The Open UniversitySkip to content
 

The 'cultural inflation of morbidity' during the English mortality decline: a new look

Gorsky, Martin; Guntupalli, Aravinda; Harris, Bernard and Hinde, Andrew (2011). The 'cultural inflation of morbidity' during the English mortality decline: a new look. Social Science & Medicine, 73(12) pp. 1775–1783.

DOI (Digital Object Identifier) Link: https://doi.org/10.1016/j.socscimed.2011.09.028
Google Scholar: Look up in Google Scholar

Abstract

This article contributes to the debate about using insurance records to reconstruct historical experiences of sickness during the Western mortality transition. Critics regard these sources as problematic as they measure morbidity indirectly through absences from work; these might be determined not by timeless biological criteria but by more contingent factors, notably shifting norms surrounding the sick role and responses to economic incentives (for which we adopt the generic term ‘cultural inflation of morbidity’). We review historical demographers’ contributions to this literature and discuss the concepts of moral hazard and the principal/agent problem as developed by health economists. This leads us to frame three empirical tests for ‘cultural inflation’ which allow us to assess the validity of insurance records for deriving morbidity trends: was there an increasing frequency of claims for complaints of diminishing severity; were unduly prolonged claims noticeable, particularly by older people for whom sickness benefit may have compensated for income insecurity; and did the insurer satisfactorily manage the agency problem to ensure reliable physician gatekeeping? We analyse records of the Hampshire Friendly Society, an exceptionally well-documented fund operational in Southern England, 1825–1989. Findings are based on a dataset of individual sickness histories of a sample of 5552 men and on qualitative documentary analysis of administrative records. On each count our results fail to demonstrate a cultural inflation of morbidity, except perhaps for those aged over 65. However, occasional discussion in the administrative records of economic incentives encouraging unnecessary prolongation of claims means we cannot rule it out entirely.

Item Type: Journal Item
Copyright Holders: 2011 Elsevier Ltd
ISSN: 0277-9536
Project Funding Details:
Funded Project NameProject IDFunding Body
Not SetRES-062-23-0324UK ESRC (Economic and Social Research Council)
Keywords: England; Morbidity; Insurance; Friendly society; Cultural inflation; Sick role; UK; Historical
Academic Unit/School: Faculty of Wellbeing, Education and Language Studies (WELS) > Health, Wellbeing and Social Care > Health and Social Care
Faculty of Wellbeing, Education and Language Studies (WELS) > Health, Wellbeing and Social Care
Faculty of Wellbeing, Education and Language Studies (WELS)
Item ID: 46345
Depositing User: Aravinda Guntupalli
Date Deposited: 20 May 2016 08:26
Last Modified: 07 Dec 2018 10:41
URI: http://oro.open.ac.uk/id/eprint/46345
Share this page:

Metrics

Altmetrics from Altmetric

Citations from Dimensions

Actions (login may be required)

Policies | Disclaimer

© The Open University   contact the OU