysis is implemented to examine changes in health care utilisation in the emergency and outpatient departments during the years of the Great Recession and subsequent austerity policies. The last chapter summarises the main findings of the PhD, discusses the policy implications of these findings, reviews the limitations and unanswered questions from the analyses, and provides recommendations for future research.