Fiscal consolidations and distributional effects: which form of fiscal austerity is least harmful?

Distributional consequences of fiscal austerity, while being increasingly recognised in the policy debate, have received little attention in the existing formal work. This paper proposes a medium scale New-Keynesian DSGE model incorporating an appropriate dimension of household heterogeneity and a well-specified fiscal structure, allowing for a comprehensive analysis of losers and winners from austerity. We find that cutting transfers and public employment and raising labour income taxes are the most regressive forms of austerity, greatly raising income inequality. In contrast, raising capital income taxes is progressive - the only such policy in our analysis - with also the smallest output losses in the short-run. Second, the speed of austerity emerges as a potential tool in fiscal adjustment. Indeed, speedy austerity yields worst distributive and output effects irrespective of its composition. Finally, fiscal consolidation is particularly damaging in downturns where distributional effects are substantially more unfavourable than in normal times

Managing public debt in the UK

The Covid-19 pandemic that emerged in early 2020 quickly turned into an economic crisis of unprecedented proportions. The UK, one of the worst affected countries, suffered a 9.9 percent drop in output in 2020, the deepest recession in 300 years.1 The required public health expenditure in the fight against the coronavirus and the ballooning cost of support programs to both households and businesses led to a sharp rise in government spending.2 When combined with the significant drop in tax revenues following the contraction in economic activity, the surge in spending pushed the debt burden to levels previously unseen in peace times. This article assesses the evolution of government debt in the UK both in the recent past as well as over the last century to put the current escalation in indebtedness into context. We then present the sources of debt consolidation both in general and in the UK context. Finally, we provide an evaluation of likely scenarios for debt management in the UK in its transitioning to a post-Covid-19 world.</p

Why are fiscal multipliers asymmetric? The role of credit constraints

Recent empirical evidence strongly points to the state-dependence of fiscal multipliers which are larger in recessions than in expansions. Yet, standard business cycle models face great difficulty in producing such asymmetric fiscal policy effects. By incorporating endogenously binding collateral constraints into a medium scale DSGE model, we find that fiscal effectiveness can vary substantially across the business cycle. The key to our framework is the state-dependent nature of collateral constraints; binding in bad times while slack in good times, amplifying the effectiveness of fiscal policy and hence generating fiscal multipliers that are larger during recessions

Additional file 1: of Intervention planning for a digital intervention for self-management of hypertension: a theory-, evidence- and person-based approach

Full methods for work stream 1: collating and analysing evidence. (DOCX 33 kb

Additional file 6: of Intervention planning for a digital intervention for self-management of hypertension: a theory-, evidence- and person-based approach

Behavioural analysis of HOME BP using the Behaviour Change Wheel (BCW) and Normalisation Process Theory (NPT). (DOCX 26 kb

Additional file 1: of Measurement of blood pressure for the diagnosis and management of hypertension in different ethnic groups: one size fits all

Diagnostic output of raw data at different BP thresholds. (DOCX 19 kb

Additional file 1: Figure S1. of Blood pressure self-monitoring in pregnancy: examining feasibility in a prospective cohort study

Study Procedures. (DOCX 20 kb

Additional file 4: of Blood pressure self-monitoring in pregnancy: examining feasibility in a prospective cohort study

Supplementary Tables. Table S1. Table S2. Table S3. (DOCX 15 kb

Cluster randomised controlled trial of screening for atrial fibrillation in people aged 70 years and over to reduce stroke: protocol for the pilot study for the SAFER trial

Introduction Atrial fibrillation (AF) is a common arrhythmia associated with 30% of strokes, as well as other cardiovascular disease, dementia and death. AF meets many criteria for screening, but there is limited evidence that AF screening reduces stroke. Consequently, no countries recommend national screening programmes for AF. The Screening for Atrial Fibrillation with ECG to Reduce stroke (SAFER) trial aims to determine whether screening for AF is effective at reducing risk of stroke. The aim of the pilot study is to assess feasibility of the main trial and inform implementation of screening and trial procedures. Methods and analysis SAFER is planned to be a pragmatic randomised controlled trial (RCT) of over 100 000 participants aged 70 years and over, not on long-term anticoagulation therapy at baseline, with an average follow-up of 5 years. Participants are asked to record four traces every day for 3 weeks on a hand-held single-lead ECG device. Cardiologists remotely confirm episodes of AF identified by the device algorithm, and general practitioners follow-up with anticoagulation as appropriate. The pilot study is a cluster RCT in 36 UK general practices, randomised 2:1 control to intervention, recruiting approximately 12 600 participants. Pilot study outcomes include AF detection rate, anticoagulation uptake and other parameters to incorporate into sample size calculations for the main trial. Questionnaires sent to a sample of participants will assess impact of screening on psychological health. Process evaluation and qualitative studies will underpin implementation of screening during the main trial. An economic evaluation using the pilot data will confirm whether it is plausible that screening might be cost-effective. Ethics and dissemination The London—Central Research Ethics Committee (19/LO/1597) and Confidentiality Advisory Group (19/CAG/0226) provided ethical approval. Dissemination will be via publications, patient-friendly summaries, reports and engagement with the UK National Screening Committee.</p