COVID-19 and health inequality: Evidence from risky behaviors

The COVID-19 pandemic has created unprecedented disruption along many dimensions, yet we do not fully understand how it might shape health inequalities. This paper studies the impact of COVID-19 outbreak on health inequality from the perspective of risky behaviors. We adopt the novel synthetic difference-in-differences approach based on longitudinal data in China. The uniqueness of China’s COVID-19 outbreak in 2020 helps disentangle the demand-side reasons from supply-side restrictions. Results show that people with more advantaged backgrounds reduced cigarette and alcohol consumption following the pandemic, while the disadvantaged were little affected. The disparities in risky behaviors are unlikely driven by unequal income reduction and we find null pandemic effect on mental health. However, there is suggestive evidence of heterogeneous responses in social activities and health attention. While social activities may eventually return to the pre-pandemic level, enlarged gap in attention to personal health likely persists, leading to widened health inequality.