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Wu W, Liao H, Yang X. Education disrupts the intergenerational transmission of health disadvantage across three generations in China. PLoS One 2024; 19:e0302963. [PMID: 38848425 PMCID: PMC11161082 DOI: 10.1371/journal.pone.0302963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Accepted: 04/17/2024] [Indexed: 06/09/2024] Open
Abstract
This article utilizes survey data from the China Family Panel Studies (CFPS) to examine whether grandparents' health disadvantage have both direct and indirect effects on the health disadvantage of their grandchildren, and whether the completion of compulsory education by parents disrupts these intergenerational transmissions in China. The findings suggest that grandparents' health disadvantage significantly increases the probability of grandchildren's health disadvantage with and without controlling parental health disadvantage and other characteristics. Moreover, the study identifies a disruptive influence of parental education on this transmission process. Rigorous robustness tests, including the use of the Compulsory Education Law as an instrumental variable to control for unobserved factors, validate these results. Mechanism analysis shows that parents completing compulsory education contribute to improving their nutritional balance and adopting healthy behaviors, attaining higher social status, earning higher income, which ultimately reduce the probability of health disadvantage for both themselves and their children. These findings highlight the persistent intergenerational transmission of health disparities within families and emphasize the importance of enhancing individuals' education levels to disrupt this transmission. By doing so, it may be possible to mitigate health inequalities and disparities across the population.
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Affiliation(s)
- Weijuan Wu
- School of Economics and Management, South China Normal University, Panyu District, Guangzhou City, Guangdong Province, China
| | - Haokai Liao
- College of Humanities and Arts, Heyuan Polytechnic, Yuancheng District, Heyuan City, Guangdong Province, China
| | - Xuelin Yang
- The School of Marxism, Jiangxi University of Technology, Gaoxin District, Nanchang City, Jiangxi Province, China
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2
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Watson B, Amin GR. An examination of health care efficiency in Canada: a two-stage semi-parametric approach. HEALTH ECONOMICS, POLICY, AND LAW 2024:1-20. [PMID: 38825866 DOI: 10.1017/s1744133124000100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2024]
Abstract
Using data envelopment analysis, we examine the efficiency of Canada's universal health care system by considering a set of labour (physicians) and capital (beds) inputs, which produce a level of care (measured in terms of health quality and quantity) in a given region. Data from 2013-2015 were collected from the Canadian Institute for Health Information regarding inputs and from the Canadian Community Health Survey and Statistics Canada regarding our output variables, health utility (quality) and life expectancy (quantity). We posit that variation in efficiency scores across Canada is the result of regional heterogeneity regarding socioeconomic and demographic disparities. Regressing efficiency scores on such covariates suggests that regional unemployment and an older population are quite impactful and associated with less efficient health care production. Moreover, regional variation indicates the Atlantic provinces (Newfoundland, Prince Edward Island, Nova Scotia, New Brunswick) are quite inefficient, have poorer economic prospects, and tend to have an older population than the rest of Canada. Oaxaca-Blinder decompositions suggest that the latter two factors explain about one-third of this efficiency gap. Based on our two-stage semi-parametric analysis, we recommend Canada adjust their transfer payments to reflect these disparities, thereby potentially reducing inequality in regional efficiency.
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Affiliation(s)
- Barry Watson
- Faculty of Business, University of New Brunswick, 100 Tucker Park Road, PO Box 5050, Saint John, New Brunswick, E2L 4L5, Canada
| | - Gholam R Amin
- Faculty of Business, University of New Brunswick, 100 Tucker Park Road, PO Box 5050, Saint John, New Brunswick, E2L 4L5, Canada
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3
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Reynolds MM, Homan PA. Income Support Policy Packages and Birth Outcomes in U.S. States: An Ecological Analysis. POPULATION RESEARCH AND POLICY REVIEW 2023; 42:73. [PMID: 38213513 PMCID: PMC10783327 DOI: 10.1007/s11113-023-09797-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 05/09/2023] [Indexed: 01/13/2024]
Abstract
Research suggests that generous social welfare programs play a role in maternal and child health. However, most studies examine a single policy in isolation. Drawing from research documenting low-income families 'packaging' of social policies, we create a novel measure summarizing the value of a collection of income support policies for the working poor. This collection includes: the Supplemental Nutrition Assistance Program (SNAP), the Earned Income Tax Credit (EITC), the minimum wage, and the unemployment insurance (UI) program. Using U.S. state-level administrative data from 1996 to 2014, we estimate fixed effects regression models to examine the relationship between birth outcomes and income support policies (individually and combined). We find that increases in the combined value of the four income supports are significantly associated with reductions in preterm births and low birthweight births, but not infant mortality rates. States with the highest observed levels of combined income support had 14% fewer PTBs and 7% fewer LBWs than states with the lowest levels of income support. Of the four individual income support policies, only unemployment insurance has no significant independent effects. SNAP benefits have the largest and most consistent effects, reducing poor birth outcomes across all three indicators. An annual increase of $1000 in SNAP benefits is associated with a 3% decline in infant deaths, 5% decline in preterm births, and 2% decline in low birthweight births. These results suggest that increasing the generosity of income support policies may be a promising strategy for improving birth outcomes in the United States.
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Affiliation(s)
- Megan M. Reynolds
- Department of Sociology, University of Utah, Salt Lake City, UT 84121, USA
| | - Patricia A. Homan
- Department of Sociology, Center for Demography and Population Health, Pepper Institute on Aging and Public Policy, Florida State University, Tallahassee, FL 32306, USA
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4
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Montez JK, Mehri N, Monnat SM, Beckfield J, Chapman D, Grumbach JM, Hayward MD, Woolf SH, Zajacova A. U.S. state policy contexts and mortality of working-age adults. PLoS One 2022; 17:e0275466. [PMID: 36288322 PMCID: PMC9604945 DOI: 10.1371/journal.pone.0275466] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 09/16/2022] [Indexed: 01/24/2023] Open
Abstract
The rise in working-age mortality rates in the United States in recent decades largely reflects stalled declines in cardiovascular disease (CVD) mortality alongside rising mortality from alcohol-induced causes, suicide, and drug poisoning; and it has been especially severe in some U.S. states. Building on recent work, this study examined whether U.S. state policy contexts may be a central explanation. We modeled the associations between working-age mortality rates and state policies during 1999 to 2019. We used annual data from the 1999-2019 National Vital Statistics System to calculate state-level age-adjusted mortality rates for deaths from all causes and from CVD, alcohol-induced causes, suicide, and drug poisoning among adults ages 25-64 years. We merged that data with annual state-level data on eight policy domains, such as labor and taxes, where each domain was scored on a 0-1 conservative-to-liberal continuum. Results show that the policy domains were associated with working-age mortality. More conservative marijuana policies and more liberal policies on the environment, gun safety, labor, economic taxes, and tobacco taxes in a state were associated with lower mortality in that state. Especially strong associations were observed between certain domains and specific causes of death: between the gun safety domain and suicide mortality among men, between the labor domain and alcohol-induced mortality, and between both the economic tax and tobacco tax domains and CVD mortality. Simulations indicate that changing all policy domains in all states to a fully liberal orientation might have saved 171,030 lives in 2019, while changing them to a fully conservative orientation might have cost 217,635 lives.
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Affiliation(s)
- Jennifer Karas Montez
- Department of Sociology, Syracuse University, Syracuse, NY, United States of America
- * E-mail:
| | - Nader Mehri
- Aging Studies Institute, Syracuse University, Syracuse, NY, United States of America
| | - Shannon M. Monnat
- Department of Sociology, Syracuse University, Syracuse, NY, United States of America
| | - Jason Beckfield
- Department of Sociology, Harvard University, Cambridge, MA, United States of America
| | - Derek Chapman
- Division of Epidemiology, Virginia Commonwealth University, Richmond, VA, United States of America
| | - Jacob M. Grumbach
- Department of Political Science, University of Washington, Seattle, WA, United States of America
| | - Mark D. Hayward
- Department of Sociology, University of Texas at Austin, Austin, TX, United States of America
| | - Steven H. Woolf
- Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA, United States of America
| | - Anna Zajacova
- Department of Sociology, University of Western Ontario, Ontario, CA, United States of America
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5
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Cardiovascular Mortality and Leaded Aviation Fuel: Evidence from Piston-Engine Air Traffic in North Carolina. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19105941. [PMID: 35627477 PMCID: PMC9140422 DOI: 10.3390/ijerph19105941] [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: 04/22/2022] [Accepted: 05/06/2022] [Indexed: 02/01/2023]
Abstract
Leaded fuel used by piston-engine aircraft is the largest source of airborne lead emissions in the United States. Previous studies have found higher blood lead levels in children living near airports where leaded aviation fuel is used. However, little is known about the health effects on adults. This study is the first to examine the association between exposure to aircraft operations that use leaded aviation fuel and adult cardiovascular mortality. We estimated the association between annual piston-engine air traffic and cardiovascular mortality among adults age 65 and older near 40 North Carolina airports during 2000 to 2017. We used several strategies to minimize the potential for bias due to omitted variables and confounding from other health hazards at airports, including coarsened exact matching, location-specific intercepts, and adjustment for jet-engine and other air traffic that does not use leaded fuel. Our findings are mixed but suggestive of adverse effects. We found higher rates of cardiovascular mortality within a few kilometers downwind of single- and multi-runway airports, though these results are not always statistically significant. We also found significantly higher cardiovascular mortality rates within a few kilometers and downwind of single-runway airports in years with more piston-engine air traffic. We did not consistently find a statistically significant association between cardiovascular mortality rates and piston-engine air traffic near multi-runway airports, where there was greater uncertainty in our measure of the distance between populations and aviation exposures. These results suggest that (i) reducing lead emissions from aviation could yield health benefits for adults, and (ii) more refined data are needed to obtain more precise estimates of these benefits. Subject Areas: Toxic Substances, Health, Epidemiology, Air Pollution, Ambient Air Quality. JEL codes: Q53, I18.
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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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7
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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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8
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Shi J, Tarkiainen L, Martikainen P, van Raalte A. The impact of income definitions on mortality inequalities. SSM Popul Health 2021; 15:100915. [PMID: 34527804 PMCID: PMC8433258 DOI: 10.1016/j.ssmph.2021.100915] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 09/01/2021] [Accepted: 09/01/2021] [Indexed: 11/23/2022] Open
Abstract
Income is a strong predictor of adult mortality. Measuring income is not as simple as it may sound. It can be conceptualized at the individual or the household level, with the former better reflecting an individual's earning ability, and the latter better capturing living standards. Furthermore, respondents are often grouped into income categories based on their positions in the income distribution, and this operationalization can be done on the basis of age-specific or total population income distributions. In this study, we look at how four combinations of different conceptualizations (individual vs. household) and operationalizations (age-specific vs. total population) of income can affect mortality inequality estimates. Using Finnish registry data, we constructed period life tables for ages 25+ from 1996 to 2017 by gender and for four income definitions. The results indicated that the slope index of inequality for life expectancy varied by 1.1-5.7 years between income definitions, with larger differences observed for women than for men. The overall age patterns of relative index of inequality for mortality rates yielded by the four definitions were similar, but the levels differed. The period trends across income definitions were consistent for men, but not for women. We conclude that researchers should pay particular attention to the choice of the income definitions when analyzing the association between income and mortality, and when comparing the magnitude of inequality across studies and over time.
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Affiliation(s)
- Jiaxin Shi
- Max Planck Institute for Demographic Research, Rostock, Germany
- Leverhulme Centre for Demographic Science, Department of Sociology, University of Oxford, Oxford, United Kingdom
| | - Lasse Tarkiainen
- Population Research Unit, University of Helsinki, Helsinki, Finland
| | - Pekka Martikainen
- Max Planck Institute for Demographic Research, Rostock, Germany
- Population Research Unit, University of Helsinki, Helsinki, Finland
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
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9
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Afoakwah C, Nghiem S, Scuffham P, Byrnes J. Rising unemployment reduces the demand for healthcare services among people with cardiovascular disease: an Australian cohort study. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2021; 22:643-658. [PMID: 33740154 DOI: 10.1007/s10198-021-01281-5] [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: 10/08/2020] [Accepted: 02/25/2021] [Indexed: 06/12/2023]
Abstract
Cardiovascular diseases (CVDs) remain a global health challenge due to number of deaths and use of healthcare services related to the condition. Although a plethora of studies have shown the impact of unemployment on health outcomes, evidence on the unemployment effects on the demand for expensive cardiac healthcare services is rare. This study exploits longitudinal cohort dataset to examine the impact of variations in local level unemployment rate on the demand for healthcare services among working aged people with CVD in Australia. Our findings show an inverse relationship between unemployment and the demand for healthcare services. Specifically, we find that a rising unemployment reduces the demand for primary and secondary healthcare services, with the largest effect observed for hospital admissions and hospitalisation days. We further show that rising unemployment at the local level has a greater impact on CVD patients with comorbidities and those who live in nonremote areas. Finally, our estimates suggest that increasing local level unemployment averts a substantial number of healthcare services use, leading to an unintended cost savings of $1.2 million to the health sector.
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Affiliation(s)
- Clifford Afoakwah
- Centre for Applied Health Economics, Griffith University, Brisbane, QLD, Australia.
- Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia.
| | - Son Nghiem
- Centre for Applied Health Economics, Griffith University, Brisbane, QLD, Australia
- Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
| | - Paul Scuffham
- Centre for Applied Health Economics, Griffith University, Brisbane, QLD, Australia
- Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
| | - Joshua Byrnes
- Centre for Applied Health Economics, Griffith University, Brisbane, QLD, Australia
- Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
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10
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Sun TT, Tao R, Su CW, Umar M. How Do Economic Fluctuations Affect the Mortality of Infectious Diseases? Front Public Health 2021; 9:678213. [PMID: 33968891 PMCID: PMC8100195 DOI: 10.3389/fpubh.2021.678213] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 03/25/2021] [Indexed: 11/24/2022] Open
Abstract
This paper uses the mixed frequency vector autoregression model to explore the impact of economic fluctuations on infectious diseases mortality (IDM) from China perspective. We find that quarterly gross domestic product (GDP) fluctuations have a negative impact on the annual IDM, indicating that the mortality of infectious diseases varies counter-cyclically with the business cycle in China. Specifically, IDM usually increases with deterioration in economic conditions, and vice versa. The empirical results are consistent with the hypothesis I derived from the theoretical analysis, which highlights that economic fluctuations can negatively affect the mortality of infectious diseases. The findings can offer revelations for the government to consider the role of economic conditions in controlling the epidemic of infectious diseases. Policymakers should adopt appropriate and effective strategies to mitigate the potential negative effects of macroeconomic downturns on the mortality of infectious diseases. In the context of the COVID-19 pandemic, these analyses further emphasize the importance of promoting economic growth, increasing public health expenditure, and preventing and controlling foreign infectious diseases.
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Affiliation(s)
- Ting-Ting Sun
- School of Economics, Qingdao University, Qingdao, China
| | - Ran Tao
- Qingdao Municipal Center for Disease Control and Preventation, Qingdao, China
| | - Chi-Wei Su
- School of Economics, Qingdao University, Qingdao, China
| | - Muhammad Umar
- School of Economics, Qingdao University, Qingdao, China
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11
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Halliday T, Mazumder B, Wong A. Intergenerational Mobility in Self-Reported Health Status in the US. JOURNAL OF PUBLIC ECONOMICS 2021; 193:104307. [PMID: 33716349 PMCID: PMC7948082 DOI: 10.1016/j.jpubeco.2020.104307] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
We present estimates of intergenerational mobility in self-reported health status (SRHS) in the US using data from the PSID. We estimate that the rank-rank slope in SRHS is 0.26. We show that including both parent health and income in models of intergenerational mobility increases the explanatory power of child outcomes. We construct a monetary metric for health and then use this to combine income and health into a measure of welfare and estimate the rank-rank slope to be about 0.4 for this new measure. Finally, we document striking health mobility gaps by race, region and parent education.
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12
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Gavurova B, Khouri S, Kovac V, Ferkova M. Exploration of Influence of Socioeconomic Determinants on Mortality in the European Union. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17134699. [PMID: 32629913 PMCID: PMC7369843 DOI: 10.3390/ijerph17134699] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 06/15/2020] [Accepted: 06/24/2020] [Indexed: 12/03/2022]
Abstract
Economic performance measured through the gross domestic product indicator and the poverty rate varies across the whole European Union, together with the considerable income inequalities in the long-term. Economic growth may not bring a reduction in the health inequalities in the individual countries themselves. In order to eliminate health inequalities, the different types of policies implemented in the health, social and economic systems need to be explored in more detail. Mortality is explored through an indicator of the standardised mortality rate for both sexes explained by the several socioeconomic determinants, among which variables such as the variations of the gross domestic product per capita, the healthcare expenditures, the unemployment rate, and the healthcare system financing. Almost in all the described cases, these dimensions have negative impact. All the influences are expressed in a relative way in order to be suitably interpretable. The analysis is not comprehensive; nevertheless, it contains 18 regression models to cover as many aspects as it is possible. The Discussion section offers an evaluation of the obtained results according to the outcome of the other studies.
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Affiliation(s)
- Beata Gavurova
- Faculty of Mining, Ecology, Process Control and Geotechnologies, Technical University of Košice, 04001 Košice, Slovakia;
- Correspondence:
| | - Samer Khouri
- Faculty of Mining, Ecology, Process Control and Geotechnologies, Technical University of Košice, 04001 Košice, Slovakia;
| | - Viliam Kovac
- Faculty of Economics, Technical University of Košice, 04001 Košice, Slovakia; (V.K.); (M.F.)
| | - Michaela Ferkova
- Faculty of Economics, Technical University of Košice, 04001 Košice, Slovakia; (V.K.); (M.F.)
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13
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Bilal U, Cooper R, Abreu F, Nau C, Franco M, Glass TA. Economic growth and mortality: do social protection policies matter? Int J Epidemiol 2018; 46:1147-1156. [PMID: 28338775 DOI: 10.1093/ije/dyx016] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/17/2017] [Indexed: 12/31/2022] Open
Abstract
Background In the 20th century, periods of macroeconomic growth have been associated with increases in population mortality. Factors that cause or mitigate this association are not well understood. Evidence suggests that social policy may buffer the deleterious impact of economic growth. We sought to explore associations between changing unemployment (as a proxy for economic change) and trends in mortality over 30 years in the context of varying social protection expenditures. Methods We model change in all-cause mortality in 21 OECD (Organization for Economic Cooperation and Development) countries from 1980 to 2010. Data from the Comparative Welfare States Data Set and the WHO Mortality Database were used. A decrease in the unemployment rate was used as a proxy for economic growth and age-adjusted mortality rates as the outcome. Social protection expenditure was measured as percentage of gross domestic product expended. Results A 1% decrease in unemployment (i.e. the proxy for economic growth) was associated with a 0.24% increase in the overall mortality rate (95% confidence interval: 0.07;0.42) in countries with no changes in social protection. Reductions in social protection expenditure strengthened this association between unemployment and mortality. The magnitude of the association was diminished over time. Conclusions Our results are consistent with the hypothesis that social protection policies that accompany economic growth can mitigate its potential deleterious effects on health. Further research should identify specific policies that are most effective.
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Affiliation(s)
- Usama Bilal
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Social and Cardiovascular Epidemiology Research Group, Universidad de Alcala, Madrid, Spain
| | - Richard Cooper
- Department of Public Health Sciences, Loyola University Stritch School of Medicine, Chicago, IL, USA
| | | | - Claudia Nau
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Manuel Franco
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Social and Cardiovascular Epidemiology Research Group, Universidad de Alcala, Madrid, Spain
| | - Thomas A Glass
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Wang H, Wang C, Halliday TJ. Health and health inequality during the great recession: Evidence from the PSID. ECONOMICS AND HUMAN BIOLOGY 2018; 29:17-30. [PMID: 29413585 DOI: 10.1016/j.ehb.2018.01.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 12/06/2017] [Accepted: 01/11/2018] [Indexed: 06/08/2023]
Abstract
We estimate the impact of the Great Recession of 2007-2009 on health outcomes in the United States. We show that a one percentage point increase in the unemployment rate resulted in a 7.8-8.8% increase in reports of poor health. In addition, mental health was adversely impacted. These effects were concentrated among those with strong labor force attachments. Whites, the less educated, and women were the most impacted demographic groups.
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Affiliation(s)
- Huixia Wang
- Hunan University, School of Economics and Trade, China
| | - Chenggang Wang
- University of Hawaii at Manoa, Department of Economics, United States
| | - Timothy J Halliday
- University of Hawaii at Manoa, Department of Economics, United States; University of Hawaii Economic Research Organization, IZA, United States.
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15
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Sameem S, Sylwester K. The business cycle and mortality: Urban versus rural counties. Soc Sci Med 2017; 175:28-35. [DOI: 10.1016/j.socscimed.2016.12.023] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Revised: 12/07/2016] [Accepted: 12/16/2016] [Indexed: 10/20/2022]
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16
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Total and cause-specific mortality before and after the onset of the Greek economic crisis: an interrupted time-series analysis. LANCET PUBLIC HEALTH 2016; 1:e56-e65. [DOI: 10.1016/s2468-2667(16)30018-4] [Citation(s) in RCA: 74] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Revised: 10/04/2016] [Accepted: 10/05/2016] [Indexed: 11/19/2022]
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17
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Sarti S, Zella S. Changes in the labour market and health inequalities during the years of the recent economic downturn in Italy. SOCIAL SCIENCE RESEARCH 2016; 57:116-132. [PMID: 26973035 DOI: 10.1016/j.ssresearch.2015.12.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Revised: 12/10/2015] [Accepted: 12/31/2015] [Indexed: 06/05/2023]
Abstract
There is widespread concern that episodes of unemployment and unstable working conditions adversely affect health. We add to the debate by focusing on the relationship between work trajectory and the self-reported health of Italian men and women during the present economic downturn. Relying on Italian data in the EU-SILC project (from 2007 to 2010), our sample includes all individuals aged 30 to 60 in 2010, and uses multivariate binomial regression models for preliminary analyses and the Structural Equations modelling (SEM) to observe the cumulative effects of health status according to different job trajectories. Our main findings show similar pictures for men and women. Individuals who are unemployed, ejected or in precarious occupational positions have a higher risk of worsening their health status during these years.
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Affiliation(s)
- Simone Sarti
- University of Milan, Department of Social and Political Sciences, Italy.
| | - Sara Zella
- Swiss Centre of Expertise in the Social Science (FORS) and University of Lausanne, Switzerland
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Chu WM, Liao WC, Li CR, Lee SH, Tang YJ, Ho HE, Lee MC. Late-career unemployment and all-cause mortality, functional disability and depression among the older adults in Taiwan: A 12-year population-based cohort study. Arch Gerontol Geriatr 2016; 65:192-8. [PMID: 27070503 DOI: 10.1016/j.archger.2016.03.020] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Accepted: 03/29/2016] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To evaluate whether late-career unemployment is associated with increased all-cause mortality, functional disability, and depression among older adults in Taiwan. METHOD In this long-term prospective cohort study, data were retrieved from the Taiwan Longitudinal Study on Aging. This study was conducted from 1996 to 2007. The complete data from 716 men and 327 women aged 50-64 years were retrieved. Participants were categorized as normally employed or unemployed depending on their employment status in 1996. The cumulative number of unemployment after age 50 was also calculated. Logistic regression analysis was used to examine the effect of the association between late-career unemployment and cumulative number of late-career unemployment on all-cause mortality, functional disability, and depression in 2007. RESULTS The average age of the participants in 1996 was 56.3 years [interquartile range (IQR)=7.0]. A total of 871 participants were in the normally employed group, and 172 participants were in the unemployed group. After adjustment of gender, age, level of education, income, self-rated health and major comorbidities, late-career unemployment was associated with increased all-cause mortality [Odds ratio (OR)=2.79; 95% confidence interval (CI)=1.74-4.47] and functional disability [OR=2.33; 95% CI=1.54-3.55]. The cumulative number of late-career unemployment was also associated with increased all-cause mortality [OR=1.91; 95% CI=1.35-2.70] and functional disability [OR=2.35; 95% CI=1.55-3.55]. CONCLUSION Late-career unemployment and cumulative number of late-career unemployment are associated with increased all-cause mortality and functional disability. Older adults should be encouraged to maintain normal employment during the later stage of their career before retirement. Employers should routinely examine the fitness for work of older employees to prevent future unemployment.
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Affiliation(s)
- Wei-Min Chu
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Family Medicine, Taichung Veterans General Hospital, Taichung, Taiwan; Center for Geriatrics and Gerontology, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Wen-Chun Liao
- School of Nursing, Chung Shan Medical University, Taichung, Taiwan; School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Chi-Rong Li
- School of Nursing, Chung Shan Medical University, Taichung, Taiwan; School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Shu-Hsin Lee
- School of Nursing, Chung Shan Medical University, Taichung, Taiwan; School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Yih-Jing Tang
- Department of Family Medicine, Taichung Veterans General Hospital, Taichung, Taiwan; Center for Geriatrics and Gerontology, Taichung Veterans General Hospital, Taichung, Taiwan; School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Hsin-En Ho
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Family Medicine, Taichung Armed Force General Hospital, Taichung, Taiwan
| | - Meng-Chih Lee
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Family Medicine, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan; Instiute of Population Sciences, National Health Research Institutes, Miaoli County, Taiwan; School of Public Health, National Defense Medical Center, Taipei, Taiwan.
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Kroll LE, Müters S, Lampert T. Arbeitslosigkeit und ihre Auswirkungen auf die Gesundheit. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2015; 59:228-37. [DOI: 10.1007/s00103-015-2282-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Laditka JN, Laditka SB. Unemployment, disability and life expectancy in the United States: A life course study. Disabil Health J 2015; 9:46-53. [PMID: 26385529 DOI: 10.1016/j.dhjo.2015.08.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Revised: 07/18/2015] [Accepted: 08/09/2015] [Indexed: 12/17/2022]
Abstract
BACKGROUND Unemployment may be associated with health through factors including stress, depression, unhealthy behaviors, reduced health care, and loss of social networks. Little is known about associations of total lifetime unemployment with disability and life expectancy. HYPOTHESIS People with high unemployment (≥the median) will live shorter lives with more disability than those with less unemployment. METHODS Data were nationally representative of African Americans and non-Hispanic whites, from the Panel Study of Income Dynamics (37 waves 1968-2011, n = 7,970, mean work years = 24.7). Seven waves (1999-2011, 58,268 person-years) measured disability in activities of daily living. We estimated monthly probabilities of disability and death associated with unemployment using multinomial logistic Markov models adjusted for age, sex, race/ethnicity, education, health status at baseline and throughout work life, and social support. We used the probabilities to create large populations with microsimulation, each individual having known monthly disability status, age 40 to death. We analyzed the populations to measure outcomes. RESULTS Respectively for African American and white women and African American and white men, life expectancies (with 95% confidence intervals) from age 40 with low unemployment were ages: 77.1 (75.0-78.3), 80.6 (78.4-81.4), 71.4 (69.6-72.5), and 76.9 (74.9-77.9). Corresponding high unemployment results were: 73.7 (71.7-75.0), 77.5 (75.1-78.0), 68.4 (66.8-69.0), and 73.7 (71.5-74.3). The percentage of life disabled from age 40 was greater with high unemployment for the same groups, by 23.9%, 21.0%, 21.3%, and 21.1% (all p < 0.01). CONCLUSIONS High lifetime unemployment may be associated with a larger proportion of later life with disability and lower life expectancy.
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Affiliation(s)
- James N Laditka
- Department of Public Health Sciences, Public Policy, University of North Carolina at Charlotte, 9201 University City Boulevard, Charlotte, NC 28223, USA
| | - Sarah B Laditka
- Department of Public Health Sciences, Public Policy, University of North Carolina at Charlotte, 9201 University City Boulevard, Charlotte, NC 28223, USA.
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