Social and economic consequences of health status Causal inference methods and longitudinal, intergenerational data

This project led by the University of Bristol sought to improve understanding of the impact of physical and mental health status on social and economic outcomes and strengthen the evidence on causal links.

Previous studies demonstrated associations between poor health and adverse social and economic outcomes. However, from the existing evidence, it was not possible to tell whether health status affected socio-economic factors, or if socio-economic factors affected health outcomes, or whether the relationships is bi-directional.

This project involved taking a broad view of health status, to consider multiple factors including obesity, cardiovascular disease, asthma, and depression.

Data was used from the UK Biobank, Avon Longitudinal Study of Parents and Children, and the Early Prediction of Adolescent Depression study. The latter two datasets have repeated measures of multiple mental and physical health factors and social and economic outcomes for parents and children.

The project team used genetic data to examine the causal links between health status and social and economic outcomes, enabling assessment on whether this impact changes across a person’s life. This identified periods in people’s lives where policy change to maintain or improve population health status is likely to have the greatest effects. There has also been analysis of whether parental health status affects the social and economic outcomes of children.

Qualitative research explored the mechanisms through which health status affected social and economic outcomes and identified potential intervention points.

Delays resulting from COVID-19 have caused the end date for this project to be extended.

The papers that have been published indicate that effective policies may be targeted more effectively within certain timeframes for a population to maximise national and local action. The key findings so far from this programme include educational attainment for young people with ADHD and the associated costs of healthcare for individuals with high BMI and interventions to improve both health and economic spend.

Follow this project on Twitter:

• @publichealthw
• @mrc_ieu
• @laurahowe_epi
• @AlishaDavies1
• @nm_davies
• @mattdickson__
• @DrHayleyJones
• @UniofBathIPR

Contact information

For more information about this project, please contact Laura Howe, Reader in Epidemiology and Medical Statistics, University of Bristol.

Learn more

Mendelian Randomization analysis of the causal effect of adiposity on hospital costs

Effects of body mass index on relationship status, social contact and socio-economic position: Mendelian randomization and within-sibling study in UK Biobank

The causal effects of health conditions and risk factors on social and socioeconomic outcomes: Mendelian randomization in UK Biobank

Common health conditions in childhood and adolescence, school absence, and educational attainment: Mendelian randomization study

Avoiding dynastic, assortative mating, and population stratification biases in Mendelian randomization through within-family analyses

Is genetic liability to ADHD and ASD causally linked to educational attainment?

The role of school enjoyment in the association between externalising and depressive symptoms and academic attainment: findings from a UK prospective cohort study

Robust causal inference for long-term policy decisions: cost effectiveness of interventions for obesity using Mendelian randomization