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Opioid abuse and austerity: evidence on health service use and mortality in England

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dc.contributor.author Friebel, Rocco
dc.contributor.author Jison Yoo, Katelyn
dc.contributor.author Maynou Pujolràs, Laia
dc.date.accessioned 2023-11-27T11:28:33Z
dc.date.available 2023-11-27T11:28:33Z
dc.date.issued 2022
dc.identifier.citation Friebel R, Yoo KJ, Maynou L. Opioid abuse and austerity: evidence on health service use and mortality in England. Social Science & Medicine. 2022 Apr;298:114511. DOI: 10.1016/j.socscimed.2021.114511
dc.identifier.issn 0277-9536
dc.identifier.uri http://hdl.handle.net/10230/58384
dc.description.abstract Opioid abuse has become a public health concern among many developed countries, with policymakers searching for strategies to mitigate adverse effects on population health and the wider economy. The United Kingdom has seen dramatic increases in opioid-related mortality following the financial crises in 2008. We examine the impact of spending cuts resulting from government prescribed austerity measures on opioid-related hospitalisations and mortality, thereby expanding on existing evidence suggesting a countercyclical relationship with macroeconomic performance. We take advantage of the variation in spending cuts passed down from central government to local authorities since 2010, with reductions in budgets of up to fifty percent in some areas resulting in the rescaling of vital public services. Longitudinal panel data methods are used to analyse a comprehensive, linked dataset that combines information from spending records, official death registry data and large administrative health care data for 152 local authorities (i.e., unitary authorities and county councils) in England between April 2010 and March 2017. A total of 280,827 people experienced a hospital admission in the English National Health Service because of an opioid overdose and 14,700 people died from opioids across the study period. Local authorities that experienced largest spending cuts also saw largest increases in opioid abuse. Interactions between changes in unemployment and spending items for welfare programmes show evidence about the importance for governments to protect populations from social-risk effects at times of deteriorating macroeconomic performance. Our study carries important lessons for countries aiming to address high rates of opioid abuse, including the United States, Canada and Sweden.
dc.format.mimetype application/pdf
dc.language.iso eng
dc.publisher Elsevier
dc.relation.ispartof Social Science & Medicine. 2022 Apr;298:114511
dc.rights © 2021 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
dc.rights.uri http://creativecommons.org/licenses/by/4.0/
dc.title Opioid abuse and austerity: evidence on health service use and mortality in England
dc.type info:eu-repo/semantics/article
dc.identifier.doi http://dx.doi.org/10.1016/j.socscimed.2021.114511
dc.subject.keyword Public policy
dc.subject.keyword Austerity
dc.subject.keyword Social-risk effects
dc.subject.keyword Opioid abuse
dc.subject.keyword England
dc.rights.accessRights info:eu-repo/semantics/openAccess
dc.type.version info:eu-repo/semantics/publishedVersion


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