VOX article on longrun determinants of health

Here is a VOX article on my joint work with James Smith and Mark McGovern on long-run determinants of health in Ireland. The extent to which decisions made in one decade have impacts on later ones is an important area of economics in terms of examining theoretical mechanisms and working out discounted values of public policies. The extent to which modern national policy-makers can target such obvious problems as infant deaths due to gastroenteritis is limited. However, there is still a strong role for looking at the long-run effects of policies aimed at improving, in particular, childhood mental health.

6 replies on “VOX article on longrun determinants of health”

Exporting Poor Health – The Irish in England

… also a useful IZA paper. you might add a link … or I will later on …

The authors deserve credit for this excellent work.

Any chance that they might extend their work to N. Ireland and come up with some explanations as to why the fall in mortality rates and increase in life expectancy in N. Ireland is lagging so far behind that in R. Ireland? I can see nothing in the differences in climate, diet, lifestyle that would explain it. Infant and child mortality rates are now far higher north of the border than south of it. It is time that there was some investigation as to why this is so. I am sure that, if it was the other way round, all hell would be breaking loose in the Irish media.

Also, I note that Liam Delaney now works in Scotland. Scotland has by far the worst health record in western Europe. Until the 1990s, its mortality rates and life expectancy were similar to Ireland’s. Both were the worst in western Europe. But, since then Ireland has caught up and is now very similar to the western European average, while Scotland’s mortality rates and life expectancy remain the worst in western Europe. The SNP were making a big play of this at their annual conference at the weekend.

This is important because there is a considerable body of opinion in Ireland, heavily represented in academia and the media, that wants R. Ireland to dump its part-private part-public health service and replace it with an all-public one, such as exists in both N. Ireland and Scotland. This should be resisted, at least until such time as health experts can come up with a convincing explanation as to why R. Ireland’s health record is so much better in recent years than N. Ireland’s or Scotland’s, both of which allow very little private sector involvement in healthcare provision.


It takes a peculiar mindset to turn a paper which extols the benefits of State intervention into an argument for private healthcare.

I’m interested in your mention of work by academics calling for an elimination of private healthcare provision in the RoI. Would you be kind enough to provide some references?

Econometric analysis to support an already-held view is always lots of fun. Let me have a go at it:

First, I will find a data set. Then, I will keep running regressions until I stumble upon a t-test score that supports my preconceived notions of how the world works….

Infant mortality rates in 1946, let me see….

“1946 and 1947 were the two years with the highest birthrates in Ireland’s recorded history, mainly because 90 thousand young men came back from the War with a yearning for some baby-making.

“In our paper we find that having made it through the Ardennes with Jerry taking Luger shots at you proved these lads were particularly able fathers (biologically or environmentally?). This combined with the Queen’s shilling in the form of a war pension was what helped put an extra shovel of coal on the fire and a nicer bit of meat for Mary to have while she was with child.

“That most would have settled in urban areas of Ireland seems plausible too – after all, would the Dubs be called Little Jacks if they didn’t fight under Britannia’s flag? This, we conclude most scientifically, is what explains the closing rural-urban gap in infant mortality.”

Finally, I need a catchy title for my paper:

“The Good Sperm Fights for King George”

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