Authors: Anelli, Massimo (Bocconi University); Biroli, Pietro (University of Bologna); De Cao, Elisabetta (University of Bologna), Martin-Bassols, Nicolau (University of Bologna); Mendolia, Silvia (University of Turin); Reichlin.
Abstract
This paper explores the short- and long-term health impacts of the National Health Service (NHS), introduced 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 health outcomes between ages 45 and 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 self-reported health, BMI, and obesity rates. The inclusion of PGIs revealed variations in health benefits based on genetic predispositions, highlighting their role in adjusting for survival bias. This study demonstrates how PGIs can refine health impact estimates and provides a more nuanced understanding of the NHS’s long-term effects.