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Essays in public provision of healthcare

Jeffrey, Genevieve (2023) Essays in public provision of healthcare. PhD thesis, London School of Economics and Political Science.

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Identification Number: 10.21953/lse.00004543


The focus of the three chapters in this thesis is to investigate causally, using quasi-experimental econometric tools, the short and long run impacts of increasing expenditure on, and access to, healthcare during the period of pregnancy, at the point of birth, and in the immediate and short run period after birth for both the mother and the child. The aim of the study is to provide a thorough evaluation of two policy changes that resulted in an increase in expenditure and an increase in access to healthcare for mothers and their children in the United Kingdom from the 1920s to the 1950s. Explicitly, this thesis questions whether increasing access to healthcare in the period of gestation, at birth and post birth can impact on health and economic outcomes in the long run. In the first two chapters, the long run impacts of increased health care access, including universal access through the initiation of the UK National Health Service (NHS) as measured at 40, 50 and 60 years after the policy was implemented are assessed. In the third chapter, the investigation extends the impact of the UK NHS to the second generation, the first born children of those exposed to the policies during gestation, at birth and during infancy. Through the course of the three chapters, in summary the main findings are that increasing access to healthcare during the period of gestation, at birth and in infancy has a measurable positive impact on short and long run health and economic outcomes. The results indicate no strong impact on the health and economic outcomes in the second generation. However, because the results document strong impacts on fertility timing and household formation decisions of the first generation, through the maternal pathway, the impacts of these decisions may obfuscate the direct impacts on the health and economic outcomes across generations. The results indicate, through the maternal pathway, increased single motherhood, teenage pregnancies and maternal hypogamy(the father has less education than the mother), which have been established in the literature to impact negatively on child outcomes.

Item Type: Thesis (PhD)
Additional Information: © 2023 Genevieve Jeffrey
Library of Congress subject classification: J Political Science > JN Political institutions (Europe) > JN101 Great Britain
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Supervisor: McGuire, Alistair and De Cao, Elisabetta

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