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Guccio C, Pignataro G, Vidoli F. It never rains but it pours: Austerity and mortality rate in peripheral areas. ECONOMICS AND HUMAN BIOLOGY 2024; 54:101408. [PMID: 38861882 DOI: 10.1016/j.ehb.2024.101408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 05/29/2024] [Accepted: 05/31/2024] [Indexed: 06/13/2024]
Abstract
This study examines the impact of austerity measures on mortality rates across Italian regions from 2003 to 2018. Since 2007, regions experiencing substantial healthcare financial deficits have been required to implement recovery plans (RPs). We use a recent difference-in-differences staggered matching estimator to assess the effects of this austerity policy on municipal-level monthly mortality rates. This allows us to evaluate the policy's spatial heterogeneity across treated municipalities, accounting for their distance from the nearest hospital. The analysis reveals a significant negative impact of austerity measures on health, particularly in peripheral areas and among vulnerable populations. Mortality rates are higher in regions under RPs, with this effect escalating with increasing distance from hospitals. The policy's impact is also more pronounced among vulnerable populations, with differences observed between genders and across seasons.
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Affiliation(s)
- C Guccio
- University of Catania, Department of Economics and Business, Corso Italia, 55, Catania, 95129, CT, Italy
| | - G Pignataro
- University of Catania, Department of Economics and Business, Corso Italia, 55, Catania, 95129, CT, Italy; Politecnico di Milano, Department of Management, Economics and Industrial Engineering, Via Raffaele Lambruschini, 4/B, Milano, 20156, MI, Italy
| | - F Vidoli
- University of Urbino Carlo Bo, Department of Economics, Society and Politics, Via Aurelio Saffi, 42, Urbino, 61029, PU, Italy.
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Lowenstein C. "Deaths of despair" over the business cycle: New estimates from a shift-share instrumental variables approach. ECONOMICS AND HUMAN BIOLOGY 2024; 53:101374. [PMID: 38518546 PMCID: PMC11060774 DOI: 10.1016/j.ehb.2024.101374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 01/31/2024] [Accepted: 03/10/2024] [Indexed: 03/24/2024]
Abstract
This study presents new evidence of the effects of short-term economic fluctuations on suicide, fatal drug overdose, and alcohol-related mortality among working-age adults in the United States from 2003-2017. Using a shift-share instrumental variables approach, I find that a one percentage point increase in the aggregate employment rate decreases current-year non-drug suicides by 1.7 percent. These protective effects are concentrated among working-age men and likely reflect a combination of individual labor market experiences as well as the indirect effects of local economic growth. I find no consistent evidence that short-term business cycle changes affect drug or alcohol-related mortality. While the estimated protective effects are small relative to secular increases in suicide in recent decades, these findings are suggestive of important, short-term economic factors affecting specific causes of death and should be considered alongside the longer-term and multifaceted social, economic, and cultural determinants of America's "despair" epidemic.
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Affiliation(s)
- Christopher Lowenstein
- University of California, Berkeley School of Public Health, Division of Health Policy and Management, 2121 Berkeley Way, Room 5302, Berkeley, CA 94720, United States.
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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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Kort I, Belhaj A, Kebsi D, Gharbaoui M, Bellali M, Allouche M. A 13-Year Study of Fatal Falls From Height in Northern Tunisia. Am J Forensic Med Pathol 2022; 43:340-346. [PMID: 35642789 DOI: 10.1097/paf.0000000000000769] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Falls from height are a major cause of unintentional injury death, resulting in high disability and mortality. We investigated the characteristics of fatal falls and their relationship with intentionality, injury patterns, and death on impact. MATERIALS AND METHODS In this retrospective study, we examined 545 cases of fatal falls from height that underwent autopsy in the forensic department of the Charles Nicolle hospital of Tunis (Tunisia) between January 2008 and December 2020. Cases were reviewed in terms of demographics, fall characteristics, and autopsy findings. RESULTS The population was predominately male (86.6%). Four hundred twenty-one (77.3%) originated from accidents, 120 (22%) were found to be suicidal, with 4 homicide cases. A notable decline in cases was noticed following the Jasmine revolution, 2011 (R squared = 0.8). The mean height of falls was 8 m. Higher falls were associated with a set of organ-specific injuries. Organ injury pattern did not differ based on intentionality. Female victims were 2.4 times more likely to sustain pelvic injuries than males. The majority of victims deceased before reaching health care structures. Death on impact was strongly associated with higher falls, cranial impact, and organ-specific injuries, including cardiac, pulmonary, and skull injuries.Falls from height are in many cases preventable. A clearly defined fall safety policy, strict implementation of evidence-based interventions, efficient allocation of resources, and raising safety awareness must to be urgently implemented. CONCLUSION Understanding patterns of injury and the factors that influence death on impact may be of further interest in the prevention and management of survivors in the acute period.
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Affiliation(s)
- Ikram Kort
- From the Department of Forensic Medicine, Charles Nicolle University Hospital, Tunis, Tunisia
| | - Azza Belhaj
- From the Department of Forensic Medicine, Charles Nicolle University Hospital, Tunis, Tunisia
| | - Dhouha Kebsi
- From the Department of Forensic Medicine, Charles Nicolle University Hospital, Tunis, Tunisia
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Salinari G, Benassi F. The long-term effect of the Great Recession on European mortality. JOURNAL OF POPULATION RESEARCH 2022; 39:417-439. [PMID: 35966415 PMCID: PMC9358630 DOI: 10.1007/s12546-022-09290-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2022] [Indexed: 12/03/2022]
Abstract
Some European countries, such as Greece and Spain, were severely hit by the 2008 economic crisis whereas others, such as Germany, were practically spared by it. This divergence allowed us to implement a difference in differences research design which offered the possibility to observe the long-lasting effects produced by the crisis on European life expectancy. Our analysis—based on Eurostat data from 2001 to 2019—shows that life expectancy increased faster, after the onset of the crisis, in those countries where the rise in unemployment was more intense. Furthermore, our results show that this gain in life expectancy persisted, and sometimes further increased, until 2019 when most macro-economic variables had returned to their pre-crisis values. Previous research has identified that mortality behaves procyclically in developed countries: when the economy slows down mortality decreases and vice versa. Our findings show, by contrast, that life expectancy behaves asymmetrically: it responded to an increase but not to a decrease in unemployment. This calls for a reconsideration of the causal mechanisms linking together the economic cycle and mortality in developed countries.
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Belotti F, Kopinska J, Palma A, Piano Mortari A. Health status and the Great Recession. Evidence from electronic health records. HEALTH ECONOMICS 2022; 31:1770-1799. [PMID: 35709182 DOI: 10.1002/hec.4551] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 05/02/2022] [Accepted: 05/06/2022] [Indexed: 06/15/2023]
Abstract
We investigate the impact of the Great Recession in Italy on the incidence of chronic diseases using new individual longitudinal data from Electronic Health Records. We exploit the exogenous shock in the economic conditions occurred in 2008 to estimate heterogeneous effects of an unprecedented rise in local unemployment rates in an individual fixed-effects model. Our results document that harsh economic downturns have a negative long-lasting effect on cardiovascular disease and a temporary effect on depression. This effect is heterogeneous across gender, increases with age and is stronger right before the retirement age. An important policy recommendation emerging from this study is that prolonged economic downturns constitute an additional external risk for individual health and not a temporary benefit.
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Affiliation(s)
- Federico Belotti
- Department of Economics and Finance, University of Rome Tor Vergata, Rome, Italy
- Centre for Economic and International Studies, University of Rome Tor Vergata, Rome, Italy
| | - Joanna Kopinska
- Centre for Economic and International Studies, University of Rome Tor Vergata, Rome, Italy
- DISSE, Sapienza University of Rome, Rome, Italy
| | - Alessandro Palma
- Centre for Economic and International Studies, University of Rome Tor Vergata, Rome, Italy
- Gran Sasso Science Institute, L'Aquila, Italy
| | - Andrea Piano Mortari
- Centre for Economic and International Studies, University of Rome Tor Vergata, Rome, Italy
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Yuda M. Healthcare Utilization Under a Comprehensive Public Welfare Program: Evidence From Japan. Front Public Health 2022; 10:895679. [PMID: 35812488 PMCID: PMC9259971 DOI: 10.3389/fpubh.2022.895679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 05/25/2022] [Indexed: 11/13/2022] Open
Abstract
The public assistance system in Japan provides detailed and comprehensive livelihood support for low-income families with various needs. As one example, and the beneficiaries of the public welfare program in Japan can receive the same medical treatments as those insured of the universal public health insurance without any financial burdens. This system has greatly contributed to maintaining and improving the health of public assistance beneficiaries but may cause excessive healthcare utilization: moral hazard. This study uses a large sample taken from two nationally representative claim data for public assistance and public health insurance patients to estimate the magnitude of moral hazard effect in basic outpatient utilization. The results of the fixed-effect regression analysis utilizing the concept of pseudo panel data analysis and those of propensity score matching show that the average treatment effect of public assistance assignment on healthcare utilization is significantly positive. Specifically, public assistance assignment increases monthly healthcare expenditure by 17.5 to 22.9 percent and the monthly number of doctor visits by 23.1 to 27.8 percent, respectively. In addition, the average treatment effects on the treated are also significantly positive, suggesting that monthly healthcare expenditure significantly decreases by 22.7 to 25.0 percent and the number of visits by 27.6 to 29.7 percent, respectively, when imposing a copayment on public assistance beneficiaries. However, the estimated price elasticity based on these results is very small, approximately −0.02, indicating that the level of copayment rate has little effect on the intensive margin of outpatient healthcare utilization.
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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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Trappolini E, Marino C, Agabiti N, Giudici C, Davoli M, Cacciani L. Mortality differences between migrants and Italians residing in Rome before, during, and in the aftermath of the great recession. A longitudinal cohort study from 2001 to 2015. BMC Public Health 2021; 21:2112. [PMID: 34789200 PMCID: PMC8600794 DOI: 10.1186/s12889-021-12176-8] [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: 03/29/2021] [Accepted: 11/03/2021] [Indexed: 11/17/2022] Open
Abstract
Background In Europe, one of the most consistent findings is that of migrant mortality advantage in high-income countries. Furthermore, the literature shows that economic shocks, which bring worse health outcomes, can severely affect the most disadvantaged individuals. We analyse differences and changes in all-cause mortality between Italians and migrants residing in Rome before, during, and in the aftermath of the Great Recession (2001–2015) by birth-cohort. Methods The analysis is a longitudinal open cohort study. Mortality data come from the Register of the Causes of Death (58,637 deaths) and the population denominator (n = 2,454,410) comes from the Municipal Register of Rome. By comparing three time-periods (2001–2005, 2006–2010, and 2011–2015), we analyse all-cause mortality of Rome residents born, respectively, in the intervals 1937–1976, 1942–1981, 1947–1986 (aged 25–64 years at entry into observation). Computing birth-cohort-specific death rates and applying parametric survival models with age as the time-scale, we compare mortality differences between migrants and Italians by gender, area of origin, and time-period. Results Overall, we find a lower risk of dying for migrants than Italians regardless of gender (Women: HR = 0.61, 95% CI 0.56–0.66; Men: HR = 0.49, 95% CI 0.45–0.53), and a lower death risk over time for the total population. Nevertheless, such a pattern changes according to gender and migrants’ area of origin. Conclusion Given the relevance of international migrations in Europe, studying migrants’ health has proved increasingly important. The deterioration in migrant health and the gradual weakening of migrants’ mortality advantage is likely to become a public health issue with important consequences for the healthcare system of all European countries. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-12176-8.
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Affiliation(s)
| | - Claudia Marino
- Department of Epidemiology, Lazio Regional Health Service, Via Cristoforo Colombo, 112, 00147, Rome, Italy
| | - Nera Agabiti
- Department of Epidemiology, Lazio Regional Health Service, Via Cristoforo Colombo, 112, 00147, Rome, Italy.
| | | | - Marina Davoli
- Department of Epidemiology, Lazio Regional Health Service, Via Cristoforo Colombo, 112, 00147, Rome, Italy
| | - Laura Cacciani
- Department of Epidemiology, Lazio Regional Health Service, Via Cristoforo Colombo, 112, 00147, Rome, Italy
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Cervini-Plá M, Vall-Castelló J. Business cycle and mortality in Spain. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2021; 22:1289-1299. [PMID: 34160727 PMCID: PMC8526462 DOI: 10.1007/s10198-021-01336-7] [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: 09/16/2020] [Accepted: 06/08/2021] [Indexed: 05/25/2023]
Abstract
In the last couple of decades, there has been a lot of interest on the impact of macroeconomic fluctuations on health and mortality rates. Many studies, for different countries, find that mortality is procyclical. However, studies examining the effects of more recent recessions are less conclusive, finding mortality to be less procyclical, or even countercyclical. In this paper, using data of Spanish provinces from 1999 to 2016, we investigate how this relationship works in the context of a country that is subject to extreme business cycle fluctuations. Furthermore, we analyze the impact of unemployment for different mortality causes and we explore differences by sex, age group and level of education. In general terms, we find mortality to be procyclical so that when the economy is in a recession, mortality falls. When exploring mortality causes, we show that deaths from cardiovascular disease, cancer, senility, transport accidents and homicides are procyclical. By sex, we find procyclicality for both men and women. By age, mortality is procyclical for all age groups; however, the causes of death that result in this procyclical behavior are specific to each age group. By educational level, suicide appears as a countercyclical cause for individuals with intermediate levels of education.
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Affiliation(s)
- María Cervini-Plá
- Universitat Autònoma de Barcelona, Edifici B. Campus UAB, Bellaterra (Cerdanyola del Vallès), 08193, Barcelona, Spain.
- EQUALITAS, Madrid, Spain.
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Gusmão R, Ramalheira C, Conceição V, Severo M, Mesquita E, Xavier M, Barros H. Suicide time-series structural change analysis in Portugal (1913-2018): Impact of register bias on suicide trends. J Affect Disord 2021; 291:65-75. [PMID: 34023749 DOI: 10.1016/j.jad.2021.04.048] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 04/20/2021] [Accepted: 04/23/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Suicide is a potentially preventable cause of death. Epidemiology might help to identify death determinants and to monitor prevention strategies. Few studies address secular trends in suicide deaths, and even fewer describe trend-changes in relation to data collection/registration bias. Moreover, suicide is admittedly underreported. It is crucial to validate results in the context of other external causes of death trends, such as unintentional and undetermined intent deaths. We aimed to explore trends in suicide and other external causes of death in Portugal from the inception of registries until 2018, considering breaks in series. METHODS We collected data from all available official primary sources. We calculated cause-specific age-standardized death rates (SDR) by sex for ages equal or higher than 15 years with reference to the European Standard Population. We considered suicide (S), undetermined intent deaths (UnD), accidents (Accs), and all causes of death (ttMty). A time-series structural analysis was executed. RESULTS Suicide and other external causes of death rates were consistently higher in males than females. A global decline of deaths by suicide, undetermined intention and unintentional is observable. Breakpoints in years 1930, 1954, 1982, 2000-2001 were associated with major changes in deaths registration procedures or methodology. CONCLUSIONS The epidemiology of suicide in Portugal has changed over 106 years. However, adjusted data and consideration of bias reduce trends fluctuation. Trend changes are akin to specific changes in methodology of death registry. Suicide surveillance will improve with more reliable and stable procedures.
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Affiliation(s)
- Ricardo Gusmão
- EPIUnit - Instituto de Saúde Pública da Universidade do Porto, Rua das Taipas 135, Porto 4050-600, Portugal; Laboratory for Integrative and Translational Research in Population Health (ITR), Rua das Taipas 135, Porto 4050-600, Portugal; Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, Portugal
| | - Carlos Ramalheira
- Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, Portugal; Hospital de Cascais, Dr. José de Almeida, Portugal
| | - Virgínia Conceição
- EPIUnit - Instituto de Saúde Pública da Universidade do Porto, Rua das Taipas 135, Porto 4050-600, Portugal; Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, Portugal.
| | - Mílton Severo
- EPIUnit - Instituto de Saúde Pública da Universidade do Porto, Rua das Taipas 135, Porto 4050-600, Portugal; Laboratory for Integrative and Translational Research in Population Health (ITR), Rua das Taipas 135, Porto 4050-600, Portugal; Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, Portugal
| | - Edgar Mesquita
- EPIUnit - Instituto de Saúde Pública da Universidade do Porto, Rua das Taipas 135, Porto 4050-600, Portugal; Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, Portugal
| | - Miguel Xavier
- NOVA Medical School, New University of Lisbon, Portugal; Directorate-General of Health, Ministry of Health, Portugal
| | - Henrique Barros
- EPIUnit - Instituto de Saúde Pública da Universidade do Porto, Rua das Taipas 135, Porto 4050-600, Portugal; Laboratory for Integrative and Translational Research in Population Health (ITR), Rua das Taipas 135, Porto 4050-600, Portugal; Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, Portugal
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Ucieklak-Jeż P, Bem A. How the Labor Market Affects the Self-Perceived Health of Older Workers. The Evidence From Central and Eastern European Countries (CEECs). Front Public Health 2021; 9:655859. [PMID: 34291024 PMCID: PMC8287098 DOI: 10.3389/fpubh.2021.655859] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 06/07/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The paper aims to analyze the impact of key labor market indicators on the self-assessed health of the population of older workers (aged 55-64). Methods: Authors build the econometric models where the dependent variable is the self-perceived health status (for women and men separately). Explanatory variables are selected key indicators of the labor market, covering unemployment, including long-term, inactivity, or under-employment. The average household income is used to control the effect of wealth. Additionally, the models incorporate the variable describing the proximity of retirement. The research sample consists of nine countries of Central and Eastern Europe: Poland, Czech Republic, Slovakia, Hungary, Lithuania, Latvia, Estonia, Bulgaria, and Romania. Results and Conclusions: The study confirms that in the group of elderly workers, the perceived state of health is influenced by long-term unemployment, inactivity, and, in the case of women, time-related underemployment.
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Affiliation(s)
| | - Agnieszka Bem
- Department of Corporate and Public Finance, Wrocław University of Economics and Business, Wrocław, Poland
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13
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Gender differences in life expectancy at birth in Greece 1994–2017. JOURNAL OF POPULATION RESEARCH 2019. [DOI: 10.1007/s12546-019-09239-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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14
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Bruckner TA, Ima AM, Nguyen TT, Noymer A. Race and life expectancy in the USA in the Great Depression. GENUS 2019. [DOI: 10.1186/s41118-019-0063-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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15
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Bartoll X, Gotsens M, Marí-Dell’Olmo M, Palència L, Calvo M, Esnaola S, Borrell C. Stable socioeconomic inequalities in ischaemic heart disease mortality during the economic crisis: a time trend analysis in 2 Spanish settings. Arch Public Health 2019; 77:12. [PMID: 30918659 PMCID: PMC6419419 DOI: 10.1186/s13690-019-0339-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Accepted: 02/20/2019] [Indexed: 12/03/2022] Open
Abstract
Background Prior studies have identified a decrease in ischaemic heart disease mortality during the recent economic recession. The Spanish population was severely affected by the Great Recession, however, there is little evidence on its effects on socioeconomic inequalities in ischaemic heart disease mortality. This study examines trends in socioeconomic inequalities in mortality due to ischaemic heart disease (IHD). Methods We used linked census records with mortality registers available from the Basque Country and Barcelona city for population above 25 years, between 2001 and 04, the accelerated economic growth period of 2005–08, and 2009–12, with the last period coinciding with the Great Recession. Applying Poisson models, we calculated relative and absolute indexes of inequalities by education level for each period, age group, gender, and site. Results We found moderate age-adjusted inequalities in IHD with a gradient of increasing rates through less educational level, but no significant evidence of increasing trends in socioeconomic inequalities in IHD mortality, rather an inverted U-shape time trend in some groups below 75 years in relative inequalities. Absolute inequalities decrease in the last period except for women from 50 to 64 years. Conclusions This study shows that the economic crisis has not increased socioeconomic inequalities in IHD mortality in two geographical settings in Spain.
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Kronenberg C, Boehnke JR. How did the 2008-11 financial crisis affect work-related common mental distress? Evidence from 393 workplaces in Great Britain. ECONOMICS AND HUMAN BIOLOGY 2019; 33:193-200. [PMID: 30959347 DOI: 10.1016/j.ehb.2019.02.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 12/21/2018] [Accepted: 02/28/2019] [Indexed: 06/09/2023]
Abstract
This paper analyses how the 2008-11 financial crisis relates to work-related common mental distress of those with continuous employment during the crisis. The literature connecting the 2008-11 financial crisis to common mental distress (anti-depressant drug use, suicide, etc.) generally estimates a negative effect. We used a sample of 393 workplaces from the 2011 Work and Employment Relations Study (WERS) for which employers and worker representatives agreed on that the crisis affected the workplace. WERS then provides detailed questions about how the financial crisis affected the workplace. We use these questions to show which crisis-induced work-changes are important for work-related common mental distress. In the British-context, increased workload and changes in nonfinancial benefits of work are most relevant worsening work-related common mental distress by 1.8 and 0.9 on a scale from 0-30 respectively.
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Affiliation(s)
| | - Jan R Boehnke
- Dundee Centre for Health and Related Research, School of Nursing and Health Sciences, University of Dundee, Scotland
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Ballester J, Robine JM, Herrmann FR, Rodó X. Effect of the Great Recession on regional mortality trends in Europe. Nat Commun 2019; 10:679. [PMID: 30737401 PMCID: PMC6368579 DOI: 10.1038/s41467-019-08539-w] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 01/16/2019] [Accepted: 01/17/2019] [Indexed: 11/08/2022] Open
Abstract
Previous studies have consistently shown the recurrent relationship between macroeconomic cycles and changes in mortality trends, so that recessions are generally associated with periods of faster life expectancy rise, and periods of economic growth with slower reductions or even increases in mortality trends. Here we analyze the link between annual per capita estimates of gross domestic product and daily atmospheric temperatures and standardized death rates for a large ensemble of European regions to describe the effect of the Great Recession on annual and seasonal changes in all-cause human mortality trends. Results show that the countries and regions with the largest (smallest) economic slowdown were also those with the largest (smallest) strengthening of the declining mortality trend. This procyclical evolution of mortality rates is found to be stronger during the cold part of the year, showing that it also depends on the seasonal timing of the underlying causes of death.
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Affiliation(s)
- Joan Ballester
- Climate and Health Program, Barcelona Institute for Global Health (ISGlobal), Barcelona, Catalonia, Spain.
| | - Jean-Marie Robine
- Institut National de la Santé et de la Recherche Médicale (INSERM), Montpellier, France
- École Pratique des Hautes Études, Paris, France
| | - François R Herrmann
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and University of Geneva, Thonex, Switzerland
| | - Xavier Rodó
- Climate and Health Program, Barcelona Institute for Global Health (ISGlobal), Barcelona, Catalonia, Spain
- ICREA, Barcelona, Catalonia, Spain
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Tapia Granados JA, Christine PJ, Ionides EL, Carnethon MR, Diez Roux AV, Kiefe CI, Schreiner PJ. Cardiovascular Risk Factors, Depression, and Alcohol Consumption During Joblessness and During Recessions Among Young Adults in CARDIA. Am J Epidemiol 2018; 187:2339-2345. [PMID: 29955769 PMCID: PMC6211238 DOI: 10.1093/aje/kwy127] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 06/01/2018] [Accepted: 06/15/2018] [Indexed: 11/14/2022] Open
Abstract
Research has shown that recessions are associated with lower cardiovascular mortality, but unemployed individuals have a higher risk of cardiovascular disease (CVD) or death. We used data from 8 consecutive examinations (1985-2011) of the Coronary Artery Risk Development in Young Adults (CARDIA) cohort, modeled in fixed-effect panel regressions, to investigate simultaneously the associations of CVD risk factors with the employment status of individuals and the macroeconomic conditions prevalent in the state where the individual lives. We found that unemployed individuals had lower levels of blood pressure, high-density lipoprotein cholesterol, and physical activity, and they had significantly higher depression scores, but they were similar to their counterparts in smoking status, alcohol consumption, low-density lipoprotein cholesterol levels, body mass index, and waist circumference. A 1-percentage-point higher unemployment rate at the state level was associated with lower systolic (-0.41 mm Hg, 95% CI: -0.65, -0.17) and diastolic (-0.19, 95% CI: -0.39, 0.01) blood pressure, higher physical activity levels, higher depressive symptom scores, lower waist circumference, and less smoking. We conclude that levels of CVD risk factors tend to improve during recessions, but mental health tends to deteriorate. Unemployed individuals are significantly more depressed, and they likely have lower levels of physical activity and high-density lipoprotein cholesterol.
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Affiliation(s)
- José A Tapia Granados
- Department of Politics, College of Arts and Sciences, Drexel University, Philadelphia, Pennsylvania
| | - Paul J Christine
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan
- Department of Internal Medicine, College of Medicine, University of Michigan, Ann Arbor, Michigan
| | - Edward L Ionides
- Department of Statistics, College of Literature, Science and the Arts, University of Michigan, Ann Arbor, Michigan
| | - Mercedes R Carnethon
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Ana V Diez Roux
- School of Public Health, Drexel University, Philadelphia, Pennsylvania
| | - Catarina I Kiefe
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts
| | - Pamela J Schreiner
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
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The medical assistance system and inpatient health care provision: Empirical evidence from short-term hospitalizations in Japan. PLoS One 2018; 13:e0204798. [PMID: 30286118 PMCID: PMC6171890 DOI: 10.1371/journal.pone.0204798] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 08/20/2018] [Indexed: 11/29/2022] Open
Abstract
This paper uses two nationally representative sets of medical claims data from medical assistance and universal public health insurance systems to examine how medical assistance system assignment affects short-term inpatient health care provision. In Japan, the medical assistance system, which is part of a public assistance system, provides medical care services for its beneficiaries without imposing any financial burdens, such as copayments or advance premium payments. These circumstances can lead to inpatient costs, as physicians may provide more treatments because there is a financial incentive. Because the assignment of public assistance in Japan is not random but is subject to means testing by the local government, I employ the instrumental variable model to control the potential correlation. I find that medical expenditure is significantly higher for medical assistance patients than for universal public health insurance patients, with an arc elasticity of approximately 0.20. This elasticity is slightly greater than that found for inpatient care in the randomized RAND Health Insurance Experiment and recent empirical studies on low-income populations. In addition, the elasticities for patients who receive medication, treatment and surgery are greater.
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20
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Fornell B, Correa M, López Del Amo MP, Martín JJ. Influence of changes in the Spanish labor market during the economic crisis (2007-2011) on perceived health. Qual Life Res 2018; 27:2095-2105. [PMID: 29478131 DOI: 10.1007/s11136-018-1824-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2018] [Indexed: 12/13/2022]
Abstract
PURPOSE We analyze the influence of the dramatic changes in the Spanish labor market during the crisis on the perceived health of the Spanish population. METHODS We use the longitudinal Living Conditions Survey database and multilevel longitudinal logistic models between 2007 and 2011, before and during the economic crisis in one of the European countries most affected by its consequences. RESULTS Unemployment (OR 1.75; p < 0.001), job insecurity (OR 1.38; p < 0.001), and being part of a household with severe material deprivation (OR 1.87; p = 0.004) increase the risk of having worsened perceived health. Available income, on the other hand, is a protective factor (OR 0.72; p < 0.001). Public expenditure policies have little impact on the perceived health. Labor market reforms reducing the degree of job insecurity and unemployment, together with income transfers to those at greater risk of social deprivation, can be more effective in improving the health of the population than the increase of aggregated social or health care expenditure. CONCLUSIONS This study provides evidence of the influence that unemployment, job insecurity, and poverty exert on the perceived health of individuals, with data collected in Spain after the onset of the financial crisis. In addition, after analyzing public social expenditure, only expenditure on FPS seems to influence self-reported health, although to a very limited degree.
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Affiliation(s)
- Beatriz Fornell
- Applied Economics, University of Granada, Campus Universitario de Cartuja, 18071, Granada, Spain
| | - Manuel Correa
- Applied Economics, University of Granada, Campus Universitario de Cartuja, 18071, Granada, Spain.
| | - M Puerto López Del Amo
- Applied Economics, University of Granada, Campus Universitario de Cartuja, 18071, Granada, Spain
| | - José J Martín
- Applied Economics, University of Granada, Campus Universitario de Cartuja, 18071, Granada, Spain
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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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Jofre-Bonet M, Serra-Sastre V, Vandoros S. The impact of the Great Recession on health-related risk factors, behaviour and outcomes in England. Soc Sci Med 2018; 197:213-225. [DOI: 10.1016/j.socscimed.2017.12.010] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Revised: 11/29/2017] [Accepted: 12/11/2017] [Indexed: 12/26/2022]
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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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Tapia Granados JA, Ionides EL. Population health and the economy: Mortality and the Great Recession in Europe. HEALTH ECONOMICS 2017; 26:e219-e235. [PMID: 28345272 DOI: 10.1002/hec.3495] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Revised: 12/22/2016] [Accepted: 01/19/2017] [Indexed: 06/06/2023]
Abstract
We analyze the evolution of mortality-based health indicators in 27 European countries before and after the start of the Great Recession. We find that in the countries where the crisis has been particularly severe, mortality reductions in 2007-2010 were considerably bigger than in 2004-2007. Panel models adjusted for space-invariant and time-invariant factors show that an increase of 1 percentage point in the national unemployment rate is associated with a reduction of 0.5% (p < .001) in the rate of age-adjusted mortality. The pattern of mortality oscillating procyclically is found for total and sex-specific mortality, cause-specific mortality due to major causes of death, and mortality for ages 30-44 and 75 and over, but not for ages 0-14. Suicides appear increasing when the economy decelerates-countercyclically-but the evidence is weak. Results are robust to using different weights in the regression, applying nonlinear methods for detrending, expanding the sample, and using as business cycle indicator gross domestic product per capita or employment-to-population ratios rather than the unemployment rate. We conclude that in the European experience of the past 20 years, recessions, on average, have beneficial short-term effects on mortality of the adult population.
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Crost B, Friedson A. Recessions and health revisited: New findings for working age adults. ECONOMICS AND HUMAN BIOLOGY 2017; 27:241-247. [PMID: 28843868 DOI: 10.1016/j.ehb.2017.07.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 07/14/2017] [Accepted: 07/14/2017] [Indexed: 06/07/2023]
Abstract
A series of influential papers have documented that state level mortality rates decrease during economic downturns. In this paper, we estimate the effect of education specific unemployment rates on mortality, which provide a more exact measure of the likelihood of being directly impacted by a recession. We find that the unemployment rate of an education group in a given state is positively related to mortality in that group. A 1% increase in the group-specific unemployment rate is associated with an approximately 0.015% increase in the group-specific mortality rate, which is consistent with the hypothesis that, while state-level unemployment may have indirect health benefits, being personally affected by a recession has a detrimental effect on health.
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Affiliation(s)
- Benjamin Crost
- Department of Agricultural and Consumer Economics, University of Illinois at Urbana-Champaign, 326 Mumford Hall, 1301 W. Gregory Drive, Urbana, IL 61801, United States.
| | - Andrew Friedson
- Department of Economics, University of Colorado Denver, Campus Box 181, Denver, CO 80217-3364, United States.
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Gavurová B, Vagašová T. Regional differences of standardised mortality rates for ischemic heart diseases in the Slovak Republic for the period 1996-2013 in the context of income inequality. HEALTH ECONOMICS REVIEW 2016; 6:21. [PMID: 27259718 PMCID: PMC4893046 DOI: 10.1186/s13561-016-0099-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2016] [Accepted: 05/25/2016] [Indexed: 06/05/2023]
Abstract
BACKGROUND The aim of paper is to analyse the development of standardised mortality rates for ischemic heart diseases in relation to the income inequality in the regions of Slovakia. This paper assesses different types of income indicators, such as mean equivalised net income per household, Gini coefficient, unemployment rate, at risk of poverty threshold (60 % of national median), S80/S20 and their effect on mortality. METHODS Using data from the Slovak mortality database 1996-2013, the method of direct standardisation was applied to eliminate variances resulted from differences in age structures of the population across regions and over time. To examine the relationships between income indicators and standardised mortality rates, we used the tools of descriptive statistics and methods of correlation and regression analysis. RESULTS At first, we show that Slovakia has the worst values of standardised mortality rates for ischemic heart diseases in EU countries. Secondly, mortality rates are significantly higher for males compared with females. Thirdly, mortality rates are improving from Eastern Slovakia to Western Slovakia; additionally, high differences in the results of variability are seen among Slovak regions. Finally, the unemployment rate, the poverty rate and equivalent disposable income were statistically significant income indicators. CONCLUSIONS Main contribution of paper is to demonstrate regional differences between mortality and income inequality, and to point out the long-term unsatisfactory health outcomes.
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Affiliation(s)
- Beáta Gavurová
- Faculty of Economics, Technical University of Košice, Němcovej 32, 040 01, Košice, Slovakia.
| | - Tatiana Vagašová
- Faculty of Economics, Technical University of Košice, Němcovej 32, 040 01, Košice, Slovakia
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Regidor E, Vallejo F, Granados JAT, Viciana-Fernández FJ, de la Fuente L, Barrio G. Mortality decrease according to socioeconomic groups during the economic crisis in Spain: a cohort study of 36 million people. Lancet 2016; 388:2642-2652. [PMID: 27745879 DOI: 10.1016/s0140-6736(16)30446-9] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Studies of the effect of macroeconomic fluctuations on mortality in different socioeconomic groups are scarce and have yielded mixed findings. We analyse mortality trends in Spain before and during the Great Recession in different socioeconomic groups, quantifying the change within each group. METHODS We did a nationwide prospective study, in which we took data from the 2001 Census. All people living in Spain on Nov 1, 2001, were followed up until Dec 31, 2011. We included 35 951 354 people alive in 2001 who were aged between 10 and 74 years in each one of the four calendar years before the economic crisis (from 2004 to 2007) and in each one of the first four calendar years of the crisis (from 2008 to 2011), and analysed all-cause and cause-specific mortality in those people. We classified individuals by socioeconomic status (low, medium, or high) using two indicators of household wealth: household floor space (<72 m2, 72-104 m2, and >104 m2) and number of cars owned by the residents of the household (none, one, and two or more). We used Poisson regression to calculate the annual percentage reduction (APR) in mortality rates during 2004-07 (pre-crisis) and 2008-11 (crisis) in each socioeconomic group, as well as the effect size, measured by the APR difference between the pre-crisis and crisis period. FINDINGS The annual decline in all-cause mortality in the three socioeconomic groups was 1·7% (95% CI 1·2 to 2·1) for the low group, 1·7% (1·3 to 2·1) for the medium group, and 2·0% (1·4 to 2·5) for the high group in 2004-07, and 3·0% (2·5 to 3·5) for the low group, 2·8% (2·5 to 3·2) for the medium group, and 2·1% (1·6 to 2·7) for the high group in 2008-11 when individuals were classified by household floor space. The annual decline in all-cause mortality when people were classified by number of cars owned by the household was 0·3% (-0·1 to 0·8) for the low group, 1·6% (1·2 to 2·0) for the medium group, and 2·2% (1·6 to 2·8) for the high group in 2004-07, and 2·3% (1·8 to 2·8) for the low group, 2·4% (2·0 to 2·7) for the medium group and 2·5% (1·9 to 3·0) for the high group in 2008-11. The low socioeconomic group showed the largest effect size for both wealth indicators. INTERPRETATION In Spain, probably due to the decrease in exposure to risk factors, all-cause mortality decreased more during the economic crisis than before the economic crisis, especially in low socioeconomic groups. FUNDING None.
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Affiliation(s)
- Enrique Regidor
- Department of Preventive Medicine and Public Health, 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.
| | - Fernando Vallejo
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; National Epidemiology Centre, Instituto de Salud Carlos III, Madrid, Spain
| | | | | | - Luis de la Fuente
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; National Epidemiology Centre, Instituto de Salud Carlos III, Madrid, Spain
| | - Gregorio Barrio
- National School of Public Health, Instituto de Salud Carlos III, Madrid, Spain
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Costa-Font J, Karlsson M, Øien H. Careful in the Crisis? Determinants of Older People's Informal Care Receipt in Crisis-Struck European Countries. HEALTH ECONOMICS 2016; 25 Suppl 2:25-42. [PMID: 27870299 DOI: 10.1002/hec.3385] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Revised: 05/27/2016] [Accepted: 06/10/2016] [Indexed: 05/25/2023]
Abstract
Macroeconomic downturns can have an important impact on the receipt of informal and formal long-term care, because recessions increase the number of unemployed and affect net wealth. This paper investigates how the market for informal care changed during and after the Great Recession in Europe, with particular focus on the determinants of care receipt. We use data from the Survey of Health, Ageing and Retirement in Europe, which includes a rich set of variables covering waves before and after the Great Recession. We find evidence of an increase in the availability of informal care after the economic downturn when controlling for year and country fixed effects. This trend is mainly driven by changes in care provision of individuals not cohabiting with the care recipient. We also find evidence of several determinants of informal care receipt changing during the crisis - such as physical needs, personal wealth, and household structures. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Joan Costa-Font
- London School of Economics and Political Science, London, UK
- CESIfo, Munich
| | | | - Henning Øien
- University of Oslo, Norway
- Akershus University College of Applied Sciences Oslo, Norway
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Tapia Granados JA. Commentary: William Ogburn, Dorothy Thomas and the influence of recessions and expansions on mortality. Int J Epidemiol 2015; 44:1484-90. [PMID: 26613711 DOI: 10.1093/ije/dyv288] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- José A Tapia Granados
- Department of Politics, Drexel University, 3141 Chestnut St., 3021E MacAlister Hall, Philadelphia, PA 19104, USA. E-mail:
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30
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Tapia Granados JA, Rodriguez JM. Health, economic crisis, and austerity: A comparison of Greece, Finland and Iceland. Health Policy 2015; 119:941-53. [PMID: 25979416 DOI: 10.1016/j.healthpol.2015.04.009] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Revised: 03/23/2015] [Accepted: 04/15/2015] [Indexed: 10/23/2022]
Abstract
Reports have attributed a public health tragedy in Greece to the Great Recession and the subsequent application of austerity programs. It is also claimed that the comparison of Greece with Iceland and Finland-where austerity policies were not applied-reveals the harmful effect of austerity on health and that by protecting spending in health and social budgets, governments can offset the harmful effects of economic crises on health. We use data on life expectancy, mortality rates, incidence of infectious diseases, rates of vaccination, self-reported health and other measures to examine the evolution of population health and health services performance in Greece, Finland and Iceland since 1990-2011 or 2012-the most recent years for which data are available. We find that in the three countries most indicators of population health continued improving after the Great Recession started. In terms of population health and performance of the health care system, in the period after 2007 for which data are available, Greece did as good as Iceland and Finland. The evidence does not support the claim that there is a health crisis in Greece. On the basis of the extant evidence, claims of a public health tragedy in Greece seem overly exaggerated.
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Affiliation(s)
- José A Tapia Granados
- Department of History and Political Science, Drexel University, Philadelphia, PA, United States.
| | - Javier M Rodriguez
- Mathematica Policy Research and Population Studies Center, Institute for Social Research, University of Michigan,, Ann Arbor, MI, USA
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