International Journal for Equity in Health | |
Individual-level changes in self-rated health before and during the economic crisis in Europe | |
Espen Dahl2  Anne Grete Tøge2  Dawit Shawel Abebe1  | |
[1] NOVA, Oslo and Akershus University College, St. Olavs plass, Oslo NO-0130, Norway;Faculty of Social Sciences, Oslo and Akershus University College, Oslo, Norway | |
关键词: Trends; Health inequality; EU-SILC; Self-rated health; | |
Others : 1235428 DOI : 10.1186/s12939-015-0290-8 |
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received in 2015-09-14, accepted in 2015-12-18, 发布年份 2016 | |
【 摘 要 】
Background
Changes over time in self-rated health (SRH) are increasingly documented during the current economic crisis, though whether these are due to selection, causation, or methodological artefacts is unclear. This study accordingly investigates changes in SRH, and social inequalities in these changes, before and during the economic crisis in 23 European countries.
Methods
We used balanced panel data, 2005–2011, from the European Union Statistics on Income and Living Conditions (EU-SILC). We included the working-age population (25–60 years old) living in 23 European countries. The data cover 65,618 respondents, 2005–2007 (pre-recession cohort), and 43,188 respondents, 2008–2011 (recession cohort). The data analyses used mixed-effects ordinal logistic regression models considering the degree of recession (i.e., pre, mild, and severe).
Results
Individual-level changes in SRH over time indicted a stable trend during the pre-recession period, while a significant increasing trend in fair and poor SRH was found in the mild- and severe-recession cohorts. Micro-level demographic and socio-economic status (SES) factors (i.e., age, gender, education, and transitions to employment/unemployment), and macro-level factors such as welfare generosity are significantly associated with SRH trends across the degrees of recession.
Conclusions
The current economic crisis accounts for an increasing trend in fair and poor SRH among the general working-age population of Europe. Despite the general SES inequalities in SRH, the health of vulnerable groups has been affected the same way before and during the current recession.
【 授权许可】
2015 Abebe et al.
【 预 览 】
Files | Size | Format | View |
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20160120095830630.pdf | 458KB | download |
【 参考文献 】
- [1]Marmot M, Bloomer E, Goldblatt P. The Role of Social Determinants in Tackling Health Objectives in a Context of Economic Crisis. Public Health Rev. 2013; 35(1):1-24.
- [2]Ruckert A, Labonté R. The global financial crisis and health equity: early experiences from Canada. Global Health. 2014; 10(1):2. BioMed Central Full Text
- [3]Ruhm CJ. Are Recessions Good for Your Health? Q J Econ. 2000; 115(2):617-650.
- [4]Ruhm CJ. Good times make you sick. J Health Econ. 2003; 22(4):637-658.
- [5]Ruhm CJ. Commentary: mortality increases during economic upturns. Int J Epidemiol. 2005; 34(6):1206-1211.
- [6]Mechanic D, Tanner J. Vulnerable people, groups, and populations: societal view. Health Aff. 2007; 26(5):1220-1230.
- [7]Suhrcke M, Stuckler D. Will the recession be bad for our health? It depends. Soc Sci Med. 2012; 74(5):647-653.
- [8]Lundberg O, Yngwe MÅ, Stjärne MK, Elstad JI, Ferrarini T, Kangas O et al.. The role of welfare state principles and generosity in social policy programmes for public health: an international comparative study. Lancet. 2008; 372(9650):1633-1640.
- [9]Lundberg O. Commentary: politics and public health—some conceptual considerations concerning welfare state characteristics and public health outcomes. Int J Epidemiol. 2008; 37(5):1105-1108.
- [10]Chung H, Muntaner C. Welfare state matters: a typological multilevel analysis of wealthy countries. Health Policy. 2007; 80(2):328-339.
- [11]Karanikolos M, Mladovsky P, Cylus J, Thomson S, Basu S, Stuckler D et al.. Financial crisis, austerity, and health in Europe. Lancet. 2013; 381(9874):1323-1331.
- [12]Hessel P, Vandoros S, Avendano M. The differential impact of the financial crisis on health in Ireland and Greece: a quasi-experimental approach. Public Health. 2014; 128(10):911-919.
- [13]Reile R, Helakorpi S, Klumbiene J, Tekkel M, Leinsalu M. The recent economic recession and self-rated health in Estonia, Lithuania and Finland: a comparative cross-sectional study in 2004–2010. J Epidemiol Commun Health 2014(68):1072-9
- [14]Vandoros S, Hessel P, Leone T, Avendano M. Have health trends worsened in Greece as a result of the financial crisis? A quasi-experimental approach. Eur J Pub Health. 2013; 23(5):727-731.
- [15]Zavras D, Tsiantou V, Pavi E, Mylona K, Kyriopoulos J. Impact of economic crisis and other demographic and socio-economic factors on self-rated health in Greece. Eur J Pub Health. 2013; 23(2):206-210.
- [16]Urbanos-Garrido RM, Lopez-Valcarcel BG. The influence of the economic crisis on the association between unemployment and health: an empirical analysis for Spain. Eur J Health Econ. 2014; 16:1-10.
- [17]Ásgeirsdóttir TL, Ragnarsdóttir DÓ. Health-income inequality: the effects of the Icelandic economic collapse. Int J Equity Health. 2014; 13(1):50. BioMed Central Full Text
- [18]Wooldridge JM. Econometric analysis of cross section and panel data. MIT Press, Cambridge, MA; 2010.
- [19]Dahl E, Tøge AG, Heggebø K, Elstad JI, Berg JE, Halvorsen K. [Is economic crisis equivalent to crisis in public health – what does the research evidence tell?]. Tidsskrift Velferdsforskning 2015;18(2)
- [20]Goldman-Mellor SJ, Saxton KB, Catalano RC. Economic contraction and mental health: a review of the evidence, 1990-2009. Int J Ment Health. 2010; 39(2):6-31.
- [21]Milner A, Page A, Lamontagne A. Cause and effect in studies on unemployment, mental health and suicide: a meta-analytic and conceptual review. Psychol Med. 2014; 44(05):909-917.
- [22]Perneger TV, Gayet-Ageron A, Courvoisier DS, Agoritsas T, Cullati S. Self-rated health: Analysis of distances and transitions between response options. Qual Life Res. 2013; 22(10):2761-2768.
- [23]Gaski JF. On the competing definitions of recession. Society. 2012; 49(2):118-121.
- [24]Mundlak Y. On the pooling of time series and cross section data. Econometrica. 1978; 48:69-85.
- [25]Saltkjel T, Dahl E, van der Wel KA. Health related social exclusion in Europe: a multilevel study of the role of welfare generosity. Int J Equity Health. 2013; 12(1):81. BioMed Central Full Text
- [26]Fitzmaurice G, Laird N, Ware J. Linear mixed effects models. Applied longitudinal analysis. John Wiley, Hoboken,NJ; 2004.
- [27]Rabe-Hesketh S, Skrondal A. Random-coefficient models. Multilevel and longitudinal modeling using Stata. 2nd ed. Stata Press, College Station,TX; 2008.
- [28]Bambra C. Yesterday once more? Unemployment and health in the 21st century. J Epidemiol Community Health. 2010; 64(3):213-215.
- [29]Minton JW, Pickett KE, Dorling D. Health, employment, and economic change, 1973-2009: repeated cross sectional study. BMJ. 2012; 344:e2316.
- [30]Kunst A, Bos V, Lahelma E, Bartley M, Lissau I, Regidor E et al.. Trends in socioeconomic inequalities in self-assessed health in 10 European countries. Int J Epidemiol. 2005; 34(2):295-305.
- [31]McKee-Ryan FM, Song ZL, Wanberg CR, Kinicki AJ. Psychological and physical well-being during unemployment: a meta-analytic study. J Appl Psychol. 2005; 90(1):53-76.
- [32]Turner JB. Economic context and the health effects of unemployment. J Health Soc Behav. 1995; 36:213-229.
- [33]Whitehead M, Drever F, Doran T. Is the health of the long-term unemployed better or worse in high unemployment areas? Health Stat Q. 2005; 25:12-17.
- [34]Huijts T, Eikemo TA. Causality, social selectivity or artefacts? Why socioeconomic inequalities in health are not smallest in the Nordic countries. Eur J Pub Health. 2009; 19:452-453.
- [35]Twaddle A. Disease, illness and sickness: three central concepts in the theory of health : A dialogue between Andrew Twaddle and Lennart Nordenfelt SHS. Dept. of Health and Society, Lindköping Lindköping University; 1994.
- [36]Rosato M. Self-reported health and mortality: exploring the relationship using administrative data deived from the UK Census. Queen’s University, Belfast; 2012.
- [37]Idler EL, Benyamini Y. Self-rated health and mortality: a review of twenty-seven community studies. J Health Soc Behav. 1997; 38(1):21-37.