Healthcare Utilization during the Great Recession: Findings from a Panel of U.S. Workers and Families

• In Event: 574 - Section on Sociology of Population Paper Session. Demographic Consequences of Economic Crises

Abstract

Studies on the health impacts of economic downturns document worsened health status among vulnerable subgroups. Most research focuses on the unemployed, with less research on the majority of the population remaining in the workforce. The severity of the latest economic contraction implies that its health impacts are graver than prior recessions. We examine trends in healthcare utilization among a panel of continuously employed, continuously insured workers at a large U.S. manufacturing firm that experienced widespread layoffs during the Great Recession of 2007-2009. Using claims data from over 11,000 employees and their families, we analyze changes in the utilization of outpatient, inpatient, and ER services during 2006-2012, using segmented regressions to examine temporal discontinuities in utilization. In addition to examining overall trends, we compare individuals who were previously healthy to those who had health problems at the beginning of the study period. To identify the effects of job insecurity, we compare individuals working at high- and low-layoff plants. We find increases in utilization of outpatient and ER services in the panel overall. Those with previous health problems demonstrate increases in outpatient, ER, and inpatient visits compared to previously healthy employees. Individuals at high-layoff plants do not increase utilization of outpatient services, suggesting foregone preventive care, but they demonstrate a trend towards increased ER and inpatient utilization. Our results suggest increased healthcare utilization and potentially adverse impacts on the health of U.S. workers during the Great Recession. This study contributes to our understanding of the impacts of economic crises on population health.

Authors

• Rita Hamad, Stanford University

• Sepideh Modrek, Stanford University

• Mark Cullen, Stanford University