Examining the Health Legacy of the NHS: Infant Mortality, Genetic Endowment and Adult Health

Nicolau Martin Bassols, University of Bologna
Elisabetta De Cao, University of Bologna
Silvia Mendolia, University of Turin
Massimo Anelli, Bocconi University
Pietro Biroli, University of Bologna

This paper examines both the short- and long-term health impacts of the introduction of the National Health Service (NHS) in the United Kingdom in 1948. The NHS revolutionized the healthcare landscape by providing universal healthcare free at the point of use. We examine the effects of the NHS’s provision of free hospital access for childbirth on children born just before and after its implementation. Using a Regression Discontinuity Design (RDD), we analyze both infant mortality rates at the time of the NHS implementation and health outcomes measured at later ages (45 to 80), including self-reported health, BMI, and obesity rates. Our study uniquely incorporates genotypic data to capture and correct for survival bias, which has been previously overlooked. By using polygenic indices (PGIs), we enhance the precision of our estimates and account for the influence of genetic predispositions on health outcomes. Our findings indicate that the NHS significantly improved infant mortality rates in the short-run and self-reported health, BMI, and obesity rates in the long-run. The inclusion of PGIs revealed variations in health benefits based on genetic predispositions, highlighting their role in adjusting for survival bias.

Keywords: Biodemography and genetics, Health and Morbidity

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