Tracing the Genetic Footprints of the UK National Health Service

Nicolau Martin-Bassols (), Pietro Biroli (), Elisabetta De Cao (), Massimo Anelli (), Stephanie von Hinke and Silvia Mendolia ()
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Nicolau Martin-Bassols: University of Bologna
Pietro Biroli: University of Bologna
Elisabetta De Cao: University of Bologna
Massimo Anelli: Bocconi University
Silvia Mendolia: University of Turin

No 18395, IZA Discussion Papers from IZA Network @ LISER

Abstract: The establishment of the UK National Health Service (NHS) in July 1948 was one of the most important health policy interventions of the 20th century, providing universal and free access to medical care and expanding maternal and infant health services. In this paper, we estimate the causal effect of the NHS introduction on early-life mortality and examine whether survival is selective. Using an RD design, we compare individuals born just before and just after July 1948. Leveraging newly digitized weekly death records, we document a significant decline in stillbirths and IMR following the NHS introduction, driven mainly by fewer deaths from congenital conditions and diarrhea. We then use polygenic indexes (PGIs), fixed at conception, to track changes in population composition. Cohorts born at or after the NHS introduction exhibit higher PGIs associated with contextually-adverse traits and lower PGIs associated with contextually-valued traits. Results based on UKBiobank data are robust to family-based designs and replicate in other UK surveys. Effects are strongest in disadvantaged areas and among males, highlighting how large-scale public policies can leave persistent imprints on population composition through selective survival.

Keywords: early-life; health systems; survival bias; infant mortality; genetics; polygenic index; UK Biobank; ESSGN (search for similar items in EconPapers)
JEL-codes: C21 I10 I38 (search for similar items in EconPapers)
Date: 2026-03
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Related works:
Working Paper: Tracing the Genetic Footprints of the UK National Health Service (2026)
Working Paper: Tracing the Genetic Footprints of the UK National Health Service (2026)
Working Paper: Tracing the Genetic Footprints of the UK National Health Service (2026)
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