Time-varying Granger Causality Between Health Care and Economic Activity in the United States

Authors

DOI:

https://doi.org/10.18690/lexonomica.17.2.121-142.2025

Keywords:

economic activity, health, health policy, time-varying Granger causality, United States

Abstract

The COVID-19 epidemic has led to the need to analyse the relationship between health care and the economy. This paper analyses the time-varying relationship between health care and economic activity in the United States, filling a gap in the literature. Using time-varying Granger causality, the study provides empirical evidence of a time-varying causal relationship between health care spending and industrial production, which has important policy implications.  

Povzetek

Epidemija covida-19 je spodbudila potrebo po analizi razmerja med zdravstveno oskrbo in gospodarstvom. Ta članek analizira časovno spremenljivo razmerje med zdravstveno oskrbo in gospodarsko aktivnostjo v Združenih državah Amerike ter zapolnjuje vrzel v obstoječi literaturi. Z uporabo časovno spremenljive Grangerjeve vzročnosti raziskava ponuja empirične dokaze o časovno spremenljivem vzročnem razmerju med izdatki za zdravstvo in industrijsko proizvodnjo, kar ima pomembne posledice za oblikovanje politik.

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Author Biographies

  • Silvo Dajčman, University of Maribor, Faculty of Economics and Business

    University of Maribor, Faculty of Economics and Business, Maribor, Slovenia, silvo.dajcman@um.si

  • Dejan Romih, University of Maribor, Faculty of Economics and Business

    University of Maribor, Faculty of Economics and Business, Maribor, Slovenia, dejan.romih@um.si 

References

Altig, D., Baker, S., Barrero, J. M., Bloom, N., Bunn, P., Chen, S., Davis, S. J., Leather, J., Meyer, B., Mihaylov, E., Mizen, P., Parker, N., Renault, T., Smietanka, P., & Thwaites, G. (2020). Economic uncertainty before and during the COVID-19 pandemic. Journal of Public Economics, 191, 104274. https://doi.org/10.1016/j.jpubeco.2020.104274

Antioch, K. M. (2024). The economics of the COVID-19 pandemic: Economic evaluation of government mitigation and suppression policies, health system innovations, and models of care. Journal of Public Health (Berlin), 32, 1717–1732. https://doi.org/10.1007/s10389-023-01919-z

Baker, S. R., Bloom, N., & Davis, S. J. (2016). Measuring economic policy uncertainty. The Quarterly Journal of Economics, 131(4), 1593–1636. https://doi.org/10.1093/qje/qjw024

Barrero, J. M., & Bloom, N. (2020, August). Economic uncertainty and the recovery. In 2020 August Economic Symposium. Federal Reserve Bank of Kansas City. https://www.kansascityfed.org/documents/7822/JH2020-Bloom.pdf

Baum, C. F., Hurn, S., & Otero, J. (2022). Testing for time-varying Granger causality. The Stata Journal, 22(2), 355–378. https://doi.org/10.1177/1536867X221106403

Baum, C. F., Hurn, S., & Otero, J. (2025). The dynamics of U.S. industrial production: A time-varying Granger causality perspective. Economic and Statistics, 33, 13–22. https://doi.org/10.1016/j.ecosta.2021.10.012

Belzer, M. H., & Quinlan, M. G. (2024). The economics of occupational health and safety. The Economic and Labour Relations Review, 35(3), 483–498. https://doi.org/10.1017/elr.2024.58

Berwick, D. M., Batchlor, E., Chokshi, D. A., Gabow, P., Gilfillan, R., Isasi, F., Milstein, A., & Nichols, L. M. (2025). From laggard to leader: Why health care in the United States is failing, and how to fix it. Health Affairs, 44(2), 10–19. https://doi.org/10.1377/hlthaff.2024.01007

Bloom, N., Bunn, P., Mizen, P., Smietanka, P., & Thwaites, G. (2025). The impact of COVID-19 on productivity. The Review of Economics and Statistics, 107(1), 28–41. https://doi.org/10.1162/rest_a_01298

Board of Governors of the Federal Reserve System. (2025a). Industrial Production: Total Index [INDPRO]. FRED, Federal Reserve Bank of St. Louis. https://fred.stlouisfed.org/series/INDPRO

Board of Governors of the Federal Reserve System. (2025b). Federal Funds Effective Rate [FEDFUNDS]. FRED, Federal Reserve Bank of St. Louis. https://fred.stlouisfed.org/series/FEDFUNDS

Caldara, D., Iacoviello, M., & Yu, D. (2025). Measuring shortages since 1900 (International Finance Discussion Papers No. 1407). Board of Governors of the Federal Reserve System. https://doi.org/10.17016/IFDP.2025.1407

Chen, A. M. (2025). Barriers to health equity in the United States of America: Can they be overcome? International Journal for Equity in Health, 24, 39. https://doi.org/10.1186/s12939-025-02401-w

Clarida, R. H., Duygan-Bump, B., & Scotti, C. (2021). The COVID-19 crisis and the Federal Reserve’s policy response (Finance and Economics Discussion Series No. 2021-035). Board of Governors of the Federal Reserve System. https://doi.org/10.17016/FEDS.2021.035

Cuadros, D. F., Moreno, C. M., Miller, F. D., Omori, R., & MacKinnon, N. J. (2023). Assessing access to digital services in health care–underserved communities in the United States: A cross-sectional study. Mayo Clinic Proceedings: Digital Health, 1(3), 217–225. https://doi.org/10.1016/j.mcpdig.2023.04.004

Cuba-Borda, P., Queralto, A., Reyes-Heroles, R., & Scaramucci, M. (2025). How do trade disruptions affect inflation? FEDS Notes. Board of Governors of the Federal Reserve System. https://doi.org/10.17016/2380-7172.3664

Curto, V., Einav, L., Finkelstein, A., Levin, J., & Bhattacharya, J. (2019). Health care spending and utilization in public and private Medicare. American Economic Journal: Applied Economics, 11(2), 302–332. https://doi.org/10.1257/app.20170295

Dickey, D. A., & Fuller, W. A. (1979). Distribution of the estimators for autoregressive time series with a unit root. Journal of the American Statistical Association, 74(336), 427–431. https://doi.org/10.2307/2286348

Dobkin, C., Finkelstein, A., Kluender, R., & Notowidigdo, M. J. (2018). The economic consequences of hospital admissions. American Economic Review, 108(2), 308–352. https://doi.org/10.1257/aer.20161038

Dolado, J.J., & Lütkepohl, H. (1996). Making wald tests work for cointegrated VAR systems. Econometric Reviews, 15(4), 369-386. https://doi.org/10.1080/07474939608800362

Dunn, J. (2021). COVID-19 and supply chains: A year of evolving disruption (Cleveland Fed District Data Brief). Federal Reserve Bank of Cleveland. https://doi.org/10.26509/frbc-ddb-20210226

Elliott, G., Rothenberg, T. J., & Stock, J. H. (1996). Efficient tests for an autoregressive unit root. Econometrica, 64(4), 813–836. https://doi.org/10.2307/2171846

Faria-e-Castro, M. (2025, January 6). A look at inflation in recent years through the lens of a macroeconomic model. On the Economy. Federal Reserve Bank of St. Louis. https://www.stlouisfed.org/on-the-economy/2025/jan/look-inflation-recent-years-lens-macroeconomic-model

Federal Reserve Bank of Atlanta. (2022). Wu-Xia Shadow Funds Rate. https://www.atlantafed.org/cqer/research/wu-xia-shadow-federal-funds-rate

Fiedler, M. (2022, March 29). What does economy-wide inflation mean for the prices of health care services (and vice versa)? Brookings Institution. https://www.brookings.edu/papers/what-does-economy-wide-inflation-mean-for-the-prices-of-health-care-services-and-vice-versa/

Fiori, G., & Iacoviello, M. (2021). What did we learn from 2 billion jabs? Early cross-country evidence on the effect of COVID-19 vaccinations on deaths, mobility, and economic activity. FEDS Notes. Board of Governors of the Federal Reserve System. https://doi.org/10.17016/2380-7172.2984

Fisman, D., Postma, M., Levin, M. J., & Mould-Quevedo, J. (2024). Absenteeism and productivity loss due to influenza or influenza-like illness in adults in Europe and North America. Diseases, 12(12), 331. https://doi.org/10.3390/diseases12120331

Flores Morales, J. (2024). Can’t buy me health-care access: Qualitative experiences of U.S.-born Latinx adults’ health insurance coverage and health-care use post ACA. RSF: The Russell Sage Foundation Journal of the Social Sciences, 10(4), 173–190. https://doi.org/10.7758/RSF.2024.10.4.08

Glied, S. (2003). Health care costs: On the rise again. Journal of Economic Perspectives, 17(2), 125–148. https://doi.org/10.1257/089533003765888476

Groenewold, M. R., Burrer, S. L., Ahmed, F., Uzicanin, A., Free, H., & Luckhaupt, S. E. (2020). Increases in health-related workplace absenteeism among workers in essential critical infrastructure occupations during the COVID-19 pandemic — United States, March–April 2020. MMWR. Morbidity and Mortality Weekly Report, 69(27), 853–858. https://doi.org/10.15585/mmwr.mm6927a1

Hamilton, B. H., Jungheim, E., McManus, B., & Pantano, J. (2018). Health care access, costs, and treatment dynamics: Evidence from in vitro fertilization. American Economic Review, 108(12), 3725–3777. https://doi.org/10.1257/aer.20161014

Hildebrandt, P., & Thomas, E. A. (1991). The rising cost of medical care and its effect on inflation. Economic Review, 76(September), 47–58.

Hoffman, C., & Paradise, J. (2008). Health insurance and access to health care in the United States. Annals of the New York Academy of Sciences, 1136, 149–160. https://doi.org/10.1196/annals.1425.007

Ihrig, J., Weinbach, G. C., & Wolla, S. A. (2020). COVID-19's effects on the economy and the Fed's response. Page One Economics. Federal Reserve Bank of St. Louis. https://www.stlouisfed.org/publications/page-one-economics/2020/08/10/covid-19s-effects-on-the-economy-and-the-feds-response

Knotek, E. S., II, Schoenle, R. S., Dietrich, A. M., Kuester, K., Müller, G. J., Myrseth, K. O. R., & Weber, M. (2020). Consumers and COVID-19: A real-time survey. Federal Reserve Bank of Cleveland. https://doi.org/10.26509/frbc-ec-202008

Lee, C., Vu, T. T., Fuller, J. A., Freedman, M., Bannon, J., Wilkins, J. T., Moskowitz, J. T., Hirschhorn, L. R., Wallia, A., & Evans, C. T. (2023). The association of burnout with work absenteeism and the frequency of thoughts in leaving their job in a cohort of healthcare workers during the COVID-19 pandemic. Frontiers in Health Services, 3, 1272285. https://doi.org/10.3389/frhs.2023.1272285

Leybourne, S. (1995). Testing for unit roots using forward and reverse Dickey-Fuller regressions. Oxford Bulletin of Economics and Statistics, 57(4), 559–571. https://doi.org/10.1111/j.1468-0084.1995.tb00040.x

Lipińska, A., Martínez García, E., & Schwartzman, F. (2025). Pandemic and war inflation: Lessons from the international experience (Finance and Economics Discussion Series No. 2025-071). Board of Governors of the Federal Reserve System. https://doi.org/10.17016/FEDS.2025.071

Movsisyan, A., Wendel, F., Bethel, A., Coenen, M., Krajewska, J., Littlecott, H., Stöckl, H., Voss, S., Wollmershäuser, T., & Rehfuess, E. (2024). Inflation and health: A global scoping review. The Lancet Global Health, 12(6), e1038–e1048. https://doi.org/10.1016/S2214-109X(24)00133-5

Murray, E. J. (2020). Epidemiology’s time of need: COVID-19 calls for epidemic-related economics. Journal of Economic Perspectives, 34(4), 105–120. https://doi.org/10.1257/jep.34.4.105

Oberlander, J. (2002). The US health care system: On a road to nowhere? CMAJ: Canadian Medical Association Journal, 167(2), 163–168.

Otero, J., & Baum, C. F. (2017). Response surface models for the Elliott, Rothenberg, and Stock unit-root test. The Stata Journal, 17(4), 985–1002. https://doi.org/10.1177/1536867X1801700413

Otero, J., & Baum, C. F. (2018). Unit-root tests based on forward and reverse Dickey–Fuller regressions. The Stata Journal, 18(1), 22–28. https://doi.org/10.1177/1536867X18018001

Prager, E. (2020). Healthcare demand under simple prices: Evidence from tiered hospital networks. American Economic Journal: Applied Economics, 12(4), 196–223. https://doi.org/10.1257/app.20180422

Rasul, I. (2020). The economics of viral outbreaks. AEA Papers and Proceedings, 110, 265–268. https://doi.org/10.1257/pandp.20201016

Rhyan, C., Turner, A., & Miller, G. (2020). Tracking the U.S. health sector: The impact of the COVID-19 pandemic. Business Economics, 55(4), 267–278. https://doi.org/10.1057/s11369-020-00195-z

Schwandt, H. (2018). Wealth shocks and health outcomes: Evidence from stock market fluctuations. American Economic Journal: Applied Economics, 10(4), 349–377. https://doi.org/10.1257/app.20140499

Schwert G.W. (1989). Tests for Unit Roots: A Monte Carlo Investigation. Journal of Business & Economic Statistics, 7(2), 147-159. https://doi.org/10.2307/1391432

Sexton, A., & Tito, M. D. (2021). The vaccine boost: An analysis of the impact of the COVID-19 vaccine rollout on measures of activity. FEDS Notes. Board of Governors of the Federal Reserve System. https://doi.org/10.17016/2380-7172.2923

Shi, S., Hurn, S., & Phillips, P. C. B. (2020). Causal change detection in possibly integrated systems: Revisiting the money-income relationship. Journal of Financial Econometrics, 18(1), 158–180. https://doi.org/10.1093/jjfinec/nbz004

Shi, S., Phillips, P. C. B., & Hurn, S. (2018). Change detection and the causal impact of the yield curve. Journal of Time Series Analysis, 39(6), 966–987. https://doi.org/10.1111/jtsa.12427

Terry, N. (2020). COVID-19 and healthcare lessons already learned. Journal of Law and the Biosciences, 7(1), lsaa016. https://doi.org/10.1093/jlb/lsaa016

Toda, H.Y., &Yamamoto, T. (1995). Statistical inference in vector autoregressions with possibly integrated processes. Journal of Econometrics, 66(1-2), 225-250. https://doi.org/10.1016/0304-4076(94)01616-8

U.S. Bureau of Economic Analysis. (2025). Table 2.8.3. Real Personal Consumption Expenditures by Major Type of Product, Monthly, Quantity Indexes, Health care. https://fred.stlouisfed.org/release/tables?eid=3196&rid=54

U.S. Bureau of Labor Statistics. (2025a). Consumer Price Index for All Urban Consumers: All Items in U.S. City Average [CPIAUCSL]. FRED, Federal Reserve Bank of St. Louis. https://fred.stlouisfed.org/series/CPIAUCSL

U.S. Bureau of Labor Statistics. (2025b). Labor Force Statistics from the Current Population Survey. (Unadj) Employed – With a job, not at work, Own illness [LNU02006735]. https://data.bls.gov/timeseries/LNU02006735

U.S. Bureau of Labor Statistics. (2025c). Labor Force Statistics from the Current Population Survey. (Unadj) Number At work part-time, usually work full-time Illness All industries 1-34 hours [LNU02028296]. https://data.bls.gov/timeseries/LNU02028296

U.S. Bureau of Labor Statistics. (2025d). Employed, Usually Work Full Time [LNU02500000]. FRED, Federal Reserve Bank of St. Louis. https://fred.stlouisfed.org/series/LNU02500000

von der Schulenburg, J.-M. G. (2021). COVID-19: not the time for health economists? A plea for more proactive health economic involvement. The European Journal of Health Economics, 22(7), 1001–1004. http://www.jstor.org/stable/45406900

Vysochyna, A., Vasylieva, T., Dluhopolskyi, O., Marczuk, M., Grytsyshen, D., Yunger, V., & Sulimierska, A. (2023). Impact of coronavirus disease COVID-19 on the relationship between healthcare expenditures and sustainable economic growth. International Journal of Environmental Research and Public Health, 20(4), 3049. https://doi.org/10.3390/ijerph20043049

Wu, J. C., & Xia, F. D. (2016). Measuring the macroeconomic impact of monetary policy at the zero lower bound. Journal of Money, Credit and Banking, 48(2–3), 253–291. https://doi.org/10.1111/jmcb.12300

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19.12.2025

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How to Cite

Dajčman, S., & Romih, D. (2025). Time-varying Granger Causality Between Health Care and Economic Activity in the United States. LeXonomica, 17(2), 121-142. https://doi.org/10.18690/lexonomica.17.2.121-142.2025