Work disability and the Northern Irish Troubles*
| Published date | 01 October 2021 |
| Author | Declan French,Sharon Cruise |
| Date | 01 October 2021 |
| DOI | http://doi.org/10.1111/obes.12435 |
Work disability and the Northern Irish Troubles*
DECLAN FRENCH†and SHARON CRUISE‡
†Queen’s Management School, Queen’s University Belfast, UK (e-mail:
declan.french@qub.ac.uk)
‡School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, UK
(e-mail: s.cruise@qub.ac.uk)
Abstract
In this paper, we examine the labour market implications of permanent illness or injury
from conflict among civilians. From 1969 to 1998, Northern Ireland experienced a violent
ethnopolitical conflict characterized by terrorist bombing campaigns, sectarian killings and
armed forces patrolling the streets. The consequences of this period for current high work
disability rates are disputed by the main political parties. We address this question using a
new high-quality dataset. Potential endogeneity and reverse causation issues are addressed
using the intensity of conflict-related deaths as instruments. We find clear evidence that
conflict has increased work disability by 28% points. The main doctor-diagnosed medical
condition mediating this effect is mental ill health.
I. Introduction
From 1969 to 1998, Northern Ireland (NI) experienced a violent ethnopolitical conflict
known locally as ‘the Troubles’which was characterized by terrorist bombing
campaigns, sectarian killings and armed forces patrolling the streets. Currently, this
region has the highest claimant rate for work disability benefits in the United Kingdom
(UK) and much higher rates of limitation among middle-aged and older people than in
the Republic of Ireland. The two major NI political parties –republican and unionist –
disagree on the extent to which these high rates are attributable to the legacy of the
conflict. In this paper, we explore this question using a new high-quality dataset which
contains the most comprehensive information available to date.
Standard economic growth models predict the loss of human capital due to conflict
will have longer lasting consequences than the destruction of physical capital and this
*We are grateful to all the participants of the NICOLA Study, and the whole NICOLA team, which includes
nursing staff, research scientists, clerical staff, computer and laboratory technicians, managers and receptionists.
The Atlantic Philanthropies, the Economic and Social Research Council, the UKCRC Centre of Excellence for
Public Health Northern Ireland, the Centre for Ageing Research and Development in Ireland, the Office of the
First Minister and Deputy First Minister, the Health and Social Care Research and Development Division of the
Public Health Agency, the Wellcome Trust/Wolfson Foundation and Queen’s University Belfast provide core
financial support for NICOLA. The authors alone are responsible for the interpretation of the data and any views
or opinions presented are solely those of the authors and do not necessarily represent those of the NICOLA
Study team.
1160
©2021 The Authors. Oxford Bulletin of Economics and Statistics published by Oxford University and John Wiley & Sons Ltd.
This is an open access article under the terms of the Creative Commons Attribution License,which permits use, distribution and reproduction in
any medium, provided the original work is properly cited.
OXFORD BULLETIN OF ECONOMICS AND STATISTICS, 83, 5 (2021) 0305-9049
doi: 10.1111/obes.12435
is often confirmed in empirical studies (Blattman and Miguel, 2010). A relatively
recent literature has examined the effect of war exposure on earnings highlighting
lower productivity due to lost opportunities for studying and working (Blattman and
Annan, 2010; Akbulut-Yuksel, 2014; Kesternich et al., 2014). War can also impact on
labour through work disablement with enduring psychological conditions, lower
cognitive ability and higher rates of heart disease (Bedard and Deschˆ
enes, 2006;
Angrist, Chen and Frandsen, 2010; David, Duggan and Lyle, 2011; Cesur and Sabia,
2016). A related literature has explored health outcomes from conflict but has largely
neglected the labour market implications of permanent illness from war experiences
due to data limitations (Akbulut-Yuksel, 2017; Havari and Peracchi, 2017).
Our paper makes the following contributions to this literature. First, we examine work
disability in the general population not just in ex-combatants. Second, we use much richer
data on the level and nature of experience of conflict. The Northern Ireland Cohort for the
Longitudinal study of Ageing (NICOLA) follows the design and methodology of the
English Longitudinal Study of Ageing (ELSA) and includes a module on exposure to
injury, death, incarceration, bombing, riots, intimidation at work and house searches
during the Troubles. A secondary source of data details fatalities during the Troubles
according to location and whether they occurred through public disorder, bomb
explosions or assassination. Using these data as instruments, we find clear evidence that
conflict has increased work disability by 28% points. Our third contribution is we explore
the medical conditions through which conflict impacts on work disability and find that
despite growing evidence for the importance of psychosocial causes of ill health the main
mediating pathway is through worse psychological morbidity.
A person is disabled if they have a health condition and have difficulties carrying
out normal daily activities (WHO, 2001). Labour market analysis of work disability
generally relies on self-assessed survey questions of the form ‘how much are you
limited in the kind or amount of work that you can do due to a health condition?’and
we also use such measures in our study (Jones, 2008). But subjective assessments of
this nature are prone to measurement error due to the lack of comparability across
individuals and justification error due to the endogeneity of self-assessments to labour
market status (Bound et al., 1999; Lindeboom, 2006). We address these biases in our
dependent variable by using the vignette methodology where respondents evaluate the
degree of work limitation of people described in hypothetical scenarios using the same
response scales as in their self-assessments (Kapteyn, Smith and Van Soest, 2007). We
also use a measure of functional limitations and work disability benefit receipt to test
the robustness of our findings. Our main explanatory variable is a subjective report of
how the Troubles have affected the respondent’s life. Potential endogeneity and reverse
causation issues with this measure are addressed using the intensity of conflict-related
deaths recorded at the local level.
The NI Troubles provide a particularly useful context in which to study the legacy
effects of conflict as we can draw on comprehensive high-quality data unlike in
developing countries where most civil wars occur but data are more limited. The
political situation in NI has been and continues to be volatile as the implications of
Brexit become apparent. It is therefore timely to consider the potential enduring
economic consequences of a return to violence.
©2021 The Authors. Oxford Bulletin of Economics and Statistics published by Oxford University and John Wiley & Sons Ltd.
Work disability and NI Troubles1161
II. Background
A review of related literature
Standard growth models predict that the long-run impact of war on human capital is
more important economically than the destruction of physical capital (Barro and Sala,
2003). A micro-literature has examined long-run human capital outcomes among those
exposed to violence focussing especially on missed education, training and work
experience opportunities. Studies provide evidence that ex-combatants earn less.
Angrist (1990) finds White Vietnam veterans earned 15% less in the long-run due to
lost labour market experience while Blattman and Annan (2010) reports lower wages
for youth abducted as child soldiers by Ugandan rebels mainly because of lost
education. Civilians have been likewise affected. Living through World War II retarded
the accumulation of human capital leading to a permanent loss of labour productivity
and earnings as educators were killed and schools were destroyed (Akbulut-Yuksel,
2014; Kesternich et al., 2014) with evidence that education effects are transmitted
onwards intergenerationally (Havari and Peracchi, 2019). The Troubles would appear
to have had less of an effect on education than these other conflicts with NI
outperforming the rest of the UK in secondary school examination results during this
time (Education, Science and Arts Committee, 1983). Studies also report many
paramilitaries using their time in prison to gain formal education qualifications and
engage in peer and collaborative learning (Irwin, 2003). In contrast, pupils often
reported an affective impact on their education despite considering schools a ‘safe
haven’from the conflict (Kilpatrick and Leitch, 2004).
The persistent effects of war on labour through work disablement have been
comparatively neglected with most studies analysing disability among war veterans.
Considering that most causalities in most recent conflicts have been civilians this emphasis
seems misplaced. The extent of war-induced mental illness has been recognized since
World War I when 65,000 ex-servicemen were still drawing disability pensions due to
neurasthenia 2 years after the Armistice Bogacz, 1989). Enduring psychological conditions
have also been noted in more recent conflicts. Veterans of the Vietnam war experienced
higher excess mortality due to motor vehicle accidents and suicides and made more
disability claims for conditions such as post-traumatic stress disorder (PTSD) (Hearst,
Newman and Hulley, 1986; Angrist et al., 2010). Many Gulf War veterans not fulfilling
the diagnostic criteria for PTSD nevertheless reported disabling conditions such as
tiredness, numbness, limb weakness and cognitive complaints such as loss of
concentration, memory problems and low mood 10–15 years after combat (Iversen,
Chalder and Wessely, 2007). Ex-combatants also have worse physical health than their
peers in the long-run. Veterans had an increased risk of death from lung cancer and heart
disease 20–50 years after discharge from military service in WWII and Korean War
(Bedard and Deschˆ
enes, 2006).
1
1
On the other hand, Angrist et al. (2010) report that Vietnam service had little effect on self-reported health
status by year 2000 but David et al. (2011) find a large increase in self-reported disability among this group in
the following decade consistent with the adverse health consequences of combat exposure.
©2021 The Authors. Oxford Bulletin of Economics and Statistics published by Oxford University and John Wiley & Sons Ltd.
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