Long-run Health and Mortality Effects of Exposure to Universal Health Care at Birth

Wilson, T. (2018) CALLS Hub conference, University of St Andrews, UK, 23 March 2018 [ONS LS]

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In this paper we investigate to what extent the childhood healthcare environment influences later life health outcomes. We examine a fundamental re-organisation of the healthcare environment to universal healthcare in the United Kingdom, which occurred through the introduction of the National Health Service (NHS) in July 1948. Immediate large decreases in infant mortality ensued. They were focused on the neo-natal period and larger for individuals who prior to the NHS had a lower access to medical services. Using a dataset drawn from the Office of National Statistics Longitudinal Study of linked census records combined with administrative mortality data, we compare mortality outcomes above age 50 of individuals born in the immediate cohorts around the introduction of the National Health Service (NHS) in a regression discontinuity design. Our findings indicate that age-specific survival rates are systematically higher among lower class individuals whose post-natal care expanded through the NHS, with the magnitude of the effect increasing monotonically with age. We supplement these findings with analysis of hospital records, which reveal a similar decrease in hospitalisations for cardiovascular disease for lower class individuals. These long run impacts of birth exposure to universal healthcare coverage through the NHS are economically significant, representing a 14% reduction in mortality at age 58.

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