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Unemployment impairs individuals' well-being and health and there is some empirical evidence showing that macroeconomic conditions can moderate these effects. This paper goes a step further and investigates differences in how macroeconomic indicators of European countries' economic situation relate to individual subjective health and well-being, and also moderate the relationship between individual labour market exclusion and these outcomes across age groups: young individuals (aged 15–29), prime working age adults (aged 30–49, base category) and pre-retirement age adults (aged 50–64). We used two different macroeconomic indicators to define macroeconomic situation: country-level unemployment rate and gross domestic product (GDP). Both indicators were disaggregated into long-term economic trend and business cycle shocks using Hodrick–Prescott filtering to allow distinguishing between expected and unexpected change in macroeconomic circumstances. We used the European Social Survey individual-level data from 35 European countries for 2002–2014. Multi-level analysis with three levels were run for men and women separately. Results revealed differences in how individual-level unemployment related to well-being depending on the age group, with pre-retirement age group adults' health and well-being suffering the most. Also, macroeconomic indicators were found to moderate the relationship between individual-level unemployment and subjective health and well-being with some noticeable differences between age groups, and with GDP trend having the most sizeable influence. [ABSTRACT FROM AUTHOR]

Policymakers often suggest that expansion of care in community settings may ease increasing pressures on hospital services. Substitution may lower overall health system costs, but complementarity due to previously unidentified needs might raise them. We used new national data on community and primary medical care services in England to undertake system-level analyses of whether activity in the community acts as a complement or a substitute for activity provided in hospitals. We used two-way fixed effects regression to relate monthly counts of community care and primary medical care contacts to emergency department attendances, outpatient visits and admissions for 242 hospitals between November 2017 and September 2019. We then used national unit costs to estimate the effects of increasing community activity on overall system expenditure. The findings show community care contacts to be weak substitutes with all types of hospital activity and primary care contacts are weak substitutes for emergency hospital attendances and admissions. Our estimates ranged from 28 [95% CI 21, 45] to 517 [95% CI 291, 7265] community care contacts and from 34 [95% CI 17, 1283] to 1655 [95% CI − 1995, 70,145] GP appointments to reduce one hospital service visit. Primary care and planned hospital services are complements. Increases in community services and primary care activity are both associated with increased overall system expenditure of £34 [95% CI £156, £54] per visit for community care and £41 [95% CI £78, £74] per appointment in general practice. Expansion of community-based services may not generate reductions in hospital activity and expenditure. [ABSTRACT FROM AUTHOR]