Estimating population mental health effects of the rollout of Universal Credit in the UK using standard and novel Difference-in-Differences analysis, 2009–2019

IF 3.9 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
M. Marimpi , B. Barr , A. Baxter , S. Hugh-Jones , D. Taylor-Robinson , S.V. Katikireddi , H. Brown , M. Cheetham , S. Morris , L. Munford , M. Richiardi , M. Sutton , C. Bambra , P. Craig , S. Wickham
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引用次数: 0

Abstract

Objectives

Universal Credit (UC) was introduced in the UK in April 2013 in selected areas, marking the beginning of its phased rollout. Previous research identifies acute health harms among unemployed people, but the policy's impacts longer-term and on broader claimant groups remain unknown. This study explored UC effects on population mental health for up to four years post-introduction on a larger cohort of claimants, including employed people.

Study design

Longitudinal study.

Methods

We used data from the UK Household Longitudinal Study between 2009 and 2019 linking 108,247 observations (29,528 working age participants) to administrative UC Local Authority district data. We compared a UC-eligible population – reporting receipt of either UC or any of six legacy benefits (treatment group) – to individuals receiving alternative benefits (comparison group). We used standard and novel difference-in-differences approaches, exploiting geographical variation of UC rollout, and accounting for heterogeneity in treatment timing, to estimate mental health impacts (SF-12 Mental Component Summary) on average and at different time points post-introduction.

Results

UC was associated with mental health declining by 0·70 units (95 % CI -1·24 to −0·15), a 1·5 % relative reduction. Effects were larger during the first year of exposure (−1·01, 95 % CI -1·93 to −0·10) without returning to baseline levels. Between 2013 and 2019, an estimated 111,954 (95 % CI 35,497 to 182,948) additional people experienced depression and/or anxiety after UC's introduction, 27,115 of whom may have reached diagnostic threshold for common mental disorders.

Conclusions

UC led to a sustained deterioration in population mental health, particularly marked in the first year of implementation. Reforms to UC are warranted to mitigate adverse mental health impacts.
2009-2019年,使用标准和新颖的异中异分析估计英国普遍信贷推出对人口心理健康的影响
2013年4月,英国在部分地区推出了通用信用(UC),标志着其分阶段推出的开始。先前的研究确定了失业人群的严重健康危害,但该政策对更广泛的索赔群体的长期影响尚不清楚。这项研究探讨了UC对人群心理健康的影响,在引入后长达四年的时间里,对更大的索赔群体进行了研究,包括就业人员。研究设计:纵向研究。方法:我们使用了2009年至2019年英国家庭纵向研究的数据,将108,247项观察结果(29,528名工作年龄参与者)与行政UC地方当局地区数据联系起来。我们比较了符合UC条件的人群-报告接受UC或六种遗留福利中的任何一种(治疗组)-接受替代福利的个人(对照组)。我们使用标准和新颖的差异中差异方法,利用UC推广的地理差异,并考虑治疗时间的异质性,来估计平均和引入后不同时间点的心理健康影响(SF-12心理成分摘要)。结果c与心理健康下降相关0.70个单位(95% CI为- 0.24 ~ - 0.15),相对降低1.5%。在暴露的第一年,影响更大(- 1.01,95% CI - 1.93至- 0.10),而没有恢复到基线水平。在2013年至2019年期间,估计有111954人(95% CI 35,497至182,948)在UC引入后出现抑郁和/或焦虑,其中27,115人可能达到了常见精神障碍的诊断阈值。结论:这导致人口心理健康状况持续恶化,在实施的第一年尤其明显。有必要对大学进行改革,以减轻对心理健康的不利影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Public Health
Public Health 医学-公共卫生、环境卫生与职业卫生
CiteScore
7.60
自引率
0.00%
发文量
280
审稿时长
37 days
期刊介绍: Public Health is an international, multidisciplinary peer-reviewed journal. It publishes original papers, reviews and short reports on all aspects of the science, philosophy, and practice of public health.
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