Do income effects mask social and behavioural factors when looking at universal health care provision?

To investigate whether permanent and transitory income effects mask the impact of unobservable factors on the uptake of health check-ups in Britain.

We used a secondary data representative of the British population, the British Household Panel Survey. Outcome variables included uptake of dental health check-ups, eyesight tests, blood pressure checks, cholesterol tests, mammograms and cervical smear tests. Transitory income was measured as monthly household income and permanent income as average income over 13 years. Estimation method applied dynamic random effect probit model.

Results showed the absence of permanent and transitory effects on the uptake of eyesight tests, cholesterol tests, mammograms and cervical smear tests. Permanent income was associated with dental check-ups and transitory income with uptake of blood pressure tests.

The presence of income effects on the uptake of blood pressure checks may be due to factors associated with income, such as stress or lifestyles, rather than income per se. A permanent income effect on dental health care in Britain, which is not free of charge, could indicate the possibility of economic constraints to service uptake, but it does not guarantee that income is the only factor that matters as there may important cultural and behavioural barriers.