Melanie Luhrmann, Royal Halloway University
Long-run Health and Mortality Effects of Exposure to Universal Health Care at Birth
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 administrative data on mortality, 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. We additionally exploit geographical variation in the change in medical services upon the NHS introduction for identification. 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.
Melanie Luhrmann received her PhD in Economics from University of Mannheim and is currently working as a Senior Lecturer at Royal Holloway University of London and as a Research Associate at the Institute for Fiscal Studies in London. Her research interests include applied microeconomics and public economics, including consumer behavior, nutrition, health and family economics.