Publications

Selected publications in peer-reviewed journals

Immigration and health outcomes: A study on native health perception and limitations in Europe, 2024,
Economic Modelling 134, 106627.
(joint with Martina Bazzoli, Federico Podesta, and Catia Nicodemo)

Abstract

This study examines the impact of immigration on the self-perceived health of natives in 16 European countries from 2006 to 2018. Utilizing data from the European Union Statistics on Income and Living Conditions (EU-SILC) and the European Union Labor Force Survey (EU-LFS), we focus on two health outcomes: natives’ self-perceived health and health-related limitations in daily activities. Contrary to concerns, our findings indicate a positive influence of immigration on natives’ health perception and a reduction in health-related limitations. Noteworthy variations by gender and age emerge, with more pronounced benefits in countries with lower human capital. These results underscore the potential health advantages of immigration, emphasizing the necessity for nuanced immigration policies that consider societal impact and call for a comprehensive evaluation of immigration’s effects.

Studying informal care during the pandemic: mental health, gender and job status, 2023,
Economics & Human Biology 50, August 2023,101245.
(joint with Francesco Moscone and Catia Nicodemo)

Abstract

Unexpected negative health shocks such as COVID-19 put pressure on households to provide more care to relatives and friends. This study uses data from the UK Household Longitudinal Study to investigate the impact of informal caregiving on mental health during the COVID-19 pandemic. Using a difference-in-differences analysis, we find that individuals who started providing care after the pandemic began reported more mental health issues than those who never provided care. Additionally, the gender gap in mental health widened during the pandemic, with women more likely to report mental health issues. We also find that those who began providing care during the pandemic reduced their work hours compared to those who never provided care. Our results suggest that the COVID-19 pandemic has had a negative impact on the mental health of informal caregivers, particularly for women.

Diverging mental health after Brexit: Evidence from a longitudinal survey, 2022,
Social Science and Medicine 302, June 2022, 114993.
(joint with Charlotte Herby, Nicolo Cavalli, and Catia Nicodemo)

Abstract

This study analyses the changes in mental health in the UK that occurred as a result of the 2016 referendum on UK membership of the EU (Brexit). Using the Household Longitudinal Study, we compare the levels of self-reported mental distress, mental functioning and life satisfaction be-fore and after the referendum. A linear fixed effects analysis revealed an overall decrease in mental health post-referendum with higher levels of mental distress, and a decline in the SF-12 Mental Component Summary score. Furthermore, the study does not find evidence of significant changes in overall life satisfaction in the two years after the referendum. Younger men, highly educated and Natives, especially those living in stronger “Remain areas”, seem to be the groups most affected by the Brexit in terms of mental health. Overall, the results of this study suggest that the outcome of the referendum and the economic uncertainty that it brought impacted the mental health of voters in a negative and diverging way.

Informal care, older people, and COVID-19: Evidence from the UK, 2023,
Journal of Economic Behavior and Organization 205, January 2023, Pages 468-488.
(joint with Francesco Moscone and Catia Nicodemo)

Abstract

The negative health effects and mortality caused by the COVID-19 pandemic disproportionately fell upon older and disabled people. Protecting these vulnerable groups has been a key policy priority throughout the pandemic and related vaccination campaigns. Using data from the latest survey of the UK Household Longitudinal Study on COVID-19 we found that people who receive informal care have higher probability of being infected when compared to those not receiving informal care. Further, we found that care recipients who are in the lowest income groups have a higher probability of catching the virus when compared to those in the highest income groups. We also estimated the likelihood of being infected for informal carers versus those who did not provide any care during the pandemic and found no significant differences between these two groups. Our empirical findings suggest that the standard measures introduced with the aim of protecting vulnerable groups, such as closing care homes or prioritising the vaccination of their staff, were not sufficient to avoid the spread of the virus amongst disabled and older people. Informal carers play an important role in the social care sector. As such, protecting vulnerable people by investing in the informal care sector should be a priority for future health policy.

The impact of school exclusion in childhood on health and well‐being outcomes in adulthood: Estimating causal effects using inverse probability of treatment weighting, 2023,
British Journal of Educational Psychology , 28 December 2023.
(joint with Ingrid Obsuth, Aja L. Murray, Ian Thompson, and Harry Daniels)

Abstract

Book chapters

Ethnicity and Inequality during the COVID-19 Pandemic in the UK, 2023,
The Economics of COVID-19:Volume 296, Edited by Badi H. Baltagi, Francesco Moscone, and Elisa Tosetti Emerald, 1 June 2022, 9781800716940.
(joint with Stuart Reading and Catia Nicodemo)

Abstract

This chapter presents a summary of existent evidence regarding the effects of the COVID-19 pandemic on Minority Ethnic Groups (MEGs) in the United Kingdom Compared to White British, MEGs have historically experienced lower levels of health and socioeconomic outcomes and the COVID-19 crisis seems to have widened these inequalities. In particular, evidence gathered between 2020 and early 2021 suggests that MEGs, and especially MEGs women, experienced a substantive deterioration in mental health. Furthermore, Black and South Asian groups were more likely to contract the infection and die than any other ethnic group. Access to preventative services and healthcare, plus residential and employment segregation seem to be important factors in explaining mortality rates due to COVID-19. Finally, data released by NHS on vaccinations (until August 2021) show that Black, Pakistani and Bangladeshi communities are lagging behind the rest, with a very low proportion of these groups receiving the first dose. Getting everyone vaccinated should be a priority for the Government in order to reduce the impact of COVID-19 and avoid new outbreaks. The evidence collected and summarised in this chapter calls for further attention on, and action to mitigate, the widening gaps in health and socioeconomic attainments across ethnic groups.

Migration and Health During COVID-19 Period, 2023,
Handbook of Labor, Human Resources and Population Economics, 1-18, Edited by Klaus F. Zimmermann, Springer, 2022.
(joint with Catia Nicodemo)

Abstract

This chapter explores how the COVID-19 pandemic has affected the health of migrants and refugees in Europe. In particular, it focuses on how the pandemic has affected migrants’ mental health and their access to vaccination and healthcare services. Throughout the pandemic, migrants were at higher risk of COVID19 infection and death, with a high rate of hesitancy to get vaccinated. Migrants are more likely to work in jobs that are at high risk of accidents and in sectors that are key for society, especially during the pandemic, such as transport and healthcare, among others. This fact, jointly with cultural barriers, socioeconomic disadvantages, and, in some cases, discrimination, has directly and indirectly deteriorated migrants’ health outcomes, or created new vulnerabilities in this population. European governments should make further effort on addressing these issues, by, for example, adopting new public health interventions to mitigate and prevent the negative consequences of COVID-19 on migrants.

Middle and Below Living Standards: What Can We Learn from Beyond Income Measures of Economic Well-being?, 2018,
Generating Prosperity for Working Families in Affluent Countries, Edited by Brian Nolan, Oxford University Press, September 2018, 9780191844836.
(joint with Marii Paskov and Tim Goedemé)

Abstract

This chapter complements the income-based measures of living standards on which earlier chapters have focused by incorporating non-income dimensions of economic well-being into its analysis, including indicators of material deprivation, economic burdens, and financial stress. It analyses how working-age households around and below the middle of the income distribution fared in European countries in the years before, during, and after the Great Recession. Harmonized household-level data across the members of the EU are analysed to see whether the evolution of these various non-income measures present a similar or different picture to household incomes over time. To probe what lies behind the patterns this reveals, four quite different countries are then examined in greater depth. Finally, the chapter also explores the relationship between material deprivation for households around and below the middle and overall income inequality.

Pre-prints and Working Papers

Does Children’s Education Improve Parental Longevity? Evidence from Two Educational Reforms in England, R&R
(joint with Christiaan Monden and Patrick Praeg)

Abstract

Parents of better-educated children are healthier and live longer. Is this a non-monetary return to education which crosses generational boundaries, or is this the consequence of unobserved factors (e.g. shared genes or living conditions) driving both children’s education and parental health? Using data from the English Longitudinal Study of Aging (ELSA) and two educational reforms that raised the mandatory school-leaving age from age 14 to 15 years in 1947 and from age 15 to 16 years in 1972, we investigate the causal effect of children’s education on parental longevity. Results suggest that both one-year increases in school-leaving age significantly reduced the hazard of dying for fathers as well as for mothers. We do not find a consistent pattern when comparing differences in the effects of daughters’ and sons’ education. Lower class parents benefitted more from the 1972 reform than higher class parents. We discuss these results against the backdrop of generational conflict and the specific English context.

Under review

Ethnicity and Health at Work during the COVID-19, R&R
(joint with Francesco Moscone and Catia Nicodemo)

Abstract

This paper explores how health-work-related illnesses and injuries have changed during the COVID-19 pandemic for different ethnic groups and by gender. We find that not all groups were affected in the same way. While almost all men in all ethnic groups were on average less likely to work during the pandemic period, women were more likely to work. We also find that Mixed Ethnic and Pakistani women who reported a higher probability of working in the reference week had a higher risk of illness/injuries at work. Meanwhile, White men and Other ethnic groups with a reduced probability of working during the pandemic had a lower risk of illness/injuries at work. Long-term illness varied by ethnicity and gender, with men experiencing a reduction and women an increase in physical and mental health issues. This research provides valuable insights into the multifaceted impact of the COVID-19 pandemic on the health and work patterns of different ethnic groups and gender. Understanding and identifying these disparities is crucial for formulating targeted policies aimed at mitigating adverse effects and promoting equitable outcomes in regional studies and urban economics.

Temporary GPs and the Effects on Patients’ Health Outcomes
(joint with Francesco Moscone, Catia Nicodemo, Cristina Tealdi, and Cristina Orso)

Abstract

The impact of temporary work has been studied extensively in the literature, but little is known about the implications of temporary work in the healthcare sector. In this paper, we investigate the impact of locum GPs on patients' satisfaction, prescription behaviours, and emergency admissions using a unique dataset that matches the information on temporary contracts for the general practices in England from 2017 to 2021, along with patient satisfaction ratings and psychotropic medication prescriptions. We employ panel data techniques that leverage both the cross-sectional and temporal dimensions of the dataset to analyse the relationship between locum GPs and patients' health outcomes. Our findings indicate that patient satisfaction is lower in practices with more temporary job contracts. This result supports the hypothesis that patients may prefer a less precarious relationship with their healthcare providers. We also find a negative association between the higher share of locums GPs and antibiotic, infection, analgesic, and statin prescriptions and positive effects on mental health. The reduced time that locums GPs may have to engage with their patients may incentivise them to under-prescribe all these types of medications. This suggests that locum doctors may have an adverse impact on the appropriateness of treatments for patients. However, we do not find any significant effect on the number of emergency admissions at the practice level. Our results have significant implications for policy interventions aimed at increasing the flexibility of the labour market in the healthcare sector. Such reforms should also consider the economic and social costs of the changes, including the psychological well-being of patients and the appropriateness of their treatments. Our study highlights the importance of ensuring that temporary work arrangements in healthcare do not compromise the quality of patient care and treatment outcomes.

Immigration and Healthcare Disparities in Prescription Drugs
(joint with Luigi Boggian and Catia Nicodemo)

Abstract

Migrants often face barriers in accessing quality healthcare, leading to unequal treatment. Access disparities in healthcare can result in persistent health inequalities and increased healthcare expenditures over time. This study explores healthcare disparities between immigrants and natives in Spain, focusing on drug prescriptions for high blood pressure and diabetes. Using administrative health data, the research investigates the likelihood of receiving prescriptions and the quantity of drugs consumed among different immigrant groups. The findings reveal that East Europeans have a higher likelihood of receiving prescriptions for high blood pressure drugs, while Latin American and African immigrants have a lower probability of treatment. Other European and Asian immigrants do not show statistically significant differences compared to natives. Most immigrant groups receive fewer prescriptions per year for both diabetes and high blood pressure drugs, indicating distinct prescription patterns. These findings underscore the importance of addressing healthcare disparities to achieve more equitable outcomes for migrants.

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