Blog

East side story: mapping Bristol

Posted on by Jerry Holliday

What can we learn about the evolution of neighbourhoods from historical maps? And why is the east side of a city often poorer than the west?

Author: Yanos Zylberberg

A striking feature of cities around the world is the large disparity in neighbourhood composition – who lives where – often reflecting long-term segregation. Bristol is no stranger to these extreme inequalities with the deprived neighbourhoods of Barton Hill or the Dings just a few miles from the affluent Clifton neighbourhood. New techniques to digitise the information contained in historical maps of the city can help us understand the how different neighbourhoods have developed, and why such inequalities are so persistent.

What can we learn about neighbourhoods in Bristol from historical maps?

During the first half of the nineteenth century, the Great Western Cotton Factory opened the Barton Hill Cotton Mill in the Barton Hill district, most likely due to the easy access to waterways. The large factory attracted poorer workers from the rural hinterlands, sometimes from much further north. The factory polluted the local area, as did the surrounding chimneys of other factories, foundries and tanneries. At the beginning of the twentieth century, the Barton Hill Cotton Mill was still operating; the neighbouring areas had however experienced a prolonged decline in living standards from the dismal environmental conditions, the low quality of public amenities such as schools, the systematic flight of richer residents to other areas, and the mirroring arrival of poorer migrants.

The Barton Hill Cotton Mill (Bristol City Council Museums)

The Great Western Cotton Factory was liquidated in the 1920s, leading to a further decline of the Barton Hill area over the twentieth century. This decline was hardly mitigated by the destruction of the factory and the subsequent land remediation, slum clearances, and other, numerous urban renewal policies. By contrast, the hillside settlement of Clifton remained the richest part of town for the past two centuries, mostly unaffected by the successive transformations of the city through industrialisation, war bombings, and then deindustrialisation.

Why are the east sides of cities poorer?

This story of industrialisation, migration from rural to urban areas, inequalities existing alongside disparities in environmental conditions, neighbourhood segregation and (mostly ineffective) urban policies has not only shaped Bristol, but many British cities. One clear illustration of these underlying forces is the east to west – poorer to richer – pattern of neighbourhoods which can be observed across many cities that were formerly heavily reliant on industry. For example, the east sides of London and Manchester, and internationally, New York City or Paris are notoriously poorer than their west sides. The main mechanism at play is reminiscent of the ‘Barton Hill story’: the prevailing winds, from west to east, meant that the atmospheric pollution from coal-burning factories was mostly driven towards the east side of the city, leading to residential flight by those who could afford it, which still persists today.

While this story of disparities within cities appears to be straightforward and simple, in fact it is not, and many different factors underlie the evolution of different areas. For example: city residents, including migrants, will care about exposure to environmental pollution to different degrees and have different means of escaping it; the cost of land in different areas can lead to factories increasingly concentrating in (cheaper) polluted areas; people who work in these industries may want to live nearby due to a lack of commuting options despite the worse amenities. Large-scale changes will also play a role over time: environmental effects on surrounding areas through the conversion of farmland to built-up land; the invention of the steam engine and improvements in public transport enabled a greater division of areas into purely residential versus commercial; and slum clearances, war bombings, social housing policies, and gentrification can further tilt the trajectory of neighbourhoods.

How to turn maps into data

Figure 2: The Barton Hill Cotton Mill in the 25 inch to the mile Ordnance Survey maps.

Our research takes a new approach to try and shed light on these mechanisms – using maps. We are generating unique data capturing the structure of cities combining information from local-level historical Census records capturing the characteristics of residents and workers and data derived from historical maps – the 25 inch to the mile Ordnance Survey maps covering England and Wales. These maps were produced at irregular intervals (approximately every twenty years) between 1880–1960, and were sufficiently precise to report detailed features such as industrial chimneys, lamp posts, or even the structure of gardens for the villas of affluent neighbourhoods – a reminder of the fastidiousness of early Victorian mappers. These maps have the potential to capture a comprehensive, changing image of the city, just like Google Maps does today.

Digitising these historical maps presents challenges. They are essentially a collection of highly unorganised information: writing, symbols, lines/segments, or coloured/striped surfaces, which have to be interpreted and converted into data. To do this, the research is using methods that rely on the latest innovations in visual recognition and machine learning to identify a collection of features that are important to understand the location of production, public amenities, and housing – e.g., industrial chimneys, factories and their names, market halls, corn exchange, schools, theatres, prisons, churches, union workhouses, roads and their names, train stations etc.. The resources produced can then be used by those interested in urban development to better understand the trajectory of their cities and how early policy decisions can leave an imprint in the very long run.

The project will create an interactive map of Bristol which combines the information drawn from the analysis of the historical maps – pollution imprints, neighbourhood composition and urban renewal activities – with oral histories from two Bristol neighbourhoods, Barton Hill and the Dings/St Philips. The data on industrialisation, pollution and slum clearances will also be added to the website “Know Your Place” and help connect it to communities for urban planning. More Broadly, the resources can be used to inform policy decisions through a deeper understanding how different neighbourhoods have developed, and why inequalities are so persistent.

 

4th Bristol Economic Policy and Behaviour Workshop – Call for Papers

Posted on by vicky.jackson

CEPS and the School of Economics at the University of Bristol are delighted to announce the 4th Bristol Economic Policy and Behaviour Workshop will take place on the 18th and 19th May 2023. The workshop provides the opportunity to discuss innovative empirical policy evaluations from different sub-fields of applied microeconomics. A focus is given to understanding the underlying behaviour that causes policy impacts. The workshop provides a forum of exchange between international scholars and policy professionals.

 

The keynote speaker is David Huffman, University of Pittsburgh.

 

A call for papers with details on how to submit is here – CfP_BEPB_2023 with a deadline of the 28 February 2023. We welcome submissions dealing with empirical policy-relevant research. We value contributions which provide innovative approaches to evaluation, data, and empirical analysis of individual behaviour. Priority will be given to contributions that go beyond showing only policy impacts but also document insights into the behaviours generating the policy effects.

Details of the previous workshop in 2019 can be found here.

For more information contact econ-appliedworkshop@bristol.ac.uk

CEPS Education Markets Workshop 2022

Posted on by zac.richardson

15 June 2022 – Vicky Jackson

We were delighted to host the Bristol Education Markets Workshop at Clifton Hill House on 6 and 7 June under the CEPS Education research programme. One of the organisers – Hans Sievertsen – explains why CEPS works on what we call ‘education markets’ – 

“We often think of markets as a place where we buy and sell things for money. But in some markets, money is not directly involved, and allocations are instead based on a set of rules. One example is allocation to schools. Often, parents provide a list of desired schools for their children and a centralised system then allocates children based on some pre-defined criteria, such as distance to the school or prior attainment. In some countries, such as France and Italy, teachers are allocated to schools in the same way. There are many details in the design of these systems that affect who ends up going to which school, and since we know that the school we attend and the teachers we have are important for how well we do later in life, it is of great policy importance to get the design of these systems right.” 

The workshop examined policies using market mechanisms in education, including design and implementation and their impact on school and university allocation in different countries. Sessions covered policy design and school choice in practice, and research on allocation mechanisms, how schools prioritise among students and implications for lower-income households and across genders.

In the first session on School Choice in Practice, Mille Bjørk from the Danish Ministry of Children and Education outlined the new Danish model for allocating high-school students to schools. The priorities for the new system are 1) to counteract ethnic and socio-economic segregation across schools, particularly in urban areas where the population distribution is more polarised, and 2) maintaining a sustainable number of students in rural schools. Emily Hunt from the Education Policy Institute presented a personal account of the experience of navigating the complexities of the English school allocation process during a pandemic. Reconciling her own experience as a parent with the evidence on school choice, she found the current school choice system favours more affluent families who are better able to navigate the system, potentially working against the government’s aim to ‘support the most disadvantaged’ and ‘level-up education standards’. 

In the second session on Design, Éva Holb (Institute of Economics, KRTK, Hungary) explored the centralised secondary school admission system in Hungary, outlining its (relatively complex) design and the implications for student choice and outcomes. Aytek Erdil from the University of Cambridge spoke on widening access and managing recruitment in university admissions. He outlined a model, developed with Battal Doğan (Bristol) for a centralised system which could be implemented after school-leaving qualifications are known.  

The final session on day one focussed on Income. Andreas Bjerre-Nielsen from the University of Copenhagen investigated why students submitted preferences for educational programs that differed from what they actually wanted to study. Using Danish admissions to higher education he examined how non-truthful reporting is linked to misguided beliefs about admission chances and to students’ backgrounds. Jose Montalban (SOFI at Stockholm University) examined the impact of low-income household priority policies on school choice and on student outcomes, asking whether these policies are effective in practice at improving outcomes for students from disadvantaged backgrounds. His paper used school choice in Madrid as a case study and tested the effect of income-based priority points on parental school choice, parental application behaviours and academic and non-academic student outcomes. 

The second day began with papers centered on Priorities. Peter Biro of the Institute of Economics, KRTK Hungary, discussed school choice with and without priorities. He looked at two case studies using non-standard school choice mechanisms. The first was Estonian kindergarten allocation where a ‘deferred acceptance’ mechanism is in use with different priorities and the second, school choice in Sweden where priorities are not used and instead a new concept of ‘constrained welfare-maximising assignment’ is employed. Julien Grenet (Paris School of Economics) looked at the effects of affirmative action on targeted and non-targeted students through a study of Paris high schools following a policy change in admission rules that gave low-income students priority over other district students.  

In a session on Gender, Caterina Calsamiglia (ICREA at the Institute of Political Economy and Governance) undertook a comprehensive evaluation of a policy change in Spain in 2010 which increased the weight of standardised exam results for university admissions from 40% to 60% and its implications for the gender gap. Soledad Giardili from the University of Edinburgh presented her paper “Single-Sex Primary Schools and Student Achievement: Evidence from Admission Lotteries” asking whether single-sex schools provided the benefits they are assumed to deliver, such as improving academic achievement and achieving gender equality. Soledad used the setting primary school allocation in Malta to explore this question, finding a positive effect on academic and non-academic factors for boys and girls. 

The workshop concluded with a session on Choice and Access. Damon Clark from UC Irvine asked how parents choose schools. He collected new survey data from parents as they choose schools, focussing on the impact of parents’ beliefs about their own child and about the wider local population on their choices. Lykke S. Christensen’s (University of Copenhagen) paper “Playing the system: Address Manipulation and Access to Education” studies address moves of students in Denmark, where proximity to a school is key in the allocation of places. Lykke and colleagues identified a 100% increase in the number of address changes around high school choice deadlines. She considered the implications for access to education, finding the increase in address changes is driven by high socio-economic status applicants to the 15% most popular schools. Low socio-economic status students lose out as a result in terms of contact with higher achieving peers. These results have implications for modelling school choice mechanisms and policy effectiveness.  

The last presentation from Ellen Greaves (University of Bristol) asked how schools shape neighbourhoods.  That is – how do schools’ admissions priorities affect households’ residential moves and how does this vary across different types of households? To examine these questions, she compared household location choices in local authority areas with a geographical admission priority against those with a non-geographic priority system, i.e. grammar school systems which concentrate on academic achievement. 

We had fantastic research presented at the workshop and the opportunity to discuss in person following two years of virtual events was hugely beneficial. Mille Bjørk from the Danish Ministry of Children and Education said of the event: 

“I really enjoyed the workshop. In the ministry we always aim to consider the research evidence when designing new policies. Interacting with the researchers at this workshop was really valuable, and I’ve built connections that will be helpful in the future.“

Thank you to all our presenters and attendees for making the event so productive and enjoyable. If you would like to learn more about the event, please see the programme.

World Health Day 2022 – Our Planet, Our Health – CEPS Research

Posted on by vicky.jackson

Vicky Jackson and Zac Richardson
07/04/2022
This post was written for the CEPS and School of Economics, University of Bristol blog pages.

On World Health Day we are highlighting the work of colleagues in the School of Economics and the Centre for Evidence Based Public Services (CEPS). This year, World Health Organisation (WHO)’s theme is ‘Our Planet, Our Health’ and focuses on the interrelated challenges of health and the environment. In particular, WHO is concerned with highlighting the political, social and commercial decisions which continue to drive the climate and health crisis. With this year’s theme they seek to challenge the present design of the economy which leads to inequitable distribution of income, wealth and power. Instead, they propose the development of sustainable well-being societies committed to achieving equitable health now and for future generations without breaching ecological limits.

Here at the School of Economics our agenda includes health, education, welfare reform, urban planning and the environment with an emphasis on data-intensive research that delivers practical solutions to real-world problems. Inequality is a key theme within economics, so it should be no surprise that our research tackles the sources and consequences of inequality. Our research and policy recommendations are intended to change everyday decisions we make, including working towards fairer, more equitable and sustainable societies through the improvement of public services. We are proud of the research and analysis that colleagues have produced, a list of recent research on health and the environment can be found at the end of this blog. Our wider research activity can be explored here.

Health

Our health research covers a range of topics, including the efficiency of healthcare delivery and individual and household decision-making in relation to health and healthcare. Much of our research focuses on the co-dependence between health and economic outcomes, exploring how shocks to health and well-being affect outcomes such as educational attainment and employment, as well as vice versa.  In a recent paper, Born on a Busy Day: Midwives Buffer Effects of Crowded Wards on Babies and Mothers, Hans Sievertsen and co-authors assessed the impact of crowded wards using a study of nearly 800,000 births to look at maternity wards. They found midwives adjusted their care strategies for mothers to ease workload pressure during busy periods. Surprisingly, the shifts in treatment brought no obvious signs of harm to mother and child. Patrick Gaule and co-author have examined what the research and development response to COVID-19 tells us about medical innovation and how lessons from the response could be used to scale up innovation to confront other deadly diseases as well as global challenges like climate change. While economists tend to see market size as the main driver for innovation, they argue a broader perspective that takes the greater good into account is needed. The response to the pandemic shows that when the incentives are right innovation can proceed at a very fast pace.

In her recent paper “The impact of health on labour supply near retirement”, Monica Costa-Dias and co-authors assessed the role of different measurements of health in the estimation of the impact of health on employment. Accurately capturing this relationship has important implications for targeted policy to help reduce inequality. Amongst their conclusions they found that health is a more important driver of employment among those who left education earlier. Jeremy McCauley has studied the link between dementia and disadvantage in the USA and England. He and his co-authors found inequality in dementia prevalence according to income, wealth and education in both the USA and England. Overall, England has lower dementia prevalence and a less strong association with socioeconomic status. Most of the difference between the two countries is concentrated in the lowest socioeconomic group, which suggests disadvantage in the USA is a disproportionately high-risk factor for dementia.

Researchers also looks at household and individual decision-making in relation to health and healthcare aiming to make policy recommendations for individual and societal good. Christine Valente’s main research interests lie in household decisions regarding fertility and human capital investments in developing countries: “Provide women with information about the risk of pregnancy to increase contraceptive demand.” Her research into contraceptive use found women in the South of Mozambique generally hold accurate or plausible beliefs about the effectiveness of contraception, but that they underestimate the risk of pregnancy in its absence. Addressing this underestimation, rather than focussing solely on free contraception is key to reducing unwanted pregnancies. She has been awarded a major grant from the Bill and Melinda Gates Foundation to continue this research with a major study in Nigeria.

Patrick Arni and colleagues examined ‘biased health perceptions’, that is how people overestimate their health and how these misperceptions are strongly linked to unhealthy behaviours: Overconfidence in Health Linked with Unhealthy Lifestyles According to Economic Report. The findings point to several potential public health interventions: those with biased health perceptions could be targeted for public health campaigns aimed at reducing risky health behaviours. Regular health check-ups and screenings, in addition to nudging people to seek regular feedback about their health, could also be effective. Stephanie von Hinke also studies the economics of obesity, diet and nutrition, looking at both potential causes and consequences of the recent rise in body weight, as well as at evaluating ways to improve dietary choices. With Eleonora Fichera she has written on nutrition labelling, evaluating the impact of the introduction of front of packet nutritional labels on households’ shopping baskets in the UK. They found that the introduction of labelling did affect households’ food choices, and also led manufacturers to improve the healthiness of their labelled products. They recommended the widening of food labelling across more products and more food retailers.

Stephanie also investigates the importance of genetics, early life environments, parental investments, and government policy in explaining individuals’ health and well-being over their lifetimes. She currently holds an ERC Starting Grant, “Developmental Origins: exploring the Nature-Nurture Interplay,” which explores these questions. Her recent CEPS blog Genes and Upbringing Both Matter for Educational Success highlighted this nature-nurture interplay as inextricably linked in a study finding that eldest siblings, typically blessed with extra attention from their parents, do especially well in education when they also possess certain genetic traits. In a recent working paper, “The Long-Term Effects of Early-Life Pollution Exposure: Evidence from the London Smog” Stephanie von Hinke and Emil N Sørensen used information on exposure to the London smog of 1952 to investigate the impact of early-life pollution exposure on individuals’ human capital and health outcomes in older age. They found those exposed to the smog have substantially lower fluid intelligence, the ability to think and reason abstractly and solve problems, and worse respiratory health.

See Stephanie Von Hinke discuss her work on Economics and Genetics in this Bristol Talk Economics talk.

Environment

Our environmental research evaluates the effects of transport infrastructure investments, as well as using house price responses to transport and environmental policies as a method of valuing their perceived costs or benefits. Other research covers the pricing policies of airports and looks at urban development in multiple country settings.

Yanos Zylberberg and colleagues’ work examines pollution and spatial inequalities in relation to urban expansion. In a recent article, “East Side Story: Historical Pollution and Persistent Neighbourhood Sorting,” they explored historical pollution patterns and their impact on urban development. They found past pollution explains up to 20% of observed neighbourhood segregation and spatial inequalities in 2011, even though coal pollution stopped in the 1970s.

Yanos’s current Open Research Area funded project:  MAPHIS: What Historical Maps Can Tell Us About Urban Development will advance our understanding of long-run urban growth through the digitisation and examination of historical maps spanning almost a century. It will explore the historical evolution of urban neighbourhoods from 1870 onwards and help us better understand how urban planning decisions made today affect the cities of tomorrow. A striking feature of cities around the World is the large differences in neighbourhood composition, which may reflect segregation fuelled by rural-urban migration and unequal exposure to environmental dis-amenities. Little is known about the patterns of city development during the structural transformation of economies, MAPHIS will seek to address this.

See Yanos Zylberberg talk about his current project, MAPHIS.

He has also studied the impact of nuclear power plant development on local areas by examining the effect of the 2011 Fukushima disaster on property prices in England. They found that property prices fell, and deprivation rose in neighbourhoods near nuclear-power plants as richer residents left the area. The study has implications for policies aimed at reviving local areas and suggests that areas with highly mobile workers are less resilient in the face of local shocks.

Helen Simpson’s research covers urban economics and the effects of place-based policies. She currently holds a British Academy Fellowship for her project “Cities, productivity and levelling up”. This will investigate whether the COVID-19 pandemic is likely to have long-term effects on where people in some occupations live and work. These choices, as well as decisions by firms on what now constitutes the workplace, could have implications for UK cities and regional economic inequality. While the direct effects of the pandemic will likely amplify existing spatial inequality in the UK, any acceleration towards working, and spending, from home may also affect affluent cities and the extent to which they derive benefits from density. Helen’s project will map these trends and their impact on local economic performance, drawing out implications for the ‘levelling up’ agenda.

Economics can provide the tools and evidence to help challenge the political, social and commercial decisions we continue to make that are driving the climate and health crisis. Economics can also shape the development of new more sustainable societies providing equitable health now and for future generations without breaching ecological limits. Here at the School of Economics and CEPS our researchers will continue to contribute to these critical conversations.

Recent Research by the School of Economics and CEPS on Health and the Environment 

Ruchir Agarwal, Patrick Gaule, ‘What does the R&D response to Covid-19 tell us about innovation?,’ Economics Observatory [Blog], 6 September 2021, https://www.economicsobservatory.com/what-does-the-rd-response-to-covid-19-tell-us-about-innovation. 

 

Ruchir Agarwal, Patrick Gaule, ‘What drives innovation? Lessons from COVID-19 R&D’, Journal of Health Economics, Volume 82, 2022, 102591, https://doi.org/10.1016/j.jhealeco.2022.102591. 

 

Karolos Arapakis, Eric Brunner, Eric French, Jeremy McCauley, ‘Dementia and disadvantage in the USA and England: population based comparative study’. BMJ Open, 11(10) (2021). https://doi.org/10.1136/bmjopen-2020-045186  

 

Karolos Arapakis, Eric French, John Bailey Jones, Jeremy McCauley ‘On the Distribution and Dynamics of Medical Expenditure Among the Elderly’. (2021). University of Michigan Retirement and Disability Research Centre Working Papers. 436. https://mrdrc.isr.umich.edu/publications/papers/pdf/wp436.pdf 

 

Patrick Arni, Davide Dragone, Lorenz Goette, Nicolas R. Ziebarth, ‘Biased health perceptions and risky health behaviors—Theory and evidence,’ Journal of Health Economics, Volume 76, 2021, 102425, https://doi.org/10.1016/j.jhealeco.2021.102425.   

 

Patrick Arni, Michelle Kilfoyle, ‘Overconfidence in Health Linked with Unhealthy Lifestyles According to Economic Report,’ CEPS [Blog] 10 November 2021. https://ceps.blogs.bristol.ac.uk/2021/11/10/overconfidence-in-health-linked-with-unhealthy-lifestyles-according-to-economic-report/  

   

Pietro Biroli Titus Galama, Stephanie von Hinke, Hans van Kippersluis, Cornelius A. Rietveld, Kevin Thom, ‘Economics and Econometrics of Gene-Environment Interplay,’ 25 February 2022, School of Economics, University of Bristol Working Paper Series wp22/759. http://www.bristol.ac.uk/efm/media/workingpapers/working_papers/pdffiles/dp22759.pdf  

 

Tom R.P. Bishopa, Stephanie von Hinke, Bruce Hollingsworth, Amelia A.Lakee, Heather Brown, Thomas Burgoine, ‘Automatic classification of takeaway food outlet cuisine type using machine (deep) learning’, December 2021, Machine Learning with Applications, vol 6, 2021. https://www.sciencedirect.com/science/article/pii/S2666827021000530?via%3Dihub 

 

Bernard Black, Eric French, Jeremy McCauley and Jae Song. ‘The effect of disability insurance receipt on mortality’. 16 November 2017. https://econ.hevra.haifa.ac.il/images/icagenda/files/di-death52.pdf 

 

Richard Blundell, Jack Britton, Monica Costa Dias, Eric French, ‘The Impact of Health on Labour Supply Near Retirement’, The Journal of Human Resources, 19 January 2021, http://jhr.uwpress.org/content/early/2020/11/04/jhr.58.3.1217-9240R4.full.pdf+html  

 

Eleonora Fichera, Stephanie von Hinke, ‘The response to nutritional labels: Evidence from a quasi-experiment,’ Journal of Health Economics, Volume 72, 2020, 102326, https://doi.org/10.1016/j.jhealeco.2020.102326.  

 

Eric B. French, John Bailey Jones, Elaine Kelly, Jeremy McCauley, ‘End of Life Medical Expenses’. 22 September 2019. VoxEU CEPR Blog. https://voxeu.org/article/end-life-medical-expenses 

 

Eric B. French John Bailey Jones, Elaine Kelly, Jeremy E Mccauley, End of Life Medical Expenses. in Handbook of Aging and the Social Sciences . 9 edn, Academic Press. https://www.richmondfed.org/-/media/richmondfedorg/publications/research/working_papers/2018/pdf/wp18-18.pdf 

 

Eric B. French, Jeremy McCauley, et al. ‘End-Of-Life Medical Spending In Last Twelve Months Of Life Is Lower Than Previously Reported’. July 2017. Health Affairs, vol. 36. https://www.healthaffairs.org/doi/10.1377/hlthaff.2017.0174 

 

Stephan Heblich, Alex Trew, Yanos Zylberberg, ‘East Side Story: Historical Pollution and Persistent Neighborhood Sorting’. Journal of Political Economy, 129(5), 1508-1552. 2021. https://doi.org/10.1086/713101 

 

Jonas Maibom, Hans H. Sievertsen, Marianne Simonsen, Miriam Wüst, ‘Maternity ward crowding, procedure use, and child health’, Journal of Health Economics, Volume 75, 2021, 102399, https://doi.org/10.1016/j.jhealeco.2020.102399.  

 

Loubaba Mamluk, Timothy Jones, Sharea Ijaz, Hannah B Edwards, Jelena Savović, Verity Leach, Theresa H M Moore, Stephanie von Hinke, Sarah J Lewis, Jenny L Donovan, Deborah A Lawlor, George Davey Smith, Abigail Fraser, Luisa Zuccolo, ‘Evidence of detrimental effects of prenatal alcohol exposure on offspring birthweight and neurodevelopment from a systematic review of quasi-experimental studies’, International Journal of Epidemiology, Vol 49, December 2020. https://doi.org/10.1093/ije/dyz272

 

Steven Proud, ‘Funding Social Care’, Bristol Economics Blog, 7 September 2021. https://economics.blogs.bristol.ac.uk/2021/09/07/funding-social-care/ 

 

Mohammad Mahbubur Rahman, Saseendran Pallikadavath, Rabeya Khatoon. ‘Does Shorter Postnatal Hospital Stay Lead to Postdischarge Complications? An Instrumental Variables Approach’. 14 April 2019. Journal of International Development, vol. 31, 5. https://onlinelibrary.wiley.com/doi/10.1002/jid.3412 

 

Han H. Sievertsen, Michelle Kilfoyle, ‘Born on a Busy Day: Midwives Buffer Effects of Crowded Wards on Babies and Mothers,’ CEPS [Blog], 24 November 2021. https://ceps.blogs.bristol.ac.uk/2021/11/24/born-on-a-busy-day-midwives-buffer-effects-of-crowded-wards-on-babies-and-mothers/. 

 

Hans H. Sievertsen, CT Kreiner. ’Neonatal health of parents and cognitive development of children’ January 2020. Journal of Health Economics, vol. 69, 102247. https://www.sciencedirect.com/science/article/pii/S0167629618310609?via%3Dihub 

 

Christine Valente, Grant Miller, Áureo de Paula, Páscoa Zualo Wate, ‘Provide women with information about the risk of pregnancy to increase contraceptive demand’, Policy Briefing 82: March 2020, Policy Bristol. http://www.bristol.ac.uk/policybristol/policy-briefings/information-pregnancy-risk/ 

 

Christine Valente, Grant Miller, Áureo de Paula, ‘Subjective Expectations and Demand for Contraception,’ July 2021 https://www.christinevalente.com/_files/ugd/573cc0_f0edc60449b64cc3b026821d634b9e3e.pdf  

 

Nicolai Vitt, Martina Vecchi, Jonathan James, Michel Belot, ‘Daily Stressors and food choice: Evidence from a lab experiment with low SES mothers’ (2021), European Economic Review, vol 136, January 2021. https://www.sciencedirect.com/science/article/abs/pii/S0014292121001070?via%3Dihub 

 

Nicolai Vitt, Martina Vecchi, Jonathan James, Michel Belot, ‘Maternal stress during pregnancy and children’s diet: Evidence from a population of low socioeconomic status’, (2021), Nutrition, vol 93, January 2021. https://www.sciencedirect.com/science/article/abs/pii/S0899900721002859?via%3Dihub 

 

Stephanie von Hinke, ‘Education, Dietary Intakes and Exercise’ 23 June 2021, University of Bristol Working Paper Series wp21/748. https://www.bristol.ac.uk/efm/media/workingpapers/working_papers/pdffiles/dp21748.pdf 

 

Stephanie von Hinke and David Avdic, ‘Extending alcohol retailers opening hours: Evidence from Sweden’ (2021), European Economic Review, vol 138, November 2021. https://www.sciencedirect.com/science/article/abs/pii/S0014292121001665?via%3Dihub 

 

Stephanie von Hinke, ‘Gene-Environment Interplay in the Generation of Health and Education Inequalities’, NORFACE, 2022. https://gene-environment.com/ 

 

Stephanie von Hinke, Michelle Kilfoyle, ‘Genes and Upbringing Both Matter for Educational Success,’ CEPS [Blog], 17 December 2021 https://ceps.blogs.bristol.ac.uk/2021/12/17/genes-and-upbringing-both-matter-for-educational-success/  

 

Stephanie von Hinke, Emil N Sørensen, ‘The Long-Term Effects of Early Life Pollution Exposure: Evidence from the London Smog,’ 18 February 2022, School of Economics, University of Bristol Working Paper Series wp22/757. http://www.bristol.ac.uk/efm/media/workingpapers/working_papers/pdffiles/dp22757.pdf  

 

Stephanie von Hinke, Eleonora Fichera, ‘Nutrition labelling helps individuals choose healthier foods,’ Policy Briefing 94: Nov 2020, Policy Bristol. http://www.bristol.ac.uk/policybristol/policy-briefings/nutrition-labelling-helps-individuals-choose-healthier-foods/ 

  

Yanos Zylberberg, Michelle Kilfoyle, ‘Study Reveals How the Flight of the Rich from Homes Near Nuclear Power-Plants Brings Local Deprivation,’ CEPS [Blog], 27 October 2021. https://ceps.blogs.bristol.ac.uk/2021/10/27/study-reveals-how-the-flight-of-the-rich-from-homes-near-nuclear-power-plants-brings-local-deprivation/    

Why We Give to Charities and When: Fundraising Lessons From Health Scares and International Disasters

Posted on by zac.richardson
Sarah Smith and Michelle Kilfoyle
22 December 2021

Charities have taken a huge hit in income during the Covid-19 pandemic. Social distancing has prevented in-person fundraising events, whether fun runs or cake sales, while lockdowns forced charity shops to shut their doors to customers for months at a time.

Of the funding that has made it to charities, there has been a notable shift in donations towards hospital and hospice charities, and away from non-Covid-19 causes.

Our research provides fresh insights for the charitable sector that could shape fundraising strategies and help boost income across the sector post-pandemic.

Lifting or shifting donations?

Fears circulate in the charitable sector that when we give money to one charity, it comes at the expense of donations to others. After all, there is only so much money and, perhaps, good will to go round. But is that really the case? Or can we be inspired to both give more, and give to more charities? Providing evidence from health charities and disaster appeals, research by Sarah Smith from the Centre for Evidence-based Public Services (CEPS) in Bristol’s School of Economics addresses this debate. It shows that there are instances of givers shifting their donations between different charities, and also examples where they expand the number of charities they support.

Health charity donations after severe illness

People who have survived a severe health scare are more likely to donate to related medical charities following their diagnosis, a phenomenon known as ‘altruism born of suffering’. A study by Smith and colleagues from Monash University provides evidence on the rate of its occurrence and, shows that this giving does divert spending away from non-health causes.

The research team analysed long-term data (2001-2015) on over 400 households across the US who were asked about their charitable giving and about their health.

In the year following a health scare, namely cancer, a heart attack or a stroke, the probability of donating to health charities went up by 11 percentage points, that is, 41% of this group donated, compared with 30% among those who had not had a health scare. Their likelihood of donating to health charities drops as the years pass, but still remains 6 percentage points higher 2-3 years after the scare.

These donors subsequently gave less money to non-health charities – switching loyalties between good causes, but were not giving more or supporting more charities overall.

Further, the health scares rarely motivated people to give to health charities if they were not already regularly donating to charity. Only 4% of new givers to the health sector had never donated to non-health causes prior to their health shock.

Disaster relief appeal effects on total giving A separate, but related, study revealed very different patterns of giving in the case of disaster relief campaigns in the UK.

Unlike the case of health charities and health shocks, disaster relief appeals trigger a lift in overall donations. People not only give to the campaigns over and above their existing charitable donations, but also go on to donate to other charities that are quite separate to the disaster relief campaign – at least in the short term.

Smith and colleagues from the University of Birmingham and IUPUI in the US studied data on the charitable giving accounts of more than 100,000 UK people who regularly donate through the Charities Aid Foundation (CAF), covering 4.5 million donations to 80,000 charities over 2009-2014.

They focused on six major appeals launched during this time by the UK Disasters Emergency Committee (DEC), including the 2010 earthquake in Haiti and the 2013 typhoon in the Philippines.

Significant spikes in overall donations through CAF were seen after each of these appeals; of the five biggest spikes over the period, four occur after DEC appeals.

Total donations were higher for 14 weeks after each appeal, before returning to normal levels.

Strikingly, donations to other, non-DEC, charities also increased by 10% immediately after each appeal, and these all came from the same people who had given to DEC.

This donation pattern is not unique to DEC appeals. The study found similar results for major annual fundraising telethons, specifically BBC Children in Need, Comic Relief and Sports Relief, where a lift in non-telethon donations also occurred immediately after the events.

A few weeks after the DEC appeals, donations to non-appeal charities dipped below typical levels before returning to normal. However, there was no subsequent drop in donations to non-appeal charities after telethons, suggesting that the degree to which people adjust donations varies by charitable cause.

Altruism vs ‘warm glow’

Smith and colleagues explain the different patterns of charitable giving in the two studies through different motivations for giving.

Health shocks are an intensely personal experience, often life-changing, and donations to health charities are explained by altruistic motivations. The donor cares deeply about the outcomes of the charities’ activities, such as new medical treatments.

Health charities could focus fundraising efforts with patients in the first year following diagnosis, the research suggests, when the salience of the illness and sense of altruism are at their peak.

Giving to disaster appeals and telethons, on the other hand, is explained by a ‘warm glow’ effect. This is the feel-good factor we experience when we help other people. Thus, increased donations to non-DEC and non-telethon charities occur not only because the appeals have acted as a reminder to give to charity, but also because they extend that warm glow feeling.

Building on these findings, the researchers developed a model that tracks the changing influence of warm glow on giving. When the warm glow effect is high, people find giving to charities relativelyeasier, as shown by the disaster appeal research. But when it is lower, perhaps depleted after a string of donations, the cost of giving to charity feels much greater.

The model helps paint a picture of how charities influence each other’s incomes through their collective effects on warm glow and points to how they could best benefit from this. The model could, for example, identify the best timings for campaigns in relation to one another, as well as the timing or targeting of government tax incentives to encourage charitable giving

Professor Sarah Smith – University of Bristol, School of Economics
Michelle Kilfoyle – CEPS Science Writer

Genes and Upbringing Both Matter for Educational Success

Posted on by zac.richardson

 

Stephanie von Hinke and Michelle Kilfoyle
17/12/2021

Nature vs. nurture is an age-old debate. Are we products of our genes or of how we were raised? It is now widely accepted that both genes and environment are inextricably linked and jointly mould our lives. A recent study of siblings and their educational achievements provides evidence to further bolster this joint gene-environment theory. It finds that eldest siblings, typically blessed with extra attention from their parents, do especially well in education when they also possess certain genetic traits.

Firstborn children have the luxury of their parents’ undivided attention until the arrival of their younger siblings. In fact, firstborns can expect to have, on average, 20-30 minutes more daily quality time with their parents than laterborns, as parents find their time increasingly stretched with each child.

This privilege goes a long way in explaining why eldest siblings tend to do better at school than their younger siblings and can be seen as a form of investment by parents in their child’s future. However, it is not always the full story, as the study co-authored by Stephanie von Hinke of the University of Bristol’s Centre for Evidence-based Public Services (CEPS) in the School of Economics shows.

In an innovative step for economics, von Hinke and collaborators from Erasmus University Rotterdam used genetic data to help understand why some people do better than others in education. They analysed DNA from UK Biobank, a national repository of biological samples and individual data, for a sample of 14,850 adult siblings (aged 40-69 at the time of study).

They measured each sibling’s ‘genetic endowment’ for educational attainment using ‘polygenic scores’. These scores are based on specific genetic variants that correlate with educational attainment.

By comparing siblings from the same family, the researchers were able to cancel out the effects of factors like parental income and social class on children’s educational attainment. (It would be much more difficult to disentangle these wealth and class-derived influences from other non-genetic factors when comparing children from different families.)

Each family was akin to a controlled experiment that allowed the researchers to explore the relative influence of each child’s genetic variation and their environment. In this study, being firstborn or laterborn was used as a measure of a child’s environment as it, at least partly, indicates whether parents invested more or less time in each child.

The results first confirmed that genetic variations are very good at predicting educational attainment. In general, the higher a person’s genetic endowment, the more years they had spent in education. Firstborns were no more or less likely to have a high endowment than laterborns.

Second, the results confirmed that firstborns do better at school. Firstborns with an average genetic endowment completed, on average, an extra 4.5 months of schooling than their laterborn siblings.

However, firstborns who have an above-average genetic endowment completed, on average, an additional two months of education (on top of the 4.5 months) than their laterborn siblings with the same genetic endowment.

This study shows that neither genetics nor environment are solely responsible for determining our education, and that both matter. Furthermore, as well as emphasising the importance of investing in skills early in life, the research supports the idea of ‘dynamic complementarity’ between nature and nurture in this setting, that is the idea that people with higher initial skills benefit more from subsequent investment.

Professor Stephanie von Hinke – Professor of Economics, University of Bristol School of Economics
Michelle Kilfoyle – CEPS Science Writer

Escalating Tuition Fees in England Have Not Made Poorer Students Less Likely to Go to University

Posted on by zac.richardson
Stephanie Simion and Michelle Kilfoyle
9 December 2021

Recent UK government proposals to reform higher-education funding, under which graduates would start repaying their student loans on lower salaries, have triggered concerns around disproportionate and negative effects on lower earners. A recent study has assessed the impacts of past changes to higher-education funding for students from different income groups in England. It finds that price hikes to tuition fees in 2006 and 2012 have not led to fewer poorer students going to university due to financial support in the form of loans and grants.

In fact, it is students from wealthier families, who are less likely to be eligible for financial support, who are now slightly less likely to enrol. The reforms also appear to have had only very small effects on students’ choices of degree subject and university location, and on their short-term career prospects.

Rising tuition fees

Many countries are considering reforms to higher-education funding. England has had three major reforms in recent decades, beginning in 1998 with a switch from no fees to means-tested fees of up to £1,000 per year.

This was followed by a rapid series of changes which now see England’s students paying among the highest undergraduate tuition fees in the world at up to £9,250 a year. Only students at private universities in the US pay more.

The financial burden of tuition fees naturally raises concerns that students from poorer backgrounds will be deterred from going to university.

Socio-economic consequences The new study, by Stefania Simion of the University of Bristol’s Centre for Evidence-based Public Services (CEPS) in the School of Economics, in collaboration with Ghazala Azmat of Sciences Po in France, unpicked rich datasets to better understand the consequences of different methods for financing higher education.

The researchers assessed enrolment rates, choice of university and subject, and post-university outcomes for students who entered higher education in England between 2004 and 2013, using data on all state-school educated students – around 2.8million individuals.

Their analysis revealed the effects of the increase in fees to £3,000 per year in 2006 (up from a maximum of£1,000, depending on family income), and the short-term effects of the 2012 reform which raised fees to their present maximum level of £9,250.

Enrolment rates and financial support

Enrolment rates across all students fell slightly, by 0.5 percentage points, after the 2006 reform, and again in the year following the 2012 reform. However, this drop was largely among students from wealthier families, classed by this study as those with an average household income of £43,000 or more.

Changes in enrolment rates for students from poorer families (with an average household income of £29,000 or less) and middle-income families (average household income of £34,000) were negligible.

These results can be explained by the financial support packages that accompanied the increases in fees.

Notably, since 2006, students in England do not have to pay fees upfront but can instead take out a loan to cover the cost. They repay this with interest over their working lives and only once their salary passes a certain threshold, currently £27,295 for those who took out a loan after 2012, or £19,895 pre-2012.

On top of this, means-tested grants of up to £2,700 were introduced in 2006 (up from £949) rising to £3,250 in 2012, plus means-tested loans of up to £4,000 in 2006, and £5,200 in 2012.

This package eases the financial burden of fees, but also means that higher education is relatively more costly for students from families who do not receive means-tested support, potentially explaining the slight drop in student numbers from higher socio-economic backgrounds.

The study calculates that an increase in fees of £1,000 for wealthy students not eligible for grants corresponded to a drop in enrolment of only around 0.025 percentage points. But there was an 0.8 percentage point increase in enrolment among students who were eligible for full financial aid.

Degree subject, university location and career outcomes

The higher cost for wealthier students may also explain why the study found that they were more likely to choose a university close to home after the reforms. It may also explain a slight shift in subject choices. Post-reform, wealthier students were slightly less likely to opt for degrees in Arts and Education programmes, preferring STEM subjects that offer higher-paid careers.

These choices could translate into different career outcomes for wealthier students. Six months after graduating, they had marginally higher earnings and they were also less likely to be unemployed or in insecure work than graduates from less well-off backgrounds compared with the pre-reform period. However, average earnings for middle and low-income groups fell slightly after the reforms.

Closing the socio-economic gap in higher education

In sum, the results show that the funding reforms have had only very small effects on higher education choices, but do suggest that the socio-economic gap in university enrolment is narrowing.

The study’s authors recommend a deeper look at the data to understand if more could be done to promote university to students from the poorest backgrounds, with family incomes far below the £29,000 threshold used in this study

Dr Stefania Simion – Lecturer at University of Bristol, School of Economics

Michelle Kilfoyle – CEPS Science Writer

Born on a Busy Day: Midwives Buffer Effects of Crowded Wards on Babies and Mothers

Posted on by zac.richardson
Hans Sievertsen and Michelle Kilfoyle
22 November 2021

The recent demands of Covid-19 have seen hospital patient numbers soar. A better understanding of how crowding on wards affects treatments and patient outcomes is essential in helping clinicians best allocate their care – both during the pandemic and beyond, and for all sectors of hospital care. Taking maternity wards as an example, a recent Danish study of nearly 800,000 births finds that midwives adjust their care strategies for mothers to ease workload pressure during busy periods. Surprisingly, the shifts in treatment – fewer inductions and later admission to hospital – bring no obvious signs of harm to mother and child.

Evidence on the effects of crowding is scarce, especially for maternity wards. Much like A&E, maternity wards face the challenge of unpredictable admission rates that are hard to plan for. The new study, by Hans Sievertsen from the University of Bristol’s Centre for Evidence-based Public Services (CEPS) and School of Economics, starts to fill this knowledge gap for maternity wards.

Working with a team of researchers from Aarhus University and the University of Copenhagen, Sievertsen analysed birth registry and medical data for 796,416 babies born during 2000–2014 and their mothers across Denmark. They focused on uncomplicated births, thus excluding those born by planned caesarean.

The research team assessed how treatment and patient outcomes varied according to the number of patients admitted to a maternity ward for each day. Admissions can substantially and rapidly fluctuate on Danish maternity wards, and surges of 200% above the average are not uncommon.

As an example of how patient numbers vary, daily admissions on Denmark’s busiest maternity ward, Hvidovre, range between six and 25.

Their results showed that midwives appear to ease pressure on busy days by choosing not to speed-up delivery by avoiding or postponing inductions. For each three additional admissions over the average, there was a 0.7 percentage point reduction in the number of inductions. This corresponds to a 4% reduction on the average induction rate of 18.6% across all the births studied.

In addition, midwives appear to admit mothers into hospital at slightly later stages of labour during busy periods, thus reducing the overall length of time that mothers spend in hospital.

Of surprise to the research team, crowding presented no obvious health risks to either mother or baby, based on various measures of wellbeing and indicators of care.

For instance, there was no increase in stillbirths or death rates among babies within the first week and year of life. It should be noted that these are rare occurrences in any case, and the study only looked at non-risky births.

For babies, there was no effect on their APGAR score – the quick health test performed immediately after birth to assess five key factors, including breathing and heart rate.

For mothers, there was no increase in the probability of having an emergency caesarean, the rate or severity of lacerations (vaginal tearing), or delay in epidural pain relief. Skin-to-skin contact with baby within two hours of birth, a central quality indicator for Danish hospitals, continued to take place in timely fashion.

Further, children born on crowded maternity wards and their mothers were no more likely than other families to access healthcare – whether GPs or hospitals – in the two years post-birth.

In fact, the study even found that there were fewer serious post-birth complications for mothers who gave birth on busy days: a 1.5% reduction, approximately, for each three extra births over the average. The researchers speculate that this may be because the lower number of inductions on crowded days reduced the need for follow-up treatments associated with this procedure.

The study, therefore, shows that Danish maternity wards’ strategies to ease workload pressure enable midwives to cope with day-to-day spikes and dips in patient numbers, and without detectable health risks for the majority of uncomplicated births. The authors do stress, however, that their results cannot be used as evidence in support of cuts to hospital funding, as they did not examine what the optimal level of maternity care should be.

Hans Sievertsen – Senior Lecturer in Economics – University of Bristol
Michelle Kilfoyle – CEPS Science Writer and Editor

Gender Stereotypes See Female Criminals Fare Better in Court

Posted on by zac.richardson
Michelle Kilfoyle and Arnaud Philippe
17 November 2021

The criminal justice system represents a rare sector of society where women fare better than men. Female criminals are less likely to be arrested, sent to court and sentenced than male offenders, even for equivalent crimes. Where women are sentenced, their punishments are usually less severe.

New research concludes that the differences in sentencing for men and women are due to gender stereotyping of defendants in court. Protective, paternalistic attitudes of male judges towards female defendants seem to be a key reason for the more lenient punishments handed to women.

Official statistics from France, the UK and the USA all show the preferential treatment of women throughout the criminal justice system. The new study, by Arnaud Philippe of the University of Bristol’s School of Economics and Centre for Evidence-based Public Services (CEPS), draws on criminal court data to both confirm and quantify genuine differences between sentences for men and women in France, and to find reasons for this gender gap.

Philippe analysed data for 1.37 million convictions in France between 2000 and 2003 for a criminal category called delits in French. This covers most forms of crime: property crimes, violent crimes, economic crimes, insults, drug-related crimes and road-related offenses.

The average prison sentence for men was 47 days, and 19 days for women. Having accounted for the influence of non-gender factors on sentencing, such as the form of crime, the defendant’s history of criminal activity and their socioeconomic characteristics, the study found that gender was responsible for a 15-day difference in sentence lengths for men and women. Women were also slightly more likely to receive suspended prison sentences.

Digging deeper into the data, Philippe homed in on court cases featuring just two people on trial, one man and one woman, convicted of the same crime. This enabled an even clearer picture of just how gender influences sentencing when other factors are equal, in particular, the judges and prosecutor working on the trial, and the trial’s time and place.

The sentencing gender gap was even more striking for these 2382 mixed-gender pairs. Women’s prison sentences were, on average, 25.6 days shorter than men’s and their probation sentences 2.4 days shorter. Men received longer prison sentences even if their female partner had a longer history of committing crimes – a factor normally associated with harsher sentencing.

Notably, the differences between sentences for men and women were smaller in trials with more female judges in court. Three judges work on each court case for delits, and an increase in the share of female judges of around 20% was associated with 1.5 days longer prison sentences for women, and 1.7 days longer probation. The gender of the prosecutor had no influence on sentencing rates or harshness.

The study’s findings suggest that gender stereotyping by judges was the main driver of the sentencing gender gap. Drawing on wider evidence from the US, Philippe points to the influence of paternalism among male judges, who may view women as fragile and perhaps less able to cope with prison.

These results reflect a common pattern in society whereby individuals tend to discriminate less against people of a similar demographic to themselves. In this case, female judges were less likely to positively discriminate towards female criminals.

The results do not support other possible explanations for the disparities, such as the need to adhere to the criminal code. This might, conceivably, see mothers treated less harshly for their

children’s sake as part of judges’ obligations to protect society, for instance, but this was not shown by the data.

As well as providing clear evidence of discrimination between men and women in court, the study also demonstrates the broader value of diversity among decision makers in reducing discrimination

Michelle Kilfoyle – CEPS Science Writer
Arnaud Philippe – Senior Lecturer, School of Economics

Overconfidence in Health Linked with Unhealthy Lifestyles According to Economic Report

Posted on by zac.richardson

Michelle Kilfoyle and Patrick Arni
10th November 2021

Rising healthcare costs have intensified the focus on nudging the public towards healthier lifestyles. But what if you mistakenly believe your health to be better than it really is? New research shows that many people are just not as healthy as they think they are, and that this overconfidence hikes up the risk of adopting unhealthy behaviours, such as regularly eating junk food or taking no exercise. Public health campaigns that give individuals a better understanding of their true health status could, therefore, help foster healthier lifestyles, the findings suggest.

For economists, health behaviours can be understood in terms of their perceived costs and benefits to the individual. Even if people know that drinking alcohol or eating junk food carries health risks, many still enjoy doing so.

The weight assigned to either cost or benefit is partly shaped by how healthy we consider ourselves to be in the first place and what we believe our bodies can tolerate. We may reason that “I’m healthy enough to ‘afford’ to drink a little alcohol every day” or “I can’t ‘afford’ the health risks of a couch-potato lifestyle”. The study, co-authored by Patrick Arni of the University of Bristol’s Centre for Evidence-based Public Services (CEPS) in the School of Economics, introduces the concept of ‘biased health perceptions’ to describe how people overestimate their health and how these misperceptions are strongly linked to unhealthy behaviours.

As part of an international research team, with colleagues from the Universities of Bologna and Bonn, and Cornell University, Arni analysed data from three large-scale health surveys from Germany which together covered nearly 7,000 adults..

These surveys included objective measures of health, namely blood pressure and cholesterol readings taken by health professionals, which can be used as proxies for physical health. Further, the surveys questioned the respondents on their health to develop a reliable measure of their overall health status, as well as their health behaviours and perceptions of their health.

The research team used these data to calculate the gap, or biased health perception, between actual and assumed levels of health.

They found that 30% of the respondents were unaware that they had high cholesterol, while 9% did not realise that their blood pressure was high.

A clear majority of respondents thought that they were as healthy or healthier than most other people of their age when presented with the question: Imagine randomly selecting 100 people of your age. How many of those 100 people would be in better health than you?.

Thirty percent of respondents placed themselves at least 30 places higher in this ranking system than their overall health status would indicate. If the answers had accurately represented people’s true health, then they would have been spread more evenly across the distribution..

The analysis revealed clear correlations in the data between biased perceptions and behaviours. Respondents who were overconfident in their health were more likely to have unhealthy lifestyles, in that they were more prone to eating junk food, drinking alcohol daily, taking no exercise and not getting enough sleep.

For instance, 54% of the respondents who were unaware that their cholesterol levels were high did no exercise at all, compared with 43% of those who were aware of high cholesterol levels. These biased respondents were also 50% more likely to drink alcohol daily, and to have higher BMIs.

Further, 50% of people who overestimated their health in relation to other people did not exercise at all, compared with the 30% who accurately or underestimated their health.

The findings point to several public health interventions. Those with biased health perceptions could be targeted for public health campaigns aimed at reducing risky health behaviours. Regular health check-ups and screenings, in addition to nudging people to seek regular feedback about their health, could also be effective.

Interestingly, biased health perceptions were not linked to smoking habits. This is probably because addiction to smoking overrides any calculations of costs to health. Hence, public health campaigns that focus on the health costs of smoking are likely less effective at curbing tobacco consumption than tougher regulatory measures, such as smoking bans.

Michelle Kilfoyle – CEPS Science Writer
Dr. Patrick Arni – University of Bristol School of Economics