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Lookup NU author(s): Professor Clare BambraORCiD
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
© 2024 The AuthorsEconomic determinants are important for population health, but actionable evidence of how policies can utilise these pathways remains scarce. This study employs a microsimulation framework to evaluate the effects of taxation and social security policies on population mental health. The UK economic crisis caused by the COVID-19 pandemic provides an informative context involving an economic shock accompanied by one of the strongest discretionary fiscal responses amongst OECD countries. The analytical setup involves a dynamic, stochastic, discrete-time microsimulation model (SimPaths) projecting changes in psychological distress given predicted economic outcomes from a static tax-benefit microsimulation model (UKMOD) based on different policy scenarios. We contrast projections of psychological distress for the working-age population from 2017 to 2025 given the observed policy environment against a counterfactual scenario where pre-crisis policies remained in place. Levels of psychological distress and potential cases of common mental disorders (CMDs) were assessed with the 12-item General Health Questionnaire (GHQ-12). The UK policy response to the economic crisis is estimated to have prevented a substantial fall (over 12 percentage points, %pt) in the employment rate in 2020 and 2021. In 2020, projected psychological distress increased substantially (CMD prevalence increase >10%pt) under both the observed and the counterfactual policy scenarios. Through economic pathways, the policy response is estimated to have prevented a further 3.4%pt [95%UI 2.8%pt, 4.0%pt] increase in the prevalence of CMDs, approximately 1.2 million cases. Beyond 2021, as employment levels rapidly recovered, psychological distress returned to the pre-pandemic trend. Sustained preventative effects on poverty are estimated, with projected levels 2.1%pt [95%UI 1.8%pt, 2.5%pt] lower in 2025 than in the absence of the observed policy response. The study shows that policies protecting employment during an economic crisis are effective in preventing short-term mental health losses and have lasting effects on poverty levels. This preventative effect has substantial public health benefits.
Author(s): Kopasker D, Bronka P, Thomson RM, Khodygo V, Kromydas T, Meier P, Heppenstall A, Bambra C, Lomax N, Craig P, Richiardi M, Katikireddi SV
Publication type: Article
Publication status: Published
Journal: Social Science and Medicine
Year: 2024
Volume: 351
Print publication date: 01/06/2024
Online publication date: 09/05/2024
Acceptance date: 07/05/2024
Date deposited: 03/06/2024
ISSN (print): 0277-9536
ISSN (electronic): 1873-5347
Publisher: Elsevier Ltd
URL: https://doi.org/10.1016/j.socscimed.2024.116953
DOI: 10.1016/j.socscimed.2024.116953
Data Access Statement: Code available on GitHub: https://github.com/centreformicrosimulation/SimPaths. Data is available from the UK Data Service.
PubMed id: 38759385
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