RT Journal Article
SR Electronic
T1 P69 The softer they fall: a natural experiment examining the health effects of job loss before and after fornero’s unemployment benefit reforms in italy
JF Journal of Epidemiology and Community Health
JO J Epidemiol Community Health
FD BMJ Publishing Group Ltd
SP A103
OP A103
DO 10.1136/jech-2019-SSMabstracts.220
VO 73
IS Suppl 1
A1 Koltai, J
A1 Varchetta, FM
A1 Stuckler, D
A1 McKee, M
YR 2019
UL http://jech.bmj.com/content/73/Suppl_1/A103.1.abstract
AB Background The Fornero unemployment benefit reforms in Italy increased replacement rates from 60% to 75% for first six months of unemployment, beginning January 1st, 2013. We exploit the roll-out of this reform as a natural experiment to evaluate whether those experiencing job loss in 2011 or 2012 (N=75) endured greater declines in health comapred to those experiencing job loss in 2013 or 2014 (N=127).Methods We utilize data from the Italian version of EU-Survey on Income and Living Conditions (SILC), longitudinal sample (2010—2014), yearly data supplemented with retrospective monthly calendar data. To construct our treatment and control groups we apply a series of restrictions in order to isolate those who were highly likely to have been affected by the pre and post-Fornero unemployment benefit regimes. Our dependent variable is change in self-rated health. To test our hypotheses, we implement difference-in-difference modelling, adjusting for gender, interview month, household income, region of residence, whether the respondent has any chronic illness, occupation, and marital status.Results Our difference-in-difference estimate for changes in health following job loss pre and post Fornero reforms is statistically significant (ATT=0.349, p<0.01). This corresponds to almost no change in self-rated health in the post-Fornero treatment group (Δ Health=0.032), and a decline in health for the pre-Fornero control group (Δ Health=-0.317). These models are robust to several alternative specifications.The decline in health for the pre-Fornero group represents 0.43 of a standard deviation for health change. For effect size comparison, the negative association between reporting any chronic illness and health change corresponds to 0.33 of a standard deviation (adjusting for age and sex).Conclusion While the links between unemployment and health are well documented, very little is known about specific policy contexts that may mitigate the health-effects of job loss. This study leverages a novel research design to shed new light on the ways that institutional factors may modify the social determinats of health at the individual level.