Opioid abuse and austerity: Evidence on health service use and mortality in England

Opioid abuse has become a public health concern among many developed countries, with policymakers searching for strategies to mitigate adverse effects on population health and the wider economy. The United Kingdom has seen dramatic increases in opioid-related mortality following the financial crises...

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Autores: Friebel, Rocco, Yoo, Katelyn Jison, Maynou Pujolràs, Laia
Tipo de recurso: artículo
Estado:Versión aceptada para publicación
Fecha de publicación:2022
País:España
Institución:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/184408
Acceso en línea:https://hdl.handle.net/2445/184408
Access Level:acceso abierto
Palabra clave:Administració pública
Política social
Política d'austeritat
Serveis sanitaris
Opiacis
Anglaterra
Public administration
Social policy
Austerity policy
Health services
Opioids
England
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spelling Opioid abuse and austerity: Evidence on health service use and mortality in EnglandFriebel, RoccoYoo, Katelyn JisonMaynou Pujolràs, LaiaAdministració públicaPolítica socialPolítica d'austeritatServeis sanitarisOpiacisAnglaterraPublic administrationSocial policyAusterity policyHealth servicesOpioidsEnglandOpioid abuse has become a public health concern among many developed countries, with policymakers searching for strategies to mitigate adverse effects on population health and the wider economy. The United Kingdom has seen dramatic increases in opioid-related mortality following the financial crises in 2008. We examine the impact of spending cuts resulting from government prescribed austerity measures on opioid-related hospitalisations and mortality, thereby expanding on existing evidence suggesting a countercyclical relationship with macroeconomic performance. We take advantage of the variation in spending cuts passed down from central government to local authorities since 2010, with reductions in budgets of up to fifty percent in some areas resulting in the rescaling of vital public services. Longitudinal panel data methods are used to analyse a comprehensive, linked dataset that combines information from spending records, official death registry data and large administrative health care data for 152 local authorities (i.e., unitary authorities and county councils) in England between April 2010 and March 2017. A total of 280,827 people experienced a hospital admission in the English National Health Service because of an opioid overdose and 14,700 people died from opioids across the study period. Local authorities that experienced largest spending cuts also saw largest increases in opioid abuse. Interactions between changes in unemployment and spending items for welfare programmes show evidence about the importance for governments to protect populations from social-risk effects at times of deteriorating macroeconomic performance. Our study carries important lessons for countries aiming to address high rates of opioid abuse, including the United States, Canada and Sweden.Elsevier Ltd2022info:eu-repo/semantics/articleinfo:eu-repo/semantics/acceptedVersionapplication/pdfhttps://hdl.handle.net/2445/184408Articles publicats en revistes (Econometria, Estadística i Economia Aplicada)reponame:Dipòsit Digital de la UBinstname:Universidad de BarcelonaInglésReproducció del document publicat a: https://doi.org/10.1016/j.socscimed.2021.114511Social Science & Medicine, 2022, vol. 298, num. 114511, p. 1-12https://doi.org/10.1016/j.socscimed.2021.114511cc-by-nc-nd (c) Elsevier Ltd, 2022http://creativecommons.org/licenses/by/3.0/es/info:eu-repo/semantics/openAccessoai:diposit.ub.edu:2445/1844082026-05-27T06:46:51Z
dc.title.none.fl_str_mv Opioid abuse and austerity: Evidence on health service use and mortality in England
title Opioid abuse and austerity: Evidence on health service use and mortality in England
spellingShingle Opioid abuse and austerity: Evidence on health service use and mortality in England
Friebel, Rocco
Administració pública
Política social
Política d'austeritat
Serveis sanitaris
Opiacis
Anglaterra
Public administration
Social policy
Austerity policy
Health services
Opioids
England
title_short Opioid abuse and austerity: Evidence on health service use and mortality in England
title_full Opioid abuse and austerity: Evidence on health service use and mortality in England
title_fullStr Opioid abuse and austerity: Evidence on health service use and mortality in England
title_full_unstemmed Opioid abuse and austerity: Evidence on health service use and mortality in England
title_sort Opioid abuse and austerity: Evidence on health service use and mortality in England
dc.creator.none.fl_str_mv Friebel, Rocco
Yoo, Katelyn Jison
Maynou Pujolràs, Laia
author Friebel, Rocco
author_facet Friebel, Rocco
Yoo, Katelyn Jison
Maynou Pujolràs, Laia
author_role author
author2 Yoo, Katelyn Jison
Maynou Pujolràs, Laia
author2_role author
author
dc.subject.none.fl_str_mv Administració pública
Política social
Política d'austeritat
Serveis sanitaris
Opiacis
Anglaterra
Public administration
Social policy
Austerity policy
Health services
Opioids
England
topic Administració pública
Política social
Política d'austeritat
Serveis sanitaris
Opiacis
Anglaterra
Public administration
Social policy
Austerity policy
Health services
Opioids
England
description Opioid abuse has become a public health concern among many developed countries, with policymakers searching for strategies to mitigate adverse effects on population health and the wider economy. The United Kingdom has seen dramatic increases in opioid-related mortality following the financial crises in 2008. We examine the impact of spending cuts resulting from government prescribed austerity measures on opioid-related hospitalisations and mortality, thereby expanding on existing evidence suggesting a countercyclical relationship with macroeconomic performance. We take advantage of the variation in spending cuts passed down from central government to local authorities since 2010, with reductions in budgets of up to fifty percent in some areas resulting in the rescaling of vital public services. Longitudinal panel data methods are used to analyse a comprehensive, linked dataset that combines information from spending records, official death registry data and large administrative health care data for 152 local authorities (i.e., unitary authorities and county councils) in England between April 2010 and March 2017. A total of 280,827 people experienced a hospital admission in the English National Health Service because of an opioid overdose and 14,700 people died from opioids across the study period. Local authorities that experienced largest spending cuts also saw largest increases in opioid abuse. Interactions between changes in unemployment and spending items for welfare programmes show evidence about the importance for governments to protect populations from social-risk effects at times of deteriorating macroeconomic performance. Our study carries important lessons for countries aiming to address high rates of opioid abuse, including the United States, Canada and Sweden.
publishDate 2022
dc.date.none.fl_str_mv 2022
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/acceptedVersion
format article
status_str acceptedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/184408
url https://hdl.handle.net/2445/184408
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.1016/j.socscimed.2021.114511
Social Science & Medicine, 2022, vol. 298, num. 114511, p. 1-12
https://doi.org/10.1016/j.socscimed.2021.114511
dc.rights.none.fl_str_mv cc-by-nc-nd (c) Elsevier Ltd, 2022
http://creativecommons.org/licenses/by/3.0/es/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc-by-nc-nd (c) Elsevier Ltd, 2022
http://creativecommons.org/licenses/by/3.0/es/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Elsevier Ltd
publisher.none.fl_str_mv Elsevier Ltd
dc.source.none.fl_str_mv Articles publicats en revistes (Econometria, Estadística i Economia Aplicada)
reponame:Dipòsit Digital de la UB
instname:Universidad de Barcelona
instname_str Universidad de Barcelona
reponame_str Dipòsit Digital de la UB
collection Dipòsit Digital de la UB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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