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Rising unemployment reduces the demand for healthcare services among people with cardiovascular disease: an Australian cohort study

Author

Listed:
  • Clifford Afoakwah

    (Griffith University
    Menzies Health Institute Queensland, Griffith University)

  • Son Nghiem

    (Griffith University
    Menzies Health Institute Queensland, Griffith University)

  • Paul Scuffham

    (Griffith University
    Menzies Health Institute Queensland, Griffith University)

  • Joshua Byrnes

    (Griffith University
    Menzies Health Institute Queensland, Griffith University)

Abstract

Cardiovascular diseases (CVDs) remain a global health challenge due to number of deaths and use of healthcare services related to the condition. Although a plethora of studies have shown the impact of unemployment on health outcomes, evidence on the unemployment effects on the demand for expensive cardiac healthcare services is rare. This study exploits longitudinal cohort dataset to examine the impact of variations in local level unemployment rate on the demand for healthcare services among working aged people with CVD in Australia. Our findings show an inverse relationship between unemployment and the demand for healthcare services. Specifically, we find that a rising unemployment reduces the demand for primary and secondary healthcare services, with the largest effect observed for hospital admissions and hospitalisation days. We further show that rising unemployment at the local level has a greater impact on CVD patients with comorbidities and those who live in nonremote areas. Finally, our estimates suggest that increasing local level unemployment averts a substantial number of healthcare services use, leading to an unintended cost savings of $1.2 million to the health sector.

Suggested Citation

  • Clifford Afoakwah & Son Nghiem & Paul Scuffham & Joshua Byrnes, 2021. "Rising unemployment reduces the demand for healthcare services among people with cardiovascular disease: an Australian cohort study," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(4), pages 643-658, June.
    • Handle: RePEc:spr:eujhec:v:22:y:2021:i:4:d:10.1007_s10198-021-01281-5
    DOI: 10.1007/s10198-021-01281-5
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    References listed on IDEAS

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    1. Ruhm, Christopher J., 2005. "Healthy living in hard times," Journal of Health Economics, Elsevier, vol. 24(2), pages 341-363, March.
    2. Halliday, Timothy J., 2014. "Unemployment and mortality: Evidence from the PSID," Social Science & Medicine, Elsevier, vol. 113(C), pages 15-22.
    3. Clark, Andrew E & Oswald, Andrew J, 1994. "Unhappiness and Unemployment," Economic Journal, Royal Economic Society, vol. 104(424), pages 648-659, May.
    4. Chou, Shin-Yi & Grossman, Michael & Saffer, Henry, 2004. "An economic analysis of adult obesity: results from the Behavioral Risk Factor Surveillance System," Journal of Health Economics, Elsevier, vol. 23(3), pages 565-587, May.
    5. Christopher J. Ruhm, 2000. "Are Recessions Good for Your Health?," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 115(2), pages 617-650.
    6. Ruhm, Christopher J. & Black, William E., 2002. "Does drinking really decrease in bad times?," Journal of Health Economics, Elsevier, vol. 21(4), pages 659-678, July.
    7. Ariizumi, Hideki & Schirle, Tammy, 2012. "Are recessions really good for your health? Evidence from Canada," Social Science & Medicine, Elsevier, vol. 74(8), pages 1224-1231.
    8. Dave, Dhaval M. & Kelly, Inas Rashad, 2012. "How does the business cycle affect eating habits?," Social Science & Medicine, Elsevier, vol. 74(2), pages 254-262.
    9. Svensson, Mikael, 2007. "Do not go breaking your heart: Do economic upturns really increase heart attack mortality?," Social Science & Medicine, Elsevier, vol. 65(4), pages 833-841, August.
    10. Mikael Svensson & Curt Hagquist, 2010. "Adolescents alcohol-use and economic conditions: a multilevel analysis of data from a period with big economic changes," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 11(6), pages 533-541, December.
    11. Ruhm, Christopher J., 2015. "Recessions, healthy no more?," Journal of Health Economics, Elsevier, vol. 42(C), pages 17-28.
    12. van den Berg, Gerard J. & Gerdtham, Ulf-G. & von Hinke, Stephanie & Lindeboom, Maarten & Lissdaniels, Johannes & Sundquist, Jan & Sundquist, Kristina, 2017. "Mortality and the business cycle: Evidence from individual and aggregated data," Journal of Health Economics, Elsevier, vol. 56(C), pages 61-70.
    13. Grossman, Michael, 1972. "On the Concept of Health Capital and the Demand for Health," Journal of Political Economy, University of Chicago Press, vol. 80(2), pages 223-255, March-Apr.
    14. Gerdtham, Ulf-G. & Johannesson, Magnus, 2005. "Business cycles and mortality: results from Swedish microdata," Social Science & Medicine, Elsevier, vol. 60(1), pages 205-218, January.
    15. Neumayer, Eric, 2004. "Recessions lower (some) mortality rates:: evidence from Germany," Social Science & Medicine, Elsevier, vol. 58(6), pages 1037-1047, March.
    16. Junankar, P N, 1991. "Unemployment and Mortality in England and Wales: A Preliminary Analysis," Oxford Economic Papers, Oxford University Press, vol. 43(2), pages 305-320, April.
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    Cited by:

    1. Clifford Afoakwah & Joshua Byrnes & Paul Scuffham & Son Nghiem, 2023. "Testing for selection bias and moral hazard in private health insurance: Evidence from a mixed public‐private health system," Health Economics, John Wiley & Sons, Ltd., vol. 32(1), pages 3-24, January.

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    More about this item

    Keywords

    Cardiovascular diseases; Unemployment; Healthcare services; Cost savings;
    All these keywords.

    JEL classification:

    • E3 - Macroeconomics and Monetary Economics - - Prices, Business Fluctuations, and Cycles
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior

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