Department of Economics, City, University of London, UK; Department of Health Policy, LSE, UK.
Department of Economics, City, University of London, UK; Department of Health Policy, LSE, UK.
Soc Sci Med. 2018 Jan;197:213-225. doi: 10.1016/j.socscimed.2017.12.010. Epub 2017 Dec 12.
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.
本文考察了大衰退对个人健康行为和风险因素的影响，如饮食选择、吸烟、饮酒、体重指数，以及英格兰的中间健康结果。我们利用了英格兰健康调查中约 9000 户家庭的数据，并使用地区失业率和衰退开始的指标变量来捕捉宏观经济条件的变化。我们的研究结果表明，经济衰退与吸烟量减少有关——这导致吸烟强度降低——同时饮酒量也有所减少。衰退指标本身与水果摄入量减少、BMI 分布向肥胖转移、药品消费增加以及患糖尿病和心理健康问题的可能性增加有关。这些关联在受教育程度较低和女性中更为明显。在存在这些关联的情况下，2008 年前后与失业率 (UR) 的关联仍然相似。我们的研究结果表明，一些健康风险和中间健康结果的变化可能是由于未被恶化的 UR 所捕捉到的机制造成的。我们假设，衰退带来的不确定性和负面预期可能会影响个人健康结果和行为，超出了宏观经济条件恶化所带来的调整。净效应导致了采取几种健康风险行为的倾向减弱，但一些发病率指标恶化。总体而言，我们发现衰退导致了风险行为的缓和，但也导致了一些风险因素和健康结果的恶化。
