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Asare S. Association of cigarette smoking with changes in macroeconomic conditions. ECONOMICS AND HUMAN BIOLOGY 2024; 54:101397. [PMID: 38703460 DOI: 10.1016/j.ehb.2024.101397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 04/08/2024] [Accepted: 04/23/2024] [Indexed: 05/06/2024]
Abstract
This study uses data from the 1987-2022 Behavioral Risk Factor Surveillance System and state-level employment rates from the US Bureau of Labor Statistics to estimate the association between macroeconomic conditions and cigarette smoking. Our finding suggests a positive association, which constantly declined with time after the 2001 recession. We find that a one percentage point increase in the employment rate is associated with a 1.4% higher likelihood of smoking cigarettes in the overall sample but declined to 0.4% among cohorts surveyed from 2011 to 2022. We also find strong positive and heterogeneous associations among sociodemographic groups, except among Blacks and persons aged 65 years and older, among whom there is no association; however, the positive associations consistently decreased among these sociodemographic groups. Consequently, the strong positive association disappeared in several sociodemographic groups in cohorts surveyed over the last decade.
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Affiliation(s)
- Samuel Asare
- Tobacco Control Research, Surveillance and Health Equity Science, American Cancer Society, United States of America.
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2
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Neshat Ghojagh HM, Agheli L, Faraji Dizaji S, Kabir MJ, Taghvaee V. Economic instability, income, and unemployment effects on mortality: using SUR panel data in Iran. INTERNATIONAL JOURNAL OF HEALTH ECONOMICS AND MANAGEMENT 2024:10.1007/s10754-024-09376-1. [PMID: 38656735 DOI: 10.1007/s10754-024-09376-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 04/10/2024] [Indexed: 04/26/2024]
Abstract
This study aims to investigate the effects of socioeconomic factors on mortality in Iran. To this end, this research examines how economic instability, income, and unemployment affect mortality using a seemingly unrelated regression (SUR) with panel data for 30 provinces in Iran from 2004 to 2019. The results indicate that unemployment and mortality have a countercyclical relationship among the working age-groups 20-59 but a procyclical pattern among old-age (60+), except for rural mortality. This result is harmonious between employment and age-group mortality. This finding implies that unemployment increases mortality in working age-groups due to psychological stress and poverty risk. In addition, the income level decreases mortality in all ages over 40 years due to the provision of higher access to health and medical services and social welfare. However, it increases mortality in rural areas and age-group 20-39 because of their hazardous, unsafe, and stressful work conditions. Therefore, policymakers should plan for an inclusive economic growth to reduce poverty and out-of-pocket payments and increase the quality and accessibility of public health services, especially for beneficiaries of lower social groups. Moreover, they should adopt strategies to alleviate the burden of premature, preventable, and treatable deaths.
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Affiliation(s)
| | - Lotfali Agheli
- Economic Research Institute, Tarbiat Modares University, Tehran, Iran.
| | - Sajjad Faraji Dizaji
- Department of Economic Development and Planning, Tarbiat Modares University, Tehran, Iran
| | - Mohammad Javad Kabir
- Health management and social development research center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Vahid Taghvaee
- Chair of Economic Growth, Structural Change and Trade, University of Greifswald, Greifswald, Germany
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3
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Kawachi I, Kyriopoulos I, Vandoros S. Economic uncertainty and cardiovascular disease mortality. HEALTH ECONOMICS 2023; 32:1550-1560. [PMID: 36952311 DOI: 10.1002/hec.4678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 02/24/2023] [Accepted: 03/06/2023] [Indexed: 06/04/2023]
Abstract
Previous studies have found a link between economic conditions, such as recessions and unemployment, and cardiovascular disease as well as other health outcomes. More recent research argues that economic uncertainty-independently of unemployment-can affect health outcomes. Using data from England and Wales, we study the association between fluctuations in economic uncertainty and cardiovascular disease mortality in the short term for the period 2001-2019. Controlling for several economic indicators (including unemployment), we find that economic uncertainty alone is strongly associated with deaths attributed to diseases of the circulatory system, ischemic heart disease and cerebrovascular disease. Our findings highlight the short-term link between economic conditions and cardiovascular health and reveal yet another health outcome that is associated with uncertainty.
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Affiliation(s)
- Ichiro Kawachi
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
| | - Ilias Kyriopoulos
- Department of Health Policy, London School of Economics and Political Science, London, UK
| | - Sotiris Vandoros
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
- Department of Economics, King's Business School, King's College London, London, UK
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Bella A, Swarnata A, Melinda G, Nurshadrina DS, Dartanto T. Changes in Smoking Status and Behaviors After the First 10 Months of COVID-19 Pandemic in Indonesia. NICOTINE & TOBACCO RESEARCH : OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON NICOTINE AND TOBACCO 2023; 25:228-236. [PMID: 35366324 DOI: 10.1093/ntr/ntac086] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 02/24/2022] [Accepted: 03/28/2022] [Indexed: 01/11/2023]
Abstract
INTRODUCTION There remains inconclusive evidence on potential changes in smoking status and behaviors during the coronavirus disease 2019 (COVID-9) pandemic, especially in developing countries. AIMS AND METHODS This study explores the direction of changes in smoking status and behaviors after 10 months of the COVID-19 pandemic in Indonesia as well as examining the association between economic shocks and changes in smoking behaviors. Primary data were gathered through a phone survey targeting productive-age mobile-phone users in Indonesia (n = 1082). Descriptive analysis was employed to determine changes in smoking status and behaviors 10 months into the pandemic, while logistic regression analysis was used to investigate how employment shocks, financial strain, COVID-19-related indicators, and demographic characteristics were associated with smoking behaviors of people who continue smoking. RESULTS Respondents experiencing changes in smoking status were dominated by people who persistently smoked during the pandemic, while those who quit, relapsed, and started smoking, was extremely small. Nevertheless, a considerable portion of people who continue smoking adjusted their smoking behaviors: 40.3% reduced smoking intensity and 25.3% switched to lower-price cigarettes. Multivariable regression analysis revealed that, among people who continue smoking, those who experienced financial strain during the pandemic had higher odds of reducing smoking intensity, while those who switched to lower job status had higher odds of switching to cheaper cigarettes. CONCLUSIONS The research has shown that smoking status and behaviors of people who continue smoking mostly remained unchanged after 10 months of the COVID-19 pandemic. Changes in employment and financial conditions during the pandemic were associated with modified smoking behaviors. IMPLICATIONS This study is the first to determine the direction and analyze the factors of changes in smoking during the COVID-19 pandemic in Indonesia. This new understanding should help improve predicting the trends in smoking in future crises or pandemics in developing countries, specifically Indonesia. The discovered patterns on smokers' reaction to an exogenous shock may provide evidence to support tobacco control policies in Indonesia.
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Affiliation(s)
- Adrianna Bella
- Research and Development Division, Centre for Indonesia's Strategic Development Initiatives (CISDI), Central Jakarta, Special Capital Region of Jakarta, Indonesia.,Centre for Health Economics, Monash Business School, Monash University, Melbourne, Victoria, Australia
| | - Arya Swarnata
- Research and Development Division, Centre for Indonesia's Strategic Development Initiatives (CISDI), Central Jakarta, Special Capital Region of Jakarta, Indonesia
| | - Gea Melinda
- Research and Development Division, Centre for Indonesia's Strategic Development Initiatives (CISDI), Central Jakarta, Special Capital Region of Jakarta, Indonesia
| | - Dimitri Swasthika Nurshadrina
- Research and Development Division, Centre for Indonesia's Strategic Development Initiatives (CISDI), Central Jakarta, Special Capital Region of Jakarta, Indonesia
| | - Teguh Dartanto
- Department of Economics, Faculty of Economics and Business, Universitas Indonesia, Depok, West Java, Indonesia
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Nawyn S, Karaoğlu E, Gasteyer S, Mansour R, Ghassani A, Marquart-Pyatt S. Resilience to Nested Crises: The Effects of the Beirut Explosion on COVID-19 Safety Protocol Adherence During Humanitarian Assistance to Refugees. Front Public Health 2022; 10:870158. [PMID: 35865250 PMCID: PMC9294164 DOI: 10.3389/fpubh.2022.870158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Accepted: 05/20/2022] [Indexed: 11/13/2022] Open
Abstract
To provide services safely to refugees during the COVID-19 pandemic, humanitarian non-governmental organizations (NGOs) have instituted public health safety protocols to mitigate the risk of spreading the SARS-CoV-2 virus. However, it can be difficult for people to adhere to protocols under the best of circumstances, and in situations of nested crises, in which one crisis contributes to a cascade of additional crises, adherence can further deteriorate. Such a nested crises situation occurred in Beirut, Lebanon, when a massive explosion in the city injured or killed thousands and destroyed essential infrastructure. Using data from a study on COVID-19 safety protocol adherence during refugee humanitarian assistance in Lebanon, Jordan, and Turkey, we conduct a cross-country comparison to determine whether the nested crises in Beirut led to a deterioration of protocol adherence-the "fragile rationalism" orientation-or whether adherence remained robust-the "collective resilience" orientation. We found greater evidence for collective resilience, and from those findings make public health recommendations for service provision occurring in disaster areas.
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Affiliation(s)
- Stephanie Nawyn
- Department of Sociology, College of Social Science, Michigan State University, East Lansing, MI, United States
| | - Ezgi Karaoğlu
- Department of Sociology, College of Social Science, Michigan State University, East Lansing, MI, United States
| | - Stephen Gasteyer
- Department of Sociology, College of Social Science, Michigan State University, East Lansing, MI, United States
| | - Rania Mansour
- Program of Social Work, Doha Institute for Graduate Studies, Doha, Qatar
| | - Ali Ghassani
- Faculty of Health Sciences, Amel Association International, American University of Beirut, Beirut, Lebanon
| | - Sandra Marquart-Pyatt
- Department of Geography College of Social Science, Michigan State University, East Lansing, MI, United States
- Department of Geography, Environment, and Spatial Sciences and Department of Political Science, College of Social Science, Michigan State University, East Lansing, MI, United States
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Lee J, Allen J. Young women's food consumption and mental health: the role of employment. BMC Womens Health 2022; 22:91. [PMID: 35337300 PMCID: PMC8957117 DOI: 10.1186/s12905-022-01675-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 03/21/2022] [Indexed: 11/10/2022] Open
Abstract
Objectives This study explores the relationship between young women’s consumption of healthy and unhealthy food and depression and examines the moderating effect of their employment status on the relationship.
Methods The National Longitudinal Survey of Youth 79 for Children and Young Adults (NLSY79 CY) was used for this study. The final sample included a total of 1524 young women aged from 18 to 35 years. Multiple Linear Regression was conducted to answer the research questions. Results Fast food consumption was related to higher levels of depression among young women while fruit intake was associated with lower levels of depression. Employment status moderated the relationship between young women’s fruit consumption and depression. Conclusions Young women are encouraged to consume more fruit and less fast food in order to ameliorate depression. Programs that target young women’s mental health should consider addressing their nutritional needs, through, for example, vouchers for fresh, nutritious foods; nutrition or cooking education; or having a certified nutrition specialist on staff.
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Affiliation(s)
- Jaewon Lee
- School of Social Welfare, Inha University, 100 Inha-ro, Michuhol-gu, Incheon, 22212, Republic of Korea.
| | - Jennifer Allen
- School of Social Work, Michigan State University, East Lansing, MI, USA
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Giri JK, Kumaresan T. The business cycle, health behavior, and chronic disease: A study over Three decades. ECONOMICS AND HUMAN BIOLOGY 2021; 43:101029. [PMID: 34174514 DOI: 10.1016/j.ehb.2021.101029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 05/19/2021] [Accepted: 06/14/2021] [Indexed: 06/13/2023]
Abstract
The effect of macroeconomic fluctuations on individual health remains highly debated. We estimate the effect of the business cycle on health and health behavior in the U.S. using the NLSY79 panel data for 11,406 respondents between 1979 and 2014. Most of our survey respondents have no chronic illness in 1979, and develop these conditions during the sample period. This allows us to estimate the true effect of economic fluctuation on the likelihood of developing chronic conditions. The results indicate a considerable difference in the cyclic variation of chronic diseases. After controlling for innate individual characteristics such as family health history, and unobserved regional characteristics, we find that obesity decreases during economic downturns, while diabetes, hypertension, and congestive heart failure increase. Sub-sample analyses show that Blacks are more likely to develop diabetes and hypertension and are less likely to develop obesity during economic downturns than other racial groups. The incidence of obesity declines during recessions for women, while males are more likely to develop diabetes. Income loss, particularly among Blacks, and lack of change in physical activity mediate these differential effects.
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Affiliation(s)
- Jeeten Krishna Giri
- Department of Economics, Union College, Lippman Hall 103, 807 Union St, Schenectady, NY, 12308, USA.
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8
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Nizalova O, Norton EC. Long-term effects of job loss on male health: BMI and health behaviors. ECONOMICS AND HUMAN BIOLOGY 2021; 43:101038. [PMID: 34304076 DOI: 10.1016/j.ehb.2021.101038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 06/20/2021] [Accepted: 06/26/2021] [Indexed: 06/13/2023]
Abstract
Employment is one of the most critical determinants of health and health behaviors for adults. This study focuses on Ukraine and measures how an involuntary job loss - defined as job loss due to business closures, reorganizations, bankruptcies, or privatization - affects BMI, being overweight or obese, smoking, alcohol consumption, and physical activity. There are three reasons to study Ukraine in the aftermath of an enormous economic transition that resulted in employment contraction as high as 40 % compared to 1990. First, nearly all published studies on the relationship between job loss and health and health behaviors have been on developed countries, meaning that our study fills the gap in the literature on transition economies. Second, the job losses that we study are plausibly exogenous and affected a significant share of the population. Third, the longitudinal survey follows individuals for up to 10 years starting from 2003, allowing us to capture the long-term effects of past job loss on outcomes at a specific point in time and their trajectories across the life cycle. Applying growth-curve models, we show that past involuntary job loss significantly alters the age trajectories of all considered outcomes at both extensive and intensive margins.
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Affiliation(s)
- Olena Nizalova
- University of Kent and GLO, CC.216 Cornwallis, Canterbury, Kent, CT2 7NF, UK.
| | - Edward C Norton
- University of Michigan and NBER, 1415 Washington Heights, Ann Arbor, MI, 48109, USA.
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9
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De PK, Segura-Escano R. Drinking during downturn: New evidence from the housing market fluctuations in the United States during the Great Recession. ECONOMICS AND HUMAN BIOLOGY 2021; 43:101070. [PMID: 34700198 DOI: 10.1016/j.ehb.2021.101070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 10/05/2021] [Accepted: 10/08/2021] [Indexed: 06/13/2023]
Abstract
We investigate how the decline in home prices over the Great Recession in the U.S. impacted drinking behavior. We match data on actual and shadow home prices (from Zillow Research) to individuals' drinking behavior from the Behavioral Risk Factor Surveillance System (BRFSS) by county of residence and year/month of the interview. We improve upon the existing literature by using new measures of exogenous macroeconomic shocks captured by fluctuations in home prices and finding heterogeneous impacts of the downturn based on homeownership. We find that decline in home prices is commonly associated with increases in alcohol consumption, both on extensive and intensive margins. Additionally, we find that the effects are more consistent among homeowners compared to renters. Given that alcohol consumption is one of the leading causes of death in the U.S. and that the COVID-19 pandemic has triggered an economic crisis in many societies, the results have important public health implications.
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Affiliation(s)
- Prabal K De
- Department of Economics, Colin Powell School at City College and The Graduate Center, City University of New York, New York, New York, USA; The Graduate Center, City University of New York, 365 5th Ave, New York, NY 10016, USA.
| | - Raul Segura-Escano
- The Graduate Center, City University of New York, 365 5th Ave, New York, NY 10016, USA.
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Simonelli G, Petit D, Delage JP, Michaud X, Lavoie MD, Morin CM, Godbout R, Robillard R, Vallières A, Carrier J, Bastien C. Sleep in times of crises: A scoping review in the early days of the COVID-19 crisis. Sleep Med Rev 2021; 60:101545. [PMID: 34571477 PMCID: PMC8461524 DOI: 10.1016/j.smrv.2021.101545] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 08/09/2021] [Accepted: 08/30/2021] [Indexed: 01/14/2023]
Abstract
During the early days of the pandemic and in the context of a seemingly unknown global threat, several potential major sleep disruptors were identified by sleep researchers and practitioners across the globe. The COVID-19 pandemic combined several features that, individually, had been shown to negatively affect sleep health in the general population. Those features included state of crisis, restrictions on in-person social interactions, as well as financial adversity. To address the lack of a comprehensive summary of sleep research across these three distinctive domains, we undertook three parallel systematic reviews based on the following themes: 1) Sleep in times of crises; 2) Sleep and social isolation; and 3) Sleep and economic uncertainty. Using a scoping review framework, we systematically identified and summarized findings from these three separated bodies of works. Potential moderating factors such as age, sex, ethnicity, socioeconomic status, psychological predisposition, occupation and other personal circumstances are also discussed. To conclude, we propose novel lines of research necessary to alleviate the short- and long-term impacts of the COVID-19 crises and highlight the need to prepare the deployment of sleep solutions in future crises.
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Affiliation(s)
- Guido Simonelli
- Center for Advanced Research in Sleep Medicine, Centre Intégré Universitaire de Santé et de Services Sociaux Du Nord-de-l'île-de-Montréal, Montreal (Quebec) Canada; Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal (Quebec), Canada; Department of Psychology, Université de Montréal, Montreal (Quebec), Canada
| | - Dominique Petit
- Center for Advanced Research in Sleep Medicine, Centre Intégré Universitaire de Santé et de Services Sociaux Du Nord-de-l'île-de-Montréal, Montreal (Quebec) Canada; Department of Psychiatry and Addictology, Université de Montréal, Montreal (Quebec), Canada
| | | | - Xavier Michaud
- Center for Advanced Research in Sleep Medicine, Centre Intégré Universitaire de Santé et de Services Sociaux Du Nord-de-l'île-de-Montréal, Montreal (Quebec) Canada; Department of Psychology, Université de Montréal, Montreal (Quebec), Canada
| | | | - Charles M Morin
- École de Psychologie, Université Laval, Québec (Québec), Canada; CERVO Brain Research Center, Université Laval, Canada
| | - Roger Godbout
- Department of Psychiatry and Addictology, Université de Montréal, Montreal (Quebec), Canada; Sleep Laboratory & Clinic, Hôpital en Santé Mentale Rivière-des-Prairies, Montreal (Quebec), Canada
| | - Rebecca Robillard
- Sleep Research Unit, Royal Ottawa Institute of Mental Health Research, Ottawa (Ontario), Canada
| | - Annie Vallières
- École de Psychologie, Université Laval, Québec (Québec), Canada; CERVO Brain Research Center, Université Laval, Canada
| | - Julie Carrier
- Center for Advanced Research in Sleep Medicine, Centre Intégré Universitaire de Santé et de Services Sociaux Du Nord-de-l'île-de-Montréal, Montreal (Quebec) Canada; Department of Psychology, Université de Montréal, Montreal (Quebec), Canada
| | - Célyne Bastien
- École de Psychologie, Université Laval, Québec (Québec), Canada; CERVO Brain Research Center, Université Laval, Canada.
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11
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Hall J, Goranitis I, Kigozi J, Guariglia A. New evidence on the impact of the Great Recession on health-compromising behaviours. ECONOMICS AND HUMAN BIOLOGY 2021; 41:100980. [PMID: 33571870 DOI: 10.1016/j.ehb.2021.100980] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Revised: 01/06/2021] [Accepted: 01/10/2021] [Indexed: 06/12/2023]
Abstract
Using data from the English Longitudinal Study of Ageing over the period 2004-2017, this paper explores the effects of the Great Recession and its aftermath upon health-compromising behaviours in adults aged 50 and over. We introduce new techniques into this area of research, namely dynamic random-effects logit estimators which control for initial conditions and correlated individual effects. We observe a lack of crisis effect upon the probabilities of smoking and being physically inactive, as well as of transitioning in and out of these behaviours. In line with other recent literature, this suggests that the relationship between economic recessions and smoking and physical inactivity may have broken down. Alternatively, the over 50s may have been protected from the crisis and subsequent austerity measures. Nonetheless, both the crisis and post-crisis period were associated with a lower probability of drinking frequently.
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Affiliation(s)
- James Hall
- Institute for Primary Care & Health Sciences, David Weatherall Building, Keele University, Newcastle-under-Lyme, ST5 5BG, United Kingdom.
| | - Ilias Goranitis
- Health Economics Unit, Institute of Applied Health Research, University of Birmingham, Edgbaston, B15 2TT, United Kingdom.
| | - Jesse Kigozi
- Health Economics Unit, Institute of Applied Health Research, University of Birmingham, Edgbaston, B15 2TT, United Kingdom.
| | - Alessandra Guariglia
- Department of Economics, University of Birmingham, University House, Edgbaston, Birmingham, B15 2TY, United Kingdom.
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12
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Jenkins RH, Vamos EP, Taylor-Robinson D, Millett C, Laverty AA. Impacts of the 2008 Great Recession on dietary intake: a systematic review and meta-analysis. Int J Behav Nutr Phys Act 2021; 18:57. [PMID: 33926455 PMCID: PMC8084260 DOI: 10.1186/s12966-021-01125-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 04/19/2021] [Indexed: 03/19/2024] Open
Abstract
Background The 2008 Great Recession significantly impacted economies and individuals globally, with potential impacts on food systems and dietary intake. We systematically reviewed evidence on the impact of the Great Recession on individuals’ dietary intake globally and whether disadvantaged individuals were disproportionately affected. Methods We searched seven databases and relevant grey literature through June 2020. Longitudinal quantitative studies with the 2008 recession as the exposure and any measure of dietary intake (energy intake, dietary quality, and food/macronutrient consumption) as the outcome were eligible for inclusion. Eligibility was independently assessed by two reviewers. The Newcastle Ottawa Scale was used for quality and risk of bias assessment. We undertook a random effects meta-analysis for changes in energy intake. Harvest plots were used to display and summarise study results for other outcomes. The study was registered with PROSPERO (CRD42019135864). Results Forty-one studies including 2.6 million people met our inclusion criteria and were heterogenous in both methods and results. Ten studies reported energy intake, 11 dietary quality, 34 food intake, and 13 macronutrient consumption. The Great Recession was associated with a mean reduction of 103.0 cal per adult equivalent per day (95% Confidence Interval: − 132.1, − 73.9) in high-income countries (5 studies) and an increase of 105.5 cal per adult per day (95% Confidence Interval: 72.8, 138.2) in middle-income countries (2 studies) following random effects meta-analysis. We found reductions in fruit and vegetable intake. We also found reductions in intake of fast food, sugary products, and soft drinks. Impacts on macronutrients and dietary quality were inconclusive, though suggestive of a decrease in dietary quality. The Great Recession had greater impacts on dietary intake for disadvantaged individuals. Conclusions The 2008 recession was associated with diverse impacts on diets. Calorie intake decreased in high income countries but increased in middle income countries. Fruit and vegetable consumption reduced, especially for more disadvantaged individuals, which may negatively affect health. Fast food, sugary products, and soft drink consumption also decreased which may confer health benefits. Implementing effective policies to mitigate adverse nutritional changes and encourage positive changes during the COVID-19 pandemic and other major economic shocks should be prioritised. Supplementary Information The online version contains supplementary material available at 10.1186/s12966-021-01125-8.
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Affiliation(s)
- Rosemary H Jenkins
- Public Health Policy Evaluation Unit, Department of Primary Care and Public Health, School of Public Health, Imperial College London, Charing Cross Campus; The Reynolds Building, St Dunstan's Road, London, W6 8RP, UK.
| | - Eszter P Vamos
- Public Health Policy Evaluation Unit, Department of Primary Care and Public Health, School of Public Health, Imperial College London, Charing Cross Campus; The Reynolds Building, St Dunstan's Road, London, W6 8RP, UK
| | - David Taylor-Robinson
- Department of Public Health, Policy and Systems, Institute of Population Health, University of Liverpool, Waterhouse Building Block B, 2nd Floor, Liverpool, L69 3BX, UK
| | - Christopher Millett
- Public Health Policy Evaluation Unit, Department of Primary Care and Public Health, School of Public Health, Imperial College London, Charing Cross Campus; The Reynolds Building, St Dunstan's Road, London, W6 8RP, UK
| | - Anthony A Laverty
- Public Health Policy Evaluation Unit, Department of Primary Care and Public Health, School of Public Health, Imperial College London, Charing Cross Campus; The Reynolds Building, St Dunstan's Road, London, W6 8RP, UK
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13
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Salazar-Fernández C, Palet D, Haeger PA, Román Mella F. COVID-19 Perceived Impact and Psychological Variables as Predictors of Unhealthy Food and Alcohol Consumption Trajectories: The Role of Gender and Living with Children as Moderators. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:4542. [PMID: 33922944 PMCID: PMC8123324 DOI: 10.3390/ijerph18094542] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 04/09/2021] [Accepted: 04/12/2021] [Indexed: 12/17/2022]
Abstract
The present study examines the trajectories of unhealthy food and alcohol consumption over time and considers whether perceived impact of COVID-19 and psychological variables are predictors of these trajectories. We ascertained whether these predictors are different in women vs. men and between women living with vs. without children. Data were collected through online surveys administered to 1038 participants from two universities (staff and students) in Chile, across five waves (July to October 2020). Participants provided information about their past-week unhealthy food and alcohol consumption and mental health. Using latent growth curve modeling analysis, we found that higher perceived health and interpersonal COVID-19 impact, younger age and lower depression symptoms were associated with more rapid increases over time in unhealthy food consumption. On the other hand, higher perceived COVID-19 economic impact and older age were associated with more rapid diachronic decreases in alcohol consumption. Gender and living with or without children, for women only, were moderators of these trajectories. This longitudinal study provides strong evidence identifying the multiple repercussions of COVID-19 and mental health factors on unhealthy food and alcohol consumption. These findings highlight the need for interventions aimed at minimizing the impact of the pandemic on unhealthy food and alcohol consumption over time.
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Affiliation(s)
- Camila Salazar-Fernández
- Departamento de Psicología, Universidad de La Frontera, Temuco 4811230, Chile; (C.S.-F.); (D.P.)
| | - Daniela Palet
- Departamento de Psicología, Universidad de La Frontera, Temuco 4811230, Chile; (C.S.-F.); (D.P.)
| | - Paola A. Haeger
- Departamento de Ciencias Biomédicas, Facultad de Medicina, Universidad Católica del Norte, Coquimbo 1781421, Chile;
| | - Francisca Román Mella
- Departamento de Psicología, Universidad de La Frontera, Temuco 4811230, Chile; (C.S.-F.); (D.P.)
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14
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Blázquez-Fernández C, Cantarero-Prieto D, Pascual-Sáez M. Quality of Life, Health and the Great Recession in Spain: Why Older People Matter? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18042028. [PMID: 33669703 PMCID: PMC7922658 DOI: 10.3390/ijerph18042028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 02/14/2021] [Accepted: 02/16/2021] [Indexed: 12/02/2022]
Abstract
The financial crisis of 2008 precipitated the “Great Recession”. In this scenario, we took Spain as a country of study, because although it experienced significant negative shocks associated with macroeconomic variables (GDP or unemployment), its welfare indicators have been marked by limited changes. This study used data from waves 2 and 4 (years 2006–2007 and 2010–2012, respectively) of the Survey on Health, Aging and Retirement in Europe (SHARE). Specifically, through logistic regressions we have analysed the effects of socioeconomic, demographic, health and “Great Recession” factors on the quality of life (QoL) of elders in Spain. Although QoL did not change too much during the “Great Recession”, the results confirmed the importance of several factors (such as chronicity) that affect the satisfaction with the QoL among the older people. In this regard, statistically significant effects were obtained for individual exposure to recession. Therefore, a decrease in household income in the crisis period with respect to the pre-crisis period would increase by 44% the probability of reporting a low QoL (OR = 1.44; 95% CI: 1.00–2.07). Furthermore, gender differences were observed. Health and socioeconomic variables are the most significant when determining individual QoL. Therefore, when creating policies, establishing multidisciplinary collaborations is essential.
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Affiliation(s)
- Carla Blázquez-Fernández
- Department of Economics, University of Cantabria, 39005 Santander, Spain; (D.C.-P.); (M.P.-S.)
- Research Group of Health Economics and Health Services Management—Research Institute Marqués de Valdecilla (IDIVAL), 39011 Santander, Spain
- Correspondence:
| | - David Cantarero-Prieto
- Department of Economics, University of Cantabria, 39005 Santander, Spain; (D.C.-P.); (M.P.-S.)
- Research Group of Health Economics and Health Services Management—Research Institute Marqués de Valdecilla (IDIVAL), 39011 Santander, Spain
| | - Marta Pascual-Sáez
- Department of Economics, University of Cantabria, 39005 Santander, Spain; (D.C.-P.); (M.P.-S.)
- Research Group of Health Economics and Health Services Management—Research Institute Marqués de Valdecilla (IDIVAL), 39011 Santander, Spain
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15
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Esteve-Llorens X, Moreira MT, Feijoo G, González-García S. Could the economic crisis explain the reduction in the carbon footprint of food? Evidence from Spain in the last decade. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 755:142680. [PMID: 33059135 DOI: 10.1016/j.scitotenv.2020.142680] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 09/24/2020] [Accepted: 09/25/2020] [Indexed: 06/11/2023]
Abstract
Dietary patterns are influenced by numerous external factors such as cultural taste and customs, nutritional and economic aspects and lifestyle and consumer preferences. Otherwise, food also causes a great impact on the environment and there can be a large difference between choosing certain foodstuffs, such as plant or animal-based ones. The key for an environmentally friendly and healthy diet is the high consumption of plant-based products, low amounts of animal-origin foodstuffs and limited quantity of refined grains, processed food and added sugars. Nevertheless, adherence to it has been decreasing over the years due to the adoption of a more westernized consumption pattern. Thus, the main goal of this study is to monitor the food consumption pattern at household level during a period of 10 years (2008-2017), selecting Spain as case study. Both the impacts that foodstuffs included in the food basket cause in the environment, and the socio-economic variables that influence the consumer choice are considered. Results show a generalized decrease of the carbon footprint over the years. However, it does not always mean an approach to a healthier diet, considering that in this case it decreases both the consumption of those foods with a greater environmental footprint as those essential for a balanced diet with low ecological impact. Additionally, there is also an increase in the consumption of processed food, which further distances the dietary pattern from the recommendations, what can be more pronounced for the most vulnerable population groups, with less purchasing power to access healthy food.
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Affiliation(s)
- Xavier Esteve-Llorens
- CRETUS institute, Department of Chemical Engineering, School of Engineering, Universidade de Santiago de Compostela, 15782 Santiago de Compostela, Galicia, Spain.
| | - Maria Teresa Moreira
- CRETUS institute, Department of Chemical Engineering, School of Engineering, Universidade de Santiago de Compostela, 15782 Santiago de Compostela, Galicia, Spain
| | - Gumersindo Feijoo
- CRETUS institute, Department of Chemical Engineering, School of Engineering, Universidade de Santiago de Compostela, 15782 Santiago de Compostela, Galicia, Spain
| | - Sara González-García
- CRETUS institute, Department of Chemical Engineering, School of Engineering, Universidade de Santiago de Compostela, 15782 Santiago de Compostela, Galicia, Spain
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16
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García-Mayor J, Moreno-Llamas A, De la Cruz-Sánchez E. Inequalities in the long-term impact of the economic recession on preventive healthcare use and health-related lifestyle in Spain (2006-2017). HEALTH & SOCIAL CARE IN THE COMMUNITY 2021; 29:42-55. [PMID: 32557930 DOI: 10.1111/hsc.13067] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 05/07/2020] [Accepted: 05/26/2020] [Indexed: 06/11/2023]
Abstract
Study of the long-term impact of economic recession on lifestyle according to socioeconomic groups is scarce. This study examines health-related lifestyle and preventive medical attendance in different socioeconomic groups in the Spanish adult population (18-64 years of age) before, during and after an economic recession. Data were collected from three waves of the Spanish National Health Survey (2006, 2012 and 2017). Self-perceived health, health-related lifestyle and common preventive medical attendance were evaluated by means of multivariate logistic models. The increase in good self-perceived health in 2006-2012 was 7.1%, 6.9% and 8.3% for the high, middle and low group, respectively, and 5.2%, 5.9% and 7.9% for the high, middle and low group, respectively, in 2006-2017. In 2006-2012 and 2006-2017, the gap increased between people of the high and low groups in smoking prevalence (2.8%-4.7%), physical activity (2.0%-4.0%), daily fruit (1.0%-6.3%) and vegetable intake (2.5%-6.1%). The probability of women´s gynaecological attendance increased statistically significant for cytology in three groups in 2006-2012 and 2006-2017 (OR = 1.35, 95% CI = 1.08-1.67; OR = 1.42, 95% CI = 1.18-1.7; OR = 1.34, 95% CI = 1.21-1.47 for the high, middle and low groups, respectively, in 2006-2012 and OR = 1.34, 95% CI = 1.08-1.67; OR = 1.62, 95% CI = 1.35-1.95; OR = 1.51, 95% CI = 1.37-1.66 for the high, middle and low groups, respectively, in 2006-2017), but not for mammography. This study reveals long-term socioeconomic inequalities in lifestyle behaviours after the economic recession. Health policies must be emphasised in these population subgroups and in more disadvantaged populations.
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17
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Gonçalves PD, Moura HF, do Amaral RA, Castaldelli-Maia JM, Malbergier A. Alcohol Use and COVID-19: Can we Predict the Impact of the Pandemic on Alcohol Use Based on the Previous Crises in the 21st Century? A Brief Review. Front Psychiatry 2020; 11:581113. [PMID: 33391048 PMCID: PMC7775307 DOI: 10.3389/fpsyt.2020.581113] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 11/23/2020] [Indexed: 01/23/2023] Open
Abstract
The enormous health and economic challenges precipitated by the 2019 coronavirus disease (COVID-19) pandemic are comparable or even greater than those associated with previous historical world crises. Alcohol use, especially drinking to cope with stress, is a concern, as an increase in its sales has been reported in some countries during the quarantine. This study aims to provide a better understanding of what to expect in terms of alcohol consumption, risk factors for excessive use, and its potential consequences during this pandemic based on previous experiences. We investigated how traumatic events related to alcohol consumption. Studies on mass traumatic events (i.e., terrorism as 9/11), epidemic outbreaks (i.e., severe acute respiratory syndrome [SARS] in 2003), economic crises (such as 2008's Great Recession), and COVID-19 were selected. The main keywords used to select the studies were alcohol use, drinking patterns, alcohol use disorders, and alcohol-related consequences. Previous studies reported increases in alcohol use associated with those events mediated, at least partially, by anxiety and depressive symptoms, and posttraumatic stress disorder (PTSD). Being male, young, and single also seems to be associated with a higher vulnerability to develop risky drinking behavior after those tragic events. The discussion of previous risk and protective factors can contribute to elaborate more specific public health policies to mitigate the impact of the current pandemic on people's mental health, especially alcohol-related problems.
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Affiliation(s)
- Priscila Dib Gonçalves
- Department of Psychiatry, Medical School of University of São Paulo (USP), São Paulo, Brazil
| | - Helena Ferreira Moura
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Faculty of Medicine, Porto Alegre, Brazil
| | | | - João Maurício Castaldelli-Maia
- Department of Psychiatry, Medical School of University of São Paulo (USP), São Paulo, Brazil
- Department of Neuroscience, ABC Health University Center, Santo André, Brazil
| | - André Malbergier
- Department of Psychiatry, Medical School of University of São Paulo (USP), São Paulo, Brazil
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Cuellar A, Mark TL, Sharfstein SS, Huskamp HA. How to Mitigate the Mental Health Care Consequences of the COVID-19 Financial Crisis. Psychiatr Serv 2020; 71:1317-1319. [PMID: 32988321 DOI: 10.1176/appi.ps.202000329] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
The COVID-19 pandemic has led to record unemployment claims and a weakened U.S. economy. This column reviews results of past research to examine how a recession might affect behavioral health and the treatment of mental and substance use disorders and suggests potential policy solutions. Despite increases in suicide and substance use, losses in employment-related health insurance could dampen treatment seeking. Federal, state, and local officials should be vigilant regarding suicide prevention. Individuals who lose employee insurance coverage should be protected through insurance marketplaces and Medicaid outreach and enrollment. Public and private coverage of telehealth, which has already been expanded, should continue beyond the pandemic. Federal support for community behavioral health organizations should continue to offset state and local budget cuts and ensure provision of needed treatment. The capacity of social services should be expanded as well as systems that facilitate client connection to social services.
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Affiliation(s)
- Alison Cuellar
- College of Health and Human Services, George Mason University, Fairfax, Virginia, and National Bureau of Economic Research, Cambridge, Massachusetts (Cuellar); RTI International, Rockville, Maryland (Mark); Sheppard Pratt Health System, Baltimore (Sharfstein); Department of Health Care Policy, Harvard Medical School, Boston (Huskamp). Dr. Sharfstein, Dr. Huskamp, and Dr. Cuellar are editors of this column
| | - Tami L Mark
- College of Health and Human Services, George Mason University, Fairfax, Virginia, and National Bureau of Economic Research, Cambridge, Massachusetts (Cuellar); RTI International, Rockville, Maryland (Mark); Sheppard Pratt Health System, Baltimore (Sharfstein); Department of Health Care Policy, Harvard Medical School, Boston (Huskamp). Dr. Sharfstein, Dr. Huskamp, and Dr. Cuellar are editors of this column
| | - Steven S Sharfstein
- College of Health and Human Services, George Mason University, Fairfax, Virginia, and National Bureau of Economic Research, Cambridge, Massachusetts (Cuellar); RTI International, Rockville, Maryland (Mark); Sheppard Pratt Health System, Baltimore (Sharfstein); Department of Health Care Policy, Harvard Medical School, Boston (Huskamp). Dr. Sharfstein, Dr. Huskamp, and Dr. Cuellar are editors of this column
| | - Haiden A Huskamp
- College of Health and Human Services, George Mason University, Fairfax, Virginia, and National Bureau of Economic Research, Cambridge, Massachusetts (Cuellar); RTI International, Rockville, Maryland (Mark); Sheppard Pratt Health System, Baltimore (Sharfstein); Department of Health Care Policy, Harvard Medical School, Boston (Huskamp). Dr. Sharfstein, Dr. Huskamp, and Dr. Cuellar are editors of this column
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19
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Trappolini E, Marino C, Agabiti N, Giudici C, Davoli M, Cacciani L. Disparities in emergency department use between Italians and migrants residing in Rome, Italy: the Rome Dynamic Longitudinal Study from 2005 to 2015. BMC Public Health 2020; 20:1548. [PMID: 33059671 PMCID: PMC7559990 DOI: 10.1186/s12889-020-09280-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 07/20/2020] [Indexed: 01/01/2023] Open
Abstract
Background The Emergency Department (ED) can be considered an indicator of accessibility and quality and can be influenced in period of economic downturns. In the last fifteen years, the number of migrants in Italy has doubled (from 2.4 million in 2005 to 5.2 in 2019, 4.1 and 8.7% of the total population, respectively). However, evidence about migrants’ healthcare use is poor, and no studies focused on the ED utilisation rate during the Great Recession are available. This study aims to analyse trends in all-cause and cause-specific ED utilisation among migrants and Italians residing in Rome, Italy, before and after 2008. Methods Longitudinal study based on data from the Municipal Register of Rome linked to the Emergency Department Register from 2005 to 2015. We analysed 2,184,467 individuals, aged 25–64 in each year. We applied a Hurdle model to estimate the propensity to use the ED and to model how often individuals accessed the ED. Results Migrants were less likely to be ED users than Italians, except for Africans (RR = 1.46, 95%CI 1.40–1.52) and Latin Americans (RR = 1.04, 95%CI 1.00–1.08) who had higher all-cause utilisation rates than non-migrants. Compared to the pre-2008 period, in the post-2008 we found an increase in the likelihood of being an ED user (OR = 1.34, 95%CI 1.34–1.35), and a decrease in ED utilisation rates (RR = 0.96, 95%CI 0.96–0.97) for the whole population, with differences among migrant subgroups, regardless of cause. Conclusions This study shows differences in the ED utilisation between migrants and Italians, and within the migrant population, during the Great Recession. The findings may reflect differentials in the health status, and barriers to access primary and secondary care among migrants. In this regard, health policies and cuts in health spending measures may have played a key role, and interventions to tackle health and access disparities should include policy measures addressing the underlying factors, adopting a Health in All Policies perspective. Further researches focusing on specific groups of migrants, and on the causes and diagnoses related to the ED utilisation, may help to explain the differences observed.
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Affiliation(s)
| | - Claudia Marino
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | - Nera Agabiti
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | | | - Marina Davoli
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | - Laura Cacciani
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy.
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20
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Triaca LM, Jacinto PDA, França MTA, Tejada CAO. Does greater unemployment make people thinner in Brazil? HEALTH ECONOMICS 2020; 29:1279-1288. [PMID: 32722883 DOI: 10.1002/hec.4139] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 06/22/2020] [Accepted: 06/30/2020] [Indexed: 06/11/2023]
Abstract
The study seeks to analyze the impact of macroeconomic conditions on weight measures, such as BMI, overweight, obesity, and severe obesity in Brazil. We examine this relationship in the specific context of a middle-income country that differs in many aspects from the high-income countries usually considered in the literature. The study uses the microdata of VIGITEL in the period from 2006 to 2014 and the state unemployment rate as a proxy for macroeconomic conditions. The results showed that the relationship is robust and presents a procyclical pattern-increases in the unemployment rate reduce BMI, and this reduction is observed throughout the entire distribution, with statistically significant effects for measures of overweight, obesity, and severe obesity. These results agree with the findings for the United States but contradict the results found for Finland and Canada.
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Affiliation(s)
- Lívia Madeira Triaca
- Department of Economics, Federal University of Rio Grande Foundation (Fundação Universidade Federal do Rio Grande-FURG), Rio Grande, Brazil
- Posgraduate Program in Economics, Federal University of Pelotas (Universidade Federal de Pelotas-UFPel), Pelotas, Brazil
| | - Paulo de Andrade Jacinto
- Department of Economics, Federal University of Paraná (Universidade Federal do Paraná-UFPR), Curitiba, Brazil
| | - Marco Túlio Aniceto França
- Posgraduate Program in Economics, Pontifical Catholic University of Rio Grande do Sul (Pontifícia Universidade Católica do Rio Grande do Sul-PUCRS), Porto Alegre, Brazil
| | - César Augusto Oviedo Tejada
- Posgraduate Program in Economics, Federal University of Pelotas (Universidade Federal de Pelotas-UFPel), Pelotas, Brazil
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21
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Kim MG, Lee SJ, Park D, Kim CH, Lee KH, Hwang JM. Relationship between the actual fine dust concentration and media exposure that influenced the changes in outdoor activity behavior in South Korea. Sci Rep 2020; 10:12006. [PMID: 32686706 PMCID: PMC7371889 DOI: 10.1038/s41598-020-68580-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 06/29/2020] [Indexed: 11/09/2022] Open
Abstract
The one reason of the decrease of walking time for adults in South Korea among various factors is the sense of fear about fine dust sparked by media reports, which has created a negative perception of fine dust. This study aimed to assess the change in concentration of fine dust, as well as individuals' walking time and health status, in South Korea, and to investigate the relationship between the media reports on fine dust. Using the national government statistics data, we analyzed the relationship between walking time, concentration of fine dust, and amount of media reports on fine dust. From 2008 to 2017, the average walking time and PM10 levels decreased from 76.17 to 49.47 min and 52 to 45 μg/m3; whereas PM10 media frequency increased from 349 to 9,234. No positive correlation existed between walking time in South Korea and exposure to fine dust. However, media reports on fine dust increased steadily from 2012 and peaked in 2015. The decrease in average walking time in South Korea was due to the negative perception created by the increase in media reports on fine dust, rather than the increase in the actual concentration of fine dust.
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Affiliation(s)
- Myung-Gwan Kim
- Graduate School of Public Health, Kyungpook National University, Daegu, South Korea
| | - Su-Jin Lee
- Graduate School of Public Health, Kyungpook National University, Daegu, South Korea
| | - Donghwi Park
- Department of Physical Medicine and Rehabilitation, Ulsan University Hospital, Ulsan, South Korea.,University of Ulsan College of Medicine, Dong-gu, Ulsan, South Korea
| | - Chul-Hyun Kim
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, 200 Dongduk-ro Jung-gu, Daegu, 700-721, South Korea.,Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University, 200 Dongduk-ro Jung-gu, Daegu, 700-721, South Korea
| | - Ki- Hoon Lee
- Mompyeonhan Rehabilitation Clinic, Daegu, South Korea
| | - Jong-Moon Hwang
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, 200 Dongduk-ro Jung-gu, Daegu, 700-721, South Korea. .,Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University, 200 Dongduk-ro Jung-gu, Daegu, 700-721, South Korea.
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Are Housing Prices Associated with Food Consumption? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17113882. [PMID: 32486226 PMCID: PMC7312069 DOI: 10.3390/ijerph17113882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 05/28/2020] [Accepted: 05/28/2020] [Indexed: 11/17/2022]
Abstract
Objective: Since January 2010, the U.S. has experienced economic recovery, including a 39% increase in home prices nationally. While higher home prices represent a wealth increase for some homeowners, it may decrease real purchasing power for others. The objective of this study is to examine the relationship between local area housing values and consumption of four food categories. Design: Observational study using data from the Behavioral Risk Factor Surveillance System between 2011 and 2015. Outcomes included number of times per week food was consumed and binary measures denoting consumption ≥2 times per day for four categories: vegetables, fruit, legumes and fruit juice. The primary explanatory variables were metropolitan/micropolitan statistical area home and rental price indices from Zillow. Differential associations by home ownership, age, race/ethnicity and education were examined. Results: Overall, housing values were not associated with intake of vegetables or fruit juice. Among homeowners, a $10,000 increase in home price was associated with small, but statistically significant reductions in fruit and legume consumption. These inverse associations were pronounced among Hispanic and non-Hispanic Black adults. Conclusions: Lower fruit and legume consumption associated with greater housing values may represent one of several explanations including a decrease in purchasing power, given increases in home prices and limited wage growth since 2010.
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23
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Rabadán A, Martínez-Carrasco L, Brugarolas M, Navarro-Rodríguez de Vera C, Sayas-Barberá E, Bernabéu R. Differences in Consumer Preferences for Lamb Meat before and duriang the Economic Crisis in Spain. Analysis and Perspectives. Foods 2020; 9:foods9060696. [PMID: 32486028 PMCID: PMC7353620 DOI: 10.3390/foods9060696] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 05/25/2020] [Accepted: 05/27/2020] [Indexed: 11/16/2022] Open
Abstract
Determining the preferences of food consumers is key for adapting supply and demand. This adaptation of supply is dynamic rather than static, given that it develops over time and is influenced by both social and economic factors. This work presents an analysis of the development of lamb meat consumption at two points in time, 2004 and 2014, before and in the midst of the economic crisis in Spain (2007–2017). Our findings show that together with the external appearance and against the backdrop of an economic recession, price has a greater impact on consumers’ purchasing decisions than origin and quality seals, despite these being attributes that are traditionally used as a guarantee of food safety and traceability. This suggests that in times of economic crisis consumer preferences shift towards attributes that are less related to product quality. Nonetheless, the comparison of the consumer segments for each of the years under study revealed that age and level of education are the socioeconomic factors that most influence the preferences of lamb meat consumers.
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Affiliation(s)
- Adrián Rabadán
- Escuela Técnica Superior de Ingenieros Agrónomos y de Montes (ETSIAM), Universidad de Castilla-La Mancha, Campus Universitario s/n, 02071 Albacete, Spain;
- Correspondence:
| | - Laura Martínez-Carrasco
- Escuela Politécnica Superior de Orihuela (EPSO), Universidad Miguel Hernández, Avenida de la Universidad de Elche, s/n, 03202 Elche, Spain; (L.M.-C.); (M.B.); (C.N.-R.d.V.); (E.S.-B.)
| | - Margarita Brugarolas
- Escuela Politécnica Superior de Orihuela (EPSO), Universidad Miguel Hernández, Avenida de la Universidad de Elche, s/n, 03202 Elche, Spain; (L.M.-C.); (M.B.); (C.N.-R.d.V.); (E.S.-B.)
| | - Casilda Navarro-Rodríguez de Vera
- Escuela Politécnica Superior de Orihuela (EPSO), Universidad Miguel Hernández, Avenida de la Universidad de Elche, s/n, 03202 Elche, Spain; (L.M.-C.); (M.B.); (C.N.-R.d.V.); (E.S.-B.)
| | - Estrella Sayas-Barberá
- Escuela Politécnica Superior de Orihuela (EPSO), Universidad Miguel Hernández, Avenida de la Universidad de Elche, s/n, 03202 Elche, Spain; (L.M.-C.); (M.B.); (C.N.-R.d.V.); (E.S.-B.)
| | - Rodolfo Bernabéu
- Escuela Técnica Superior de Ingenieros Agrónomos y de Montes (ETSIAM), Universidad de Castilla-La Mancha, Campus Universitario s/n, 02071 Albacete, Spain;
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Briody J, Doyle O, Kelleher C. The effect of local unemployment on health: A longitudinal study of Irish mothers 2001-2011. ECONOMICS AND HUMAN BIOLOGY 2020; 37:100859. [PMID: 32114328 DOI: 10.1016/j.ehb.2020.100859] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 12/19/2019] [Accepted: 01/29/2020] [Indexed: 06/10/2023]
Abstract
The relationship between economic conditions and health is mixed, with some evidence from the most recent financial crisis finding a positive effect of periods of unemployment on heath behaviours. This study uses longitudinal data spanning the periods before, during and after the Irish crisis of 2007, to test the impact of economic expansion and contraction on mothers physical and mental health and health behaviours. Three waves of data from the Irish Lifeways Cohort Study for the period 2001-2011, and local area employment rates from the Irish Census, are used to capture the impact of a period of increased unemployment on health before, during and after the Irish recession, independent of individual employment status. The results from fixed effect linear probability models demonstrate that an additional unit of local area unemployment increases the probability of reporting poor self-rated health by 1-1.8 percentage points and of reporting poor mental well-being by 1.4 and 2.7 percentage points depending on the instrument used. There are decreases in the probability of consuming cigarettes by 3.3 percentage points, self-describing as a regular smoker by 2.9 percentage points and obesity by 0.9 percentage points. The probability of engaging in at least 20 minutes of strenuous or moderate exercise per week declines by 7.8 and 8.7 percentage points respectively, while the probability of engaging in at least 20 minutes of mild exercise rises by 10 percentage points. These results are largely consistent with the US literature, which is predominantly based on working men, thus demonstrating the universal impact of economic vulnerability on health.
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Affiliation(s)
- Jonathan Briody
- School Of Economics, Geary Institute for Public Policy, University College Dublin Belfield, Dublin 4, Ireland.
| | - Orla Doyle
- School Of Economics, Geary Institute for Public Policy, University College Dublin Belfield, Dublin 4, Ireland
| | - Cecily Kelleher
- School of Public Health, Physiotherapy and Sports Science, Woodview House, University College Dublin Belfield, Dublin 4, Ireland
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25
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Birgisdóttir KH, Hauksdóttir A, Ruhm C, Valdimarsdóttir UA, Ásgeirsdóttir TL. The effect of the economic collapse in Iceland on the probability of cardiovascular events. ECONOMICS AND HUMAN BIOLOGY 2020; 37:100861. [PMID: 32106017 DOI: 10.1016/j.ehb.2020.100861] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 02/03/2020] [Accepted: 02/03/2020] [Indexed: 06/10/2023]
Abstract
After several years of a booming economy in Iceland, the economic bubble burst in 2008 and affected most Icelanders in one way or another. We explore whether the economic collapse in 2008 and subsequent economic crisis affected the probability of ischemic heart disease (IHD) events, independent of regular cyclical effects that can be attributed to typical economic conditions. Moreover, we conduct a mediation analysis to study the potential mechanisms through which the relationship between the economic collapse and cardiovascular health travels. We estimate linear probability models using administrative data on IHD events, earnings and balance-sheet status, as well as unemployment for all Icelanders aged 16 and older in 2000-2014. We find that the sharp change in economic conditions in 2008 increased the probability of cardiovascular events in both males and females in the long term. In absolute terms, these effects were small in magnitude but often statistically significant, amounting to approximately 13-16 extra cases of IHD events in each of the two years following the collapse for males and 3-5 addition cases for females. Moreover, they contrast with the finding that general business-cycle fluctuations operated in the opposite direction. Several potential mediators were correlated with the probability of IHD events, but their inclusion had little impact on the estimated effects of the economic crisis. A statistically significant business-cycle effect is found for both genders indicating that in general, harder economic times are beneficial for heart health. Thus, the general business cycle and the economic collapse in 2008 and subsequent crisis can be thought of as separate phenomena with differing effects on IHD.
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Affiliation(s)
- Kristín Helga Birgisdóttir
- Faculty of Economics, University of Iceland, Reykjavik, Iceland, Oddi v/Sturlugötu, 101 Reykjavík, Iceland.
| | - Arna Hauksdóttir
- Faculty of Medicine, Center of Public Health Sciences, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Christopher Ruhm
- Frank Batten School of Leadership and Public Policy, University of Virginia, VA, USA
| | - Unnur Anna Valdimarsdóttir
- Faculty of Medicine, Center of Public Health Sciences, School of Health Sciences, University of Iceland, Reykjavik, Iceland; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm Sweden; Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA
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Uphoff EP, Small N, Pickett KE. Using Birth Cohort Data to Assess the Impact of the UK 2008-2010 Economic Recession on Smoking During Pregnancy. Nicotine Tob Res 2020; 21:1021-1026. [PMID: 29741730 DOI: 10.1093/ntr/nty083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 05/07/2018] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Despite the well-known link between stress and smoking, evidence for associations between economic recession, financial stress, and smoking is contradictory. In this study, we assess whether women were more likely to continue smoking during pregnancy if they were exposed to the UK 2008-2010 economic recession during pregnancy than those who were unexposed, and whether this relationship is mediated by financial stress. METHODS We used cross-sectional data on 2775 pregnant women who were regular smokers before pregnancy and who were enrolled in the UK Born in Bradford cohort study between March 2007 and December 2010. The cutoff date for exposure to recession was set as August 1, 2008, based on local and national economic data. Multivariable logistic regression analysis included potential confounders: maternal age, parity, cohabitation, ethnicity, and maternal age. The mediating role of financial stress was analyzed using "worse off financially" and a "difficult financial situation" as indicators of financial stress in Sobel-Goodman mediation tests with bootstrap resampling. RESULTS After taking into account potential confounders, exposure to recession was associated with continued smoking during pregnancy (OR = 1.19, 95% CI = 1.01 to 1.41, p = 0.03). A worse financial situation and a difficult financial situation were identified as mediators, explaining 8.4% and 17.6%, respectively, of the relationship between exposure to recession and smoking during pregnancy. CONCLUSIONS Smoking during pregnancy is associated with exposure to the UK 2008-2010 economic recession during pregnancy, and this relationship is partly mediated by financial stress. IMPLICATIONS Health inequalities in smoking during pregnancy are affected by economic recession, as those who are most likely to smoke are also most likely to experience the financial stress resulting from economic recession. Socioeconomic conditions at the societal and individual level are important targets when aiming to reduce rates of smoking during pregnancy.
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Affiliation(s)
- Eleonora P Uphoff
- Bradford Institute for Health Research, Temple Bank House, Bradford Royal Infirmary, Duckworth Lane, Bradford, UK.,Department of Health Sciences, Seebohm Rowntree Building, University of York, Heslington, York, UK
| | - Neil Small
- Faculty of Health Studies, University of Bradford, Bradford, UK
| | - Kate E Pickett
- Department of Health Sciences, Seebohm Rowntree Building, University of York, Heslington, York, UK
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Caroli D, Rosa-Rizzotto E, Pilerci C, Lobello S, De Lazzari F, Saia M. Falling Rates of Hospital Admissions for Alcoholic Liver Disease in Northeast Italy: A Retrospective Study on a Large Database. Alcohol Alcohol 2019; 54:662-666. [PMID: 31566688 DOI: 10.1093/alcalc/agz070] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 07/07/2019] [Accepted: 07/21/2019] [Indexed: 12/19/2022] Open
Abstract
AIM To describe recent trends in hospital admission rates for alcoholic liver disease (ALD) in the Veneto region of Italy. METHODS This retrospective cohort study is based on anonymous hospital discharge records (HDRs) for 2000-2017 from all public and accredited private hospitals operating within the context of the Regional (Veneto) Health Services that are conserved in National/Regional database. It examined the HDR's of all the hospitalizations of the residents of the Veneto region that were registered under an ALD diagnosis. These were classified under three subheadings: acute alcoholic hepatitis Alcoholic liver cirrhosis and 'other ALD'. RESULTS During 2000-2017, 30,089 hospital admissions (out of a total regional population of 4,900,000) were registered for ALD. Hospitalization stratified by age showed that the percentage attributable to acute alcoholic hepatitis is higher in younger age groups: 42% in 15-24-year-old (odds ratios (ORs): 14.74; CI95%: 7-30.86; P < 0.000) and 15% in the 25-44-year-old (OR: 3.51; CI95%: 3.12-3.94; P < 0.000). A longitudinal analysis of hospitalization patterns showed a 7% increase in average age in both sexes (from 58.8 ± 9.2 to 62.4 ± 9.7) and a substantial decrease (63.5%) in standardized hospitalization rates (HRs, χ2 trend: 4099.827; P < 0.000) and a smaller decrease (47%) in standardized mortality rates (χ2 trend: 89.563; P < 0.000). CONCLUSIONS The fall in the overall ALD-related HR in the Veneto region can be explained by a decrease in population alcohol consumption. Increase in the HRs for acute alcoholic hepatitis in the age group 15-44 suggests an ongoing need for strategies to prevent alcohol abuse by young people.
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Affiliation(s)
- Diego Caroli
- Gastroenterology Unit, St. Anthony Hospital, Local Health Unit 6, Padova, Italy
| | - Erik Rosa-Rizzotto
- Gastroenterology Unit, St. Anthony Hospital, Local Health Unit 6, Padova, Italy
| | | | | | - Franca De Lazzari
- Gastroenterology Unit, St. Anthony Hospital, Local Health Unit 6, Padova, Italy
| | - Mario Saia
- Medical Directorate, Local Health Unit 6, Padova, Italy
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Moreno-Lostao A, Guerras JM, Lostao L, de la Fuente L, Martínez D, Rodríguez-Artalejo F, Regidor E. Cardiovascular mortality and risk behaviours by degree of urbanization before, during and after the economic crisis in Spain. BMC Public Health 2019; 19:1109. [PMID: 31412835 PMCID: PMC6694539 DOI: 10.1186/s12889-019-7427-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 07/31/2019] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND To estimate the relationship of the degree of urbanization to cardiovascular mortality and to risk behaviours before, during and after the 2008 economic crisis in Spain. METHODS In three areas of residence - large urban areas, small urban areas and rural areas - we calculated the rate of premature mortality (0-74 years) from cardiovascular diseases before the crisis (2005-2007), during the crisis (2008-2010 and 2011-2013) and after the crisis (2014-2016), and the prevalence of risk behaviours in 2006, 2011 and 2016. In each period we estimated the mortality rate ratio (MRR) and the prevalence ratio, taking large urban areas as the reference. RESULTS In men, no significant differences were observed in mortality between the two urban areas, while the MRR in rural areas went from 0.92 [95% confidence interval, 0.90-0.94) in 2005-2007 to 0.94 (0.92-0.96) in 2014-2016. In women, no significant differences were observed in mortality between the rural and large urban areas, whereas the MRR in small urban areas decreased from 1.11 (1.08-1.14) in 2005-2007 to 1.06 (1.02-1.09) in 2014-2016. The rural areas had the lowest prevalence of smoking, obesity and physical inactivity in men, and of obesity in women. No significant differences were observed in smoking or physical inactivity by area of residence in women. CONCLUSION The pattern of cardiovascular mortality by degree of urbanization was similar before and after the crisis, although in women the excess mortality in small urban areas with respect to large urban areas was smaller after the crisis. The different pattern of risk behaviours in men and women, according to area of residence, could explain these findings.
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Affiliation(s)
- Almudena Moreno-Lostao
- National Epidemiology Center, Instituto de Salud Carlos III, Monforte de Lemos 5, 28029, Madrid, Spain.
| | - Juan M Guerras
- National Epidemiology Center, Instituto de Salud Carlos III, Monforte de Lemos 5, 28029, Madrid, Spain
| | - Lourdes Lostao
- Department of Sociology, Universidad Pública de Navarra, Pamplona, Spain
| | - Luis de la Fuente
- National Epidemiology Center, Instituto de Salud Carlos III, Monforte de Lemos 5, 28029, Madrid, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - David Martínez
- Department of Public Health & Maternal and Child Health, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain.,Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Fernando Rodríguez-Artalejo
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPaz, Madrid, Spain.,IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
| | - Enrique Regidor
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Department of Public Health & Maternal and Child Health, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain.,Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
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Díaz-Méndez C, García-Espejo I. Social Inequalities in Following Official Guidelines on Healthy Diet During the Period of Economic Crisis in Spain. INTERNATIONAL JOURNAL OF HEALTH SERVICES 2019; 49:582-605. [PMID: 31142185 DOI: 10.1177/0020731419847589] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In Spanish society, social inequalities continue in connection with diet; however, no data examines whether these inequalities altered during the period of economic crisis. This article aims to analyze trends in inequalities related to adherence to government guidelines concerning healthy diet during the period of economic crisis based on the data obtained from the National Health Surveys conducted by the National Statistics Institute. The approach involves studying first the data from the 2006 survey, shortly before the crisis, and then comparing these with the data from the 2011-2012 survey. Applying models of logistic regression shows that certain social inequalities were accentuated by the crisis. However, the general and widespread pattern of eating habits does not disappear in times of crisis. Inequalities are more commonly seen when socioeconomic factors affect foods that the guidelines indicate should be eaten daily. However, with respect to more expensive products, socioeconomic factors did not have so much negative effect on how far a healthy diet was followed because it is recommended that consumption of these foods should be limited. The results suggest that food policy should have specific focuses during times of economic recession.
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Affiliation(s)
- Cecilia Díaz-Méndez
- 1 Departamento de Sociología, Facultad de Economía y Empresa, Universidad de Oviedo, Asturias, Spain
| | - Isabel García-Espejo
- 1 Departamento de Sociología, Facultad de Economía y Empresa, Universidad de Oviedo, Asturias, Spain
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Regidor E, Albaladejo R, Mateo A, de la Fuente L, Barrio G, Ortega P. Macroeconomic fluctuations, changes in lifestyles and mortality from diabetes: a quasiexperimental study. J Epidemiol Community Health 2019; 73:317-323. [PMID: 30700493 DOI: 10.1136/jech-2018-211464] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2018] [Revised: 12/07/2018] [Accepted: 01/10/2019] [Indexed: 01/04/2023]
Abstract
BACKGROUND To evaluate trends in diabetes-related health behaviours and mortality from diabetes and other chronic diseases in the Spanish population before, during and after the 2008 economic crisis. METHODS Annual population measurements were obtained from national surveys and administrative registries for 2004-2016. Using segmented regression analysis, we calculated the annual percentage change (APC) in 2004-2007, 2008-2010, 2011-2013 and 2014-2016 in risk behaviours (smoking, alcohol consumption, obesity and meals away from home), in healthy behaviours (fruit and vegetable intake and physical activity) and in mortality rates from diabetes, cardiovascular disease and cancer. RESULTS In general, during the economic crisis (2008-2013), the Spanish population reduced risk behaviours and improved healthy behaviours as compared with the trend observed before and afterwards. Diabetes mortality decreased more during the crisis than before or afterwards. The APC in each time interval was -3.3, -3.7, -4.4 and -2.6 in all-age mortality and -2.9, -5.2, -6.7 and -1.3 in premature mortality (less than 75 years). Only in older people (≥75 years) diabetes mortality showed similar decline before and during the crisis. Mortality from cardiovascular disease also declined more during the crisis, except for all-age mortality and older people in the second part of the crisis, whereas the downward trend in cancer mortality was smaller during the crisis years. CONCLUSIONS During the 6 years of the economic crisis in Spain, the favourable changes in health behaviours were accompanied by an important reduction in diabetes mortality in the population.
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Affiliation(s)
- Enrique Regidor
- Department of Public Health & Maternal and Child Health, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Romana Albaladejo
- Department of Public Health & Maternal and Child Health, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - Alberto Mateo
- School of Public Health, Health Education North West, Manchester, UK.,National Epidemiology Center, Instituto de Salud Carlos III, Madrid, Spain
| | - Luis de la Fuente
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,National Epidemiology Center, Instituto de Salud Carlos III, Madrid, Spain
| | - Gregorio Barrio
- National School of Public Health, Instituto de Salud Carlos III, Madrid, Spain
| | - Paloma Ortega
- Department of Public Health & Maternal and Child Health, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain.,Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
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Koritala BSC, Çakmaklı S. The human circadian clock from health to economics. Psych J 2018; 7:176-196. [DOI: 10.1002/pchj.252] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 09/13/2018] [Accepted: 09/19/2018] [Indexed: 12/18/2022]
Affiliation(s)
- Bala S. C. Koritala
- Department of Biology; Rutgers, The State University of New Jersey; Camden New Jersey USA
- Center for Computational and Integrative Biology; Rutgers, The State University of New Jersey; Camden New Jersey USA
| | - Selim Çakmaklı
- Department of Economics; Rutgers, The State University of New Jersey; Camden New Jersey USA
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Ketilsdottir A, Ingadottir B, Jaarsma T. Self-reported health and quality of life outcomes of heart failure patients in the aftermath of a national economic crisis: a cross-sectional study. ESC Heart Fail 2018; 6:111-121. [PMID: 30338668 PMCID: PMC6351898 DOI: 10.1002/ehf2.12369] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 09/03/2018] [Accepted: 09/06/2018] [Indexed: 11/07/2022] Open
Abstract
AIMS There are indications that economic crises can affect public health. The aim of this study was to describe characteristics, health status, and socio-economic status of outpatient heart failure (HF) patients several years after a national economic crisis and to assess whether socio-economic factors were associated with patient-reported outcome measures (PROMs). METHODS AND RESULTS In this cross-sectional survey, PROMs were measured with seven validated instruments, as follows: self-care (the 12-item European Heart Failure Self-Care Behaviour scale), HF-related knowledge (Dutch Heart Failure Knowledge Scale), symptoms (Edmonton Symptom Assessment System), sense of security (Sense of Security in Care-'Patients' evaluation'), health status (EQ-5D visual analogue scale), health-related quality of life (HRQoL) (Kansas City Cardiomyopathy Questionnaire), and anxiety and depression (Hospital Anxiety and Depression Scale). Additional data were collected on access and use of health care, household income, demographics, and clinical status. The patients' (n = 124, mean age 73 ± 14.9, 69% male) self-care was low for exercising (53%) and weight monitoring (50%) but optimal for taking medication (100%). HF-specific knowledge was high (correct answers 12 out of 15), but only 38% knew what to do when symptoms worsened suddenly. Patients' sense of security was high (>70% had a mean score of 5 or 6, scale 1-6). The most common symptom was tiredness (82%); 12% reported symptoms of anxiety, and 18% had symptoms of depression. Patients rated their overall health (EQ-5D) on average at 65.5 (scale 0-100), and 33% had poor or very bad HRQoL. The monthly income per household was <€3900 for 84% of the patients. A total of 22% had difficulties making appointments with a general practitioner (GP), and 5% had no GP. On average, patients paid for six health care-related items, and >90% paid for medications, primary care, and visits to hospital and private clinics out of their own pocket. The cost of health care had changed for 71% of the patients since the 2008 economic crisis, and increased out-of-pocket costs were most often explained by a greater need for health care services and medication expenses. There was no significant difference in PROMs related to changes in out-of-pocket expenses after the crisis, income, or whether patients lived alone or with others. CONCLUSIONS This Icelandic patient population reported similar health-related outcomes as have been previously reported in international studies. This study indicates that even after a financial crisis, most of the patients have managed to prioritize and protect their health even though a large proportion of patients have a low income, use many health care resources, and have insufficient access to care. It is imperative that access and affordable health care services are secured for this vulnerable patient population.
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Affiliation(s)
- Audur Ketilsdottir
- Department of Medical Services, Landspitali University Hospital, Reykjavik, Iceland.,Faculty of Nursing, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Brynja Ingadottir
- Faculty of Nursing, School of Health Sciences, University of Iceland, Reykjavik, Iceland.,Department of Surgical Services, Landspitali University Hospital, Reykjavik, Iceland
| | - Tiny Jaarsma
- Division of Nursing Science, Department of Social and Welfare Studies, Faculty of Medicine and Health Sciences, Linköping University, Sweden
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Heggebø K, Tøge AG, Dahl E, Berg JE. Socioeconomic inequalities in health during the Great Recession: A scoping review of the research literature. Scand J Public Health 2018; 47:635-654. [DOI: 10.1177/1403494818801637] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Aims: The so-called ‘Great Recession’ in Europe triggered widespread concerns about population health, as reflected by an upsurge in empirical research on the health impacts of the economic crisis. A growing body of empirical studies has also been devoted to socioeconomic inequalities in health during the Great Recession. The aim of the current study is to summarise this health inequality literature by means of a scoping review. Methods: We have performed a scoping review of the research literature (English language) published in the years 2012–2017. Only empirical papers with (a) health status measured on the individual level, (b) information on socioeconomic position (i.e. employment status, educational level, income/wealth, and/or occupational class), and (c) data from European countries in both pre- and post-crisis years were considered relevant. In total, 49 empirical studies fulfilled these inclusion criteria. Results: The empirical findings in the 49 included studies predominantly show that socioeconomic inequalities in health either increased or remained stable from pre- to post-crisis years. Two-thirds (65%) of the studies found evidence of either increasing or partially increasing health inequalities. Thus, people in lower socioeconomic strata fared worse overall in terms of health during the Great Recession, compared to people with higher socioeconomic status. Conclusions: The Great Recession in Europe tends to be followed by increasing socioeconomic inequalities in health. Policymakers should take note of this finding. Widening socioeconomic inequalities in health is a major cause of concern, in particular if health deterioration among ‘vulnerable groups’ is caused by accelerating cumulative disadvantages.
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Affiliation(s)
| | - Anne Grete Tøge
- Work Research Institute (AFI), Oslo Metropolitan University, Norway
| | - Espen Dahl
- Department of Social Work, Child Welfare and Social Policy, Oslo Metropolitan University, Norway
| | - John Erik Berg
- Department of Occupational Therapy, Oslo Metropolitan University, Norway
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Beleche T, Cintina I. Fracking and risky behaviors: Evidence from Pennsylvania. ECONOMICS AND HUMAN BIOLOGY 2018; 31:69-82. [PMID: 30170297 DOI: 10.1016/j.ehb.2018.08.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Revised: 06/29/2018] [Accepted: 08/06/2018] [Indexed: 06/08/2023]
Abstract
In the past decade, the technological developments in the oil and natural gas extraction industry made the extraction of shale gas economically feasible and prompted local economic booms across the US. Anecdotal evidence suggests that areas with unconventional gas development experience a disproportionate increase in the young male population who are more likely to be involved in risk-taking behavior. Moreover, the sudden income gains or demographic shifts might increase the demand for various goods and services, including entertainment and illegal activities provided by the adult entertainment industry. We investigate the relationship between unconventional gas development and a variety of risk-taking outcomes such as sexually transmitted infections, and prostitution-related arrests. Our identification strategy exploits the variation in shale gas or unconventional well drilling across time and counties in conjecture with a number of datasets that allow us to investigate the potential mechanisms. Our findings indicate that Pennsylvania counties with fracking activities have higher rates of gonorrhea and chlamydia infections (7.8% and 2.6%, respectively), as well as higher prostitution related arrests (19.7%). We posit that changes in the labor market and associated impacts to income or composition of workers may play a role in the estimated effects, but we do not find evidence in support of these hypotheses.
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Affiliation(s)
- Trinidad Beleche
- Food and Drug Administration (FDA), 10903 New Hampshire Ave, Silver Spring, MD 20993, United States.
| | - Inna Cintina
- The Lewin Group, 3130 Fairview Park Drive # 500, Falls Church, VA 22042, United States.
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Boyce CJ, Delaney L, Wood AM. The Great Recession and subjective well-being: How did the life satisfaction of people living in the United Kingdom change following the financial crisis? PLoS One 2018; 13:e0201215. [PMID: 30157180 PMCID: PMC6114278 DOI: 10.1371/journal.pone.0201215] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Accepted: 07/11/2018] [Indexed: 11/18/2022] Open
Abstract
The financial crisis of 2007/08 precipitated a severe global economic downturn, typically referred to as the Great Recession. However, in the United Kingdom this period has been marked by limited change in national indicators of subjective well-being. We assessed the life satisfaction change in response to the Great Recession in a sample of British adults (N = 8,661). We first show that on average the life satisfaction change across the sample was limited. However, average effects may mask substantial amounts of heterogeneity in the data. We therefore explore beyond this average effect to determine whether there were disproportionate changes (losses and gains) in life satisfaction in key sub-groups of the population. We found that individuals experiencing unemployment, who lost income, were sick or disabled, experienced the greatest well-being reductions. Contrastingly the life satisfaction of many individuals did not greatly change following the Great Recession and for some it may have even improved. Our work highlights vulnerable groups that may need additional help during recession periods and also cautions against the over reliance on average measures of well-being.
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Affiliation(s)
- Christopher J. Boyce
- Behavioural Science Centre, Stirling Management School, University of Stirling, Stirling, Scotland
| | - Liam Delaney
- Behavioural Science Centre, Stirling Management School, University of Stirling, Stirling, Scotland
- UCD Geary Institute, University College Dublin, Bellfield, Dublin, Ireland
| | - Alex M. Wood
- Behavioural Science Centre, Stirling Management School, University of Stirling, Stirling, Scotland
- School of Psychological Sciences, University of Manchester, Manchester, England
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Lersch PM, Jacob M, Hank K. Long-term Health Consequences of Adverse Labor Market Conditions at Time of Leaving Education: Evidence from West German Panel Data. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2018; 59:151-168. [PMID: 29303619 DOI: 10.1177/0022146517749848] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Using longitudinal survey data from the Socio-Economic Panel Study ( N = 3,003 respondents with 22,165 individual-year observations) and exploiting temporal and regional variation in state-level unemployment rates in West Germany, we explore differences in trajectories of individuals' self-rated health over a period of up to 23 years after leaving education under different regional labor market conditions. We find evidence for immediate positive effects of contextual unemployment when leaving education on individuals' health. We find no evidence for generally accelerated or decelerated health deterioration when leaving education in high-unemployment contexts. We find, however, that individual unemployment experience when leaving education is associated with worse health and with more accelerated health deterioration in high-unemployment contexts. The cumulative experience of unemployment after leaving education does not mediate the influence of early labor market experiences for long-term health outcomes. In addition, our analyses indicate no gender differences in these results.
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Socio-economic differences in the change of fruit and vegetable intakes among Dutch adults between 2004 and 2011: the GLOBE study. Public Health Nutr 2018; 21:1704-1716. [DOI: 10.1017/s1368980017004219] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractObjectiveTo investigate socio-economic differences in changes in fruit and vegetable intake between 2004 and 2011 and explore the mediating role of financial barriers in this change.DesignRespondents completed a self-reported questionnaire in 2004 and 2011, including questions on fruit and vegetable intake (frequency per week), indicators of socio-economic position (education, income) and perceived financial barriers (fruits/vegetables are expensive, financial distress). Associations were analysed using ordinal logistic regression. The mediating role of financial barriers in the association between socio-economic position and change in fruit and vegetable intake was studied with the Baron and Kenny approach.SettingLongitudinal GLOBE study.SubjectsA total of 2978 Dutch adults aged 25–75 years.ResultsRespondents with the lowest income in 2004 were more likely to report a decrease in intake of cooked vegetables (P-trend<0·001) and raw vegetables (P-trend<0·001) between 2004 and 2011, compared with those with the highest income level. Respondents with the lowest education level in 2004 were more likely to report a decrease in intake of fruits (P-trend=0·021), cooked vegetables (P-trend=0·033), raw vegetables (P-trend<0·001) and fruit juice (P-trend=0·027) between 2004 and 2011, compared with those with the highest education level. Financial barriers partially mediated the association between income and education and the decrease in fruit and cooked vegetable intake between 2004 and 2011.ConclusionsThese results show a widening of relative income and educational differences in fruit and vegetable intake between 2004 and 2011. Financial barriers explained a small part of this widening.
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Di Pietro G. Revisiting the impact of macroeconomic conditions on health behaviours. ECONOMICS AND HUMAN BIOLOGY 2018; 28:173-181. [PMID: 29153871 DOI: 10.1016/j.ehb.2017.11.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 10/24/2017] [Accepted: 11/06/2017] [Indexed: 06/07/2023]
Abstract
This paper estimates the average population effect of macroeconomic conditions on health behaviours accounting for the heterogeneous impact of the business cycle on individuals. While previous studies use models relying on area-specific unemployment rates to estimate this average effect, this paper employs a model based on area-specific unemployment rates by gender and age group. The rationale for breaking down unemployment rates is that the severity of cyclical upturns and downturns does not only significantly vary across geographical areas, but also across gender and age. The empirical analysis uses microdata from the Italian Multipurpose Household Survey on Everyday Life Issues. The estimates suggest that models employing aggregated and disaggregated unemployment rate measures as a proxy for the business cycle produce similar findings for some health behaviours (such as smoking), whereas different results are obtained for others. While using unemployment rates by gender and age group, fruits and/or vegetables consumption turns out to be procyclical (a 1pp increase in this unemployment rate decreases the probability of consuming at least five daily fruit and/or vegetable servings by 0.0016pp), the opposite effect, though statistically insignificant, is observed once general unemployment rates are used. While both models conclude that physical activity declines during economic downturns, the size of the procyclical effect is much smaller when employing disaggregated rather than aggregated unemployment rates (a 1pp increase in the unemployment rate by gender and age group decreases the probability of doing any physical activity by 0.0017pp).
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Affiliation(s)
- Giorgio Di Pietro
- Westminster Business School, Department of Economics and Quantitative Methods, 35 Marylebone Road, London NW1 5LS, United Kingdom; IZA, Schaumburg-Lippe-Straße 5-9, 53113 Bonn, Germany.
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Colombo E, Rotondi V, Stanca L. Macroeconomic conditions and health: Inspecting the transmission mechanism. ECONOMICS AND HUMAN BIOLOGY 2018; 28:29-37. [PMID: 29197240 DOI: 10.1016/j.ehb.2017.11.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Revised: 10/12/2017] [Accepted: 11/17/2017] [Indexed: 06/07/2023]
Abstract
We study the relationship between macroeconomic conditions and self-reported health in a large sample of Italian individuals, focusing on the mediating role played by health behaviors (smoking, alcohol consumption, physical activity, eating habits) and economic stress. Our findings indicate that, overall, higher local unemployment is negatively related to individuals' health conditions. A one percentage point increase in the province-level unemployment rate is associated with a significant increase in the probability of experiencing diabetes (0.03 percentage points), infarction (0.01), ulcer (0.06), cirrhosis (0.01) and nervous disorders (0.07), with a time lag that differs across individual health conditions. Employment status and educational level play a significant role as moderators of these relationships. Eating habits, in addition to economic stress, play a key role as mediators, by enhancing the negative relationship between macroeconomic conditions and health outcomes, while physical exercise is found to play a dampening role.
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Affiliation(s)
- Emilio Colombo
- Università Cattolica del Sacro Cuore, DISEIS, Largo Gemelli 1, 20123 Milano, Italy.
| | - Valentina Rotondi
- Bocconi University, Dondena Centre for Research on Social Dynamics and Public Policy, Italy.
| | - Luca Stanca
- University of Milan Bicocca, Department of Economics Management and Statistics and Neuro-MI, Piazza dell'Ateneo Nuovo 1, 20126 Milan, Italy.
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Kotsiou OS, Zouridis S, Kosmopoulos M, Gourgoulianis KI. Impact of the financial crisis on COPD burden: Greece as a case study. Eur Respir Rev 2018; 27:27/147/170106. [PMID: 29367410 DOI: 10.1183/16000617.0106-2017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Accepted: 10/16/2017] [Indexed: 11/05/2022] Open
Abstract
Poverty and low socioeconomic status have been associated with chronic obstructive pulmonary disease (COPD). The current financial crisis has forced millions back into poverty. Greece is one of the countries hit the hardest, and is in the middle of a deep ongoing collapse. There have been early reports stating the apparent effects of the Greek downturn on respiratory health. This review summarises the overall impact of the financial crisis on COPD burden throughout the period of economic downturn by analysing the case study of Greece. In all levels of the healthcare system, current economic restrictions have reduced the capacity to prevent, diagnose and treat COPD in parallel with current higher detection rates of COPD. Remarkably, expenditure on healthcare has been reduced by >25%, resulting in major healthcare equipment shortages. Lower wages (by up to 20%) and higher co-payments of up to 25% of a drug's purchase price have led to patients struggling to afford inhaled medications. Treatment nonadherence has been reported, resulting in 11.5% more exacerbations and 14.1% more hospitalisations annually, while the mean cost per severe COPD exacerbation has been approximated as €2600. Greece is a noteworthy example illustrating how COPD burden, quality of care and patients' outcome can be affected by economic crisis.
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Affiliation(s)
- Ourania S Kotsiou
- Dept of Respiratory Medicine, Faculty of Medicine, University of Thessaly, BIOPOLIS, Larissa, Greece
| | - Spyridon Zouridis
- Faculty of Medicine, National and Kapodistrian University of Athens, Panepistimiopolis, Athens, Greece
| | - Marinos Kosmopoulos
- Faculty of Medicine, National and Kapodistrian University of Athens, Panepistimiopolis, Athens, Greece
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Nguyen HT, Connelly LB. Out of sight but not out of mind: Home countries' macroeconomic volatilities and immigrants' mental health. HEALTH ECONOMICS 2018; 27:189-208. [PMID: 28618448 DOI: 10.1002/hec.3532] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Revised: 04/19/2017] [Accepted: 04/28/2017] [Indexed: 06/07/2023]
Abstract
We provide the first empirical evidence that better economic performances by immigrants' countries of origin, as measured by lower consumer price index (CPI) or higher gross domestic product, improve immigrants' mental health. We use an econometrically-robust approach that exploits exogenous changes in macroeconomic conditions across immigrants' home countries over time and controls for immigrants' observable and unobservable characteristics. The CPI effect is statistically significant and sizeable. Furthermore, the CPI effect diminishes as the time since emigrating increases. By contrast, home countries' unemployment rates and exchange rate fluctuations have no impact on immigrants' mental health.
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Affiliation(s)
- Ha Trong Nguyen
- Bankwest Curtin Economics Centre, Curtin University, Perth, WA, Australia
| | - Luke Brian Connelly
- Centre for the Business and Economics of Health, The University of Queensland, St Lucia, Australia
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van den Berg GJ, Gerdtham UG, von Hinke S, Lindeboom M, Lissdaniels J, Sundquist J, Sundquist K. Mortality and the business cycle: Evidence from individual and aggregated data. JOURNAL OF HEALTH ECONOMICS 2017; 56:61-70. [PMID: 28968530 PMCID: PMC6690392 DOI: 10.1016/j.jhealeco.2017.09.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Revised: 07/17/2017] [Accepted: 09/10/2017] [Indexed: 05/12/2023]
Abstract
There has been much interest recently in the relationship between economic conditions and mortality, with some studies showing that mortality is pro-cyclical, while others find the opposite. Some suggest that the aggregation level of analysis (e.g. individual vs. regional) matters. We use both individual and aggregated data on a sample of 20-64 year-old Swedish men from 1993 to 2007. Our results show that the association between the business cycle and mortality does not depend on the level of analysis: the sign and magnitude of the parameter estimates are similar at the individual level and the aggregate (county) level; both showing pro-cyclical mortality.
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Affiliation(s)
- Gerard J van den Berg
- School of Economics, Finance and Management, University of Bristol, Bristol, United Kingdom; The Institute for Evaluation of Labour Market and Education Policy (IFAU), Uppsala, Sweden
| | - Ulf-G Gerdtham
- Health Economics Unit, Department of Clinical Sciences, Malmö, Lund University, Sweden; Department of Economics, Lund University, Lund, Sweden; Centre for Economic Demography, Lund University, Lund, Sweden
| | - Stephanie von Hinke
- School of Economics, Finance and Management, University of Bristol, Bristol, United Kingdom
| | - Maarten Lindeboom
- School of Business and Economics, Vrije University Amsterdam, Amsterdam, Netherlands
| | - Johannes Lissdaniels
- Health Economics Unit, Department of Clinical Sciences, Malmö, Lund University, Sweden; The Swedish Agency for Health and Care Services Analysis, Stockholm, Sweden.
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Ásgeirsdóttir TL, Jóhannsdóttir HM. Income-related inequalities in diseases and health conditions over the business cycle. HEALTH ECONOMICS REVIEW 2017; 7:12. [PMID: 28275988 PMCID: PMC5342994 DOI: 10.1186/s13561-017-0150-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Accepted: 02/27/2017] [Indexed: 05/19/2023]
Abstract
How business cycles affect income-related distribution of diseases and health disorders is largely unknown. We examine how the prevalence of thirty diseases and health conditions is distributed across the income spectrum using survey data collected in Iceland in 2007, 2009 and 2012. Thus, we are able to take advantage of the unusually sharp changes in economic conditions in Iceland during the Great Recession initiated in 2008 and the partial recovery that had already taken place by 2012 to analyze how income-related health inequality changed across time periods that can be described as a boom, crisis and recovery. The concentration curve and the concentration index are calculated for each disease, both overall and by gender. In all cases, we find a considerable income-related health inequality favoring higher income individuals, with a slight increase over the study period. Between 2007 and 2009, our results indicate increased inequality for women but decreased inequality for men. Between 2009 and 2012 on the contrary, men's inequality increases but women's decreases. The overarching result is thus that the economic hardship of the crisis temporarily increased female income-related health inequality, but decreased that of men.
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Birgisdóttir KH, Jónsson SH, Ásgeirsdóttir TL. Economic conditions, hypertension, and cardiovascular disease: analysis of the Icelandic economic collapse. HEALTH ECONOMICS REVIEW 2017; 7:20. [PMID: 28536969 PMCID: PMC5442036 DOI: 10.1186/s13561-017-0157-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Accepted: 05/15/2017] [Indexed: 06/07/2023]
Abstract
Previous research has found a positive short-term relationship between the 2008 collapse and hypertension in Icelandic males. With Iceland's economy experiencing a phase of economic recovery, an opportunity to pursue a longer-term analysis of the collapse has emerged. Using data from a nationally representative sample, fixed-effect estimations and mediation analyses were performed to explore the relationship between the Icelandic economic collapse in 2008 and the longer-term impact on hypertension and cardiovascular health. A sensitivity analysis was carried out with pooled logit models estimated as well as an alternative dependent variable. Our attrition analysis revealed that results for cardiovascular diseases were affected by attrition, but not results from estimations on the relationship between the economic crisis and hypertension. When compared to the boom year 2007, our results point to an increased probability of Icelandic women having hypertension in the year 2012, when the Icelandic economy had recovered substantially from the economic collapse in 2008. This represents a deviation from pre-crisis trends, thus suggesting a true economic-recovery impact on hypertension.
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Affiliation(s)
| | - Stefán Hrafn Jónsson
- Faculty of Social and Human Sciences, University of Iceland, Oddi v/Sturlugotu, 101 Reykjavik, Iceland
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Kronenberg C, Jacobs R, Zucchelli E. The impact of the UK National Minimum Wage on mental health. SSM Popul Health 2017; 3:749-755. [PMID: 29349261 PMCID: PMC5769093 DOI: 10.1016/j.ssmph.2017.08.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 08/11/2017] [Accepted: 08/17/2017] [Indexed: 11/28/2022] Open
Abstract
Despite an emerging literature, there is still sparse and mixed evidence on the wider societal benefits of Minimum Wage policies, including their effects on mental health. Furthermore, causal evidence on the relationship between earnings and mental health is limited. We focus on low-wage earners, who are at higher risk of psychological distress, and exploit the quasi-experiment provided by the introduction of the UK National Minimum Wage (NMW) to identify the causal impact of wage increases on mental health. We employ difference-in-differences models and find that the introduction of the UK NMW had no effect on mental health. Our estimates do not appear to support earlier findings which indicate that minimum wages affect mental health of low-wage earners. A series of robustness checks accounting for measurement error, as well as treatment and control group composition, confirm our main results. Overall, our findings suggest that policies aimed at improving the mental health of low-wage earners should either consider the non-wage characteristics of employment or potentially larger wage increases.
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Affiliation(s)
- Christoph Kronenberg
- CINCH-Health Economics Research Center, University of Duisburg-Essen, Germany
- RWI – Leibniz-Institut für Wirtschaftsforschung, Germany
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The consequences of unemployment on diet composition and purchase behaviour: a longitudinal study from Denmark. Public Health Nutr 2017; 21:580-592. [PMID: 29115198 DOI: 10.1017/s136898001700266x] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To explore and describe quantitatively the effect over time of unemployment on food purchase behaviour and diet composition. DESIGN Longitudinal data from 2008-2012, with monthly food purchase data aligned with register data on unemployment measured as a dichotomous indicator as well as a trend accounting for the duration. SETTING A household panel which registers daily food purchases combined with detailed nutritional information and registration of the duration of unemployment at individual level. The structure of the data set facilitates the detection of effects or associations between duration of unemployment and diet composition, purchase behaviour in terms of food expenditure, and share of food purchased on offer and in discounters while controlling for important confounding factors. SUBJECTS Danish households of working age (n 3440) adjusted to household equivalents. We use fixed-effects econometric methods to control for unobserved heterogeneity. RESULTS In the short run, unemployment led to substitution in favour of discount stores and increases in food expenditure and in consumption of saturated fat, total fat and protein due to increased consumption of animal-based foods. In the medium run food expenditure declined together with consumption of fresh animal-based foods and saturated fat, total fat and protein. In the even longer run these nutrients were substituted by carbohydrates and added sugar. CONCLUSIONS Unemployment has a substantial influence on diet composition, but effects vary with duration of the unemployment period, which may have potential health implications. This ought to be taken into consideration in evaluations of existing reforms and in future reforms of welfare systems.
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Sigursteinsdóttir H, Rafnsdóttir GL, Jónsdóttir GA. Changes in occupational mental and physical health and health symptoms during the economic recession. Work 2017; 56:603-615. [PMID: 28372340 DOI: 10.3233/wor-172523] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND In 2008, many Western countries faced a great economic recession, the result of which was increased unemployment and reduced public expenditure. OBJECTIVE This article focuses on changes in the self-reported mental and physical health and health symptoms of the remaining employees of Icelandic municipalities who worked within the educational system and the care service during the economic recession. We examine gender differences in health and differences between downsized workplaces and workplaces where no downsizing occurred and differences between workplaces with heavy workload and light workload. METHODS The study is based on a balanced panel online survey and focus groups. RESULTS The main finding is that both the mental and physical health of employees deteriorated year by year between 2010, 2011 and 2013 in all workplaces although the downsized workplaces and workplaces with heavy workloads fared worse. At the same time, public expenditure on the health care system was reduced. CONCLUSIONS We hope that our results encourage further studies in the field and that they will be taken into account when dealing with prevention and rehabilitation initiatives.
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Mattei G, De Vogli R, Ferrari S, Pingani L, Rigatelli M, Galeazzi GM. Impact of the economic crisis on health-related behaviors in Italy. Int J Soc Psychiatry 2017; 63:649-656. [PMID: 28831854 DOI: 10.1177/0020764017726097] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Evidence exists supporting the impact of the Great Recession on health-related behaviors internationally, though few studies are available concerning the Italian population. AIM To assess the impact of the late 2000s economic crisis on health-related behaviors linked to population mental health in Italy. METHODS Descriptive study. Health indicators came from the Italian Institute of Statistics database (years 2000-2015). Statistics performed by means of linear regression models. RESULTS Increased smokers (β = 1.68, p = .03), heavy smokers, that is, people smoking 11-20 cigarettes per day (β = 2.18, p = .04) or more than 20 cigarettes per day (β = 1.04, p < .01) and mean number of smoked cigarettes per day (β = 0.56, p = .02) were noticeable. Also, prevalence of overweight increased (β = 0.91, p = .04), while the Italian families' expenditure for alcoholic beverages decreased (β = -812.80, p = .01). Alcohol consumption decreased (β = -0.60, p < .01), especially in men (β = -0.95, p < .01); binge drinking increased in years 2009-2010. No change was noticeable in the diet indicators collected. CONCLUSION The economic crisis may have increased smoking, overweight and binge drinking in Italy (though data on the latter phenomenon are not conclusive), and reduced overall alcohol consumption.
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Affiliation(s)
- Giorgio Mattei
- 1 Section of Psychiatry, Department of Diagnostics, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy.,4 Association for Research in Psychiatry, Castelnuovo Rangone (Modena), Italy
| | - Roberto De Vogli
- 2 Department of Developmental Psychology and Socialization, University of Padua, Padua, Italy
| | - Silvia Ferrari
- 1 Section of Psychiatry, Department of Diagnostics, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | | | - Marco Rigatelli
- 1 Section of Psychiatry, Department of Diagnostics, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Gian Maria Galeazzi
- 1 Section of Psychiatry, Department of Diagnostics, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy
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Paling T, Vall Castello J. Business cycle impacts on substance use of adolescents: A multi-country analysis. ECONOMICS AND HUMAN BIOLOGY 2017; 27:1-11. [PMID: 28472713 DOI: 10.1016/j.ehb.2017.04.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Revised: 04/05/2017] [Accepted: 04/18/2017] [Indexed: 06/07/2023]
Abstract
Populations respond to changes in the economic climate in a variety of ways. The recent 'Great Recession' has brought attention to the vulnerability of many economies around the world to changes in non-domestic macroeconomic fluctuations. However, empirical evidence on the responses of adolescents' substance consumption behaviour when the economy deteriorates is very scarce. Thus, the focus of this paper is to analyse the substance consumption patterns displayed by adolescents in response to changes in macroeconomic conditions in a large number of countries. Our results show that beer and wine consumption vary counter-cyclically (a 1pp increase in the unemployment rate increases the probability of drinking beer (wine) by 3% (5.5%)) while adolescent smoking prevalence varies pro-cyclically (a 1pp increase in the unemployment rate decreases the probability of being a current smoker by 3.8%). More importantly, we find that the probability of ever being drunk increases by 1.3% for a 1pp increase in the unemployment rate. Further to this, substantial heterogeneous effects from the aggregate-level results were found when analysing a variety of demographic and geographic dimensions. In light of the existing empirical evidence which outlines that early substance initiators demonstrate worse neurological deficits and suffer stronger labour market penalties (compared to later initiators or abstainers) these findings can aid policy makers in reducing these lasting adverse outcomes.
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Affiliation(s)
| | - Judit Vall Castello
- Centre for Research in Health and Economics, Universitat Pompeu Fabra, Ramon Trias Fargas 25-27, Barcelona, Spain.
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