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Tanaka H, Nusselder WJ, Kobayashi Y, Mackenbach JP. Socioeconomic inequalities in self-rated health in Japan, 32 European countries and the United States: an international comparative study. Scand J Public Health 2023; 51:1161-1172. [PMID: 35538617 PMCID: PMC10642222 DOI: 10.1177/14034948221092285] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 02/13/2021] [Accepted: 03/16/2022] [Indexed: 11/16/2022]
Abstract
AIMS Japan is known as a country with low self-rated health despite high life expectancy. We compared socioeconomic inequalities in self-rated health in Japan with those in 32 European countries and the US using nationally representative samples. METHODS We analysed individual data from the Comprehensive Survey of Living Conditions (Japan), the European Union Statistics on Income and Living Conditions, and the Behavioral Risk Factor Surveillance System (US) in 2016. We used ordered logistic regression models with four ordinal categories of self-rated health as an outcome, and educational level or occupational class as independent variables, controlling for age. RESULTS In Japan, about half the population perceived their health as 'fair', which was much higher than in Europe (≈20-40%). The odds ratios of lower self-rated health among less educated men compared with more educated were 1.72 (95% confidence interval (CI) 1.61-1.85) in Japan, and ranged from 1.67 to 4.74 in Europe (pooled; 2.10 (95% CI 2.01-2.20)), and 6.65 (95% CI 6.22-7.12) in the US. The odds ratios of lower self-rated health among less educated women were 1.79 (95% CI 1.65-1.95) in Japan, and ranged from 1.89 to 5.30 in Europe (pooled; 2.43 (95% CI 2.33-2.54)), and 8.82 (95% CI 8.29-9.38) in the US. Socioeconomic inequalities were large when self-rated health was low for European countries, but Japan and the US did not follow the pattern. CONCLUSIONS Japan has similar socioeconomic gradient patterns to European countries for self-rated health, and our findings revealed smaller socioeconomic inequalities in self-rated health in Japan compared with those in western countries.
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Affiliation(s)
- Hirokazu Tanaka
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Public Health and Occupational Medicine, Mie University, Mie, Japan
- Department of Public Health, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan
| | - Wilma J. Nusselder
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Yasuki Kobayashi
- Department of Public Health, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan
| | - Johan P. Mackenbach
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
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Alexiou C, Trachanas E. Health Outcomes, Income and Income Inequality: Revisiting the Empirical Relationship. Forum Health Econ Policy 2021; 24:75-100. [PMID: 36259395 DOI: 10.1515/fhep-2021-0042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 10/03/2022] [Indexed: 01/05/2023]
Abstract
In this paper we revisit the relationship between health outcomes, income, and income inequality by applying alternative panel methodologies to a dataset of high-income countries spanning the time period 1980-2017. In this direction, we adopt alternative methodological frameworks in order to provide a) meaningful results by taking into account standard errors that alleviate problems of cross-sectional (spatial) and temporal dependence, and b) insights into the underlying relationships at several points of the conditional distribution of the health outcomes dependent variables. The evidence strongly supports the significant role that income plays in determining health outcomes. The findings relating to income inequality and nonlinear terms are more fragmented in that their significance and sign-direction depend on the functional form and the respective quantiles of the distribution the relationships are evaluated.
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Affiliation(s)
| | - Emmanouil Trachanas
- Department of Accounting and Finance, University of Macedonia, Thessaloniki, Greece
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Tanaka H, Mackenbach JP, Kobayashi Y. Trends and socioeconomic inequalities in self-rated health in Japan, 1986-2016. BMC Public Health 2021; 21:1811. [PMID: 34625032 PMCID: PMC8501722 DOI: 10.1186/s12889-021-11708-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 08/29/2021] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Despite having very high life expectancy, Japan has relatively poor self-rated health, compared to other high-income countries. We studied trends and socioeconomic inequalities in self-rated health in Japan using nationally representative data. METHODS The Comprehensive Survey of Living Conditions was analyzed, every 3 years (n ≈ 0.6-0.8 million/year) from 1986 to 2016. Whereas previous studies dichotomized self-rated health as an outcome, we used four categories: very good, good, fair, and bad/very bad. Proportional odds ordinal logistic regression models are used, with ordinal scale self-rated health as an outcome, and age category, survey year and occupational class or educational level as independent variables. RESULTS In 2016, the age-adjusted percentages for self-rated health categorized as very good, good, fair, and bad/very bad, were 24.0, 17.1, 48.7, and 10.2% among working-age men, and 21.6, 17.5, 49.4, and 11.5% among working-age women, respectively. With 1986 as the reference year, the odds ratios (ORs) of less good self-rated health were lowest in 1995 (0.69; 95% Confidence Interval [95% CI]: 0.66-0.71 of working-age men), and highest in 2010 (1.23 [95% CI: 1.19-1.27]). The ORs of male, lower non-manual workers (compared to upper non-manual) increased from 1.12 (95% CI: 1.07-1.17) in 2010 to 1.20 (95% CI: 1.15-1.26) in 2016. Between 2010 and 2016, the ORs of working-age men with middle and low levels of education (compared to a high level of education) increased from 1.22 (95% CI: 1.18-1.27) to 1.34 (95% CI: 1.29-1.38), and from 1.47 (95% CI: 1.39-1.56) to 1.75 (95% CI: 1.63-1.88), respectively. The ORs of working-age women with middle and low levels of education also increased from 1.22 (95% CI: 1.17-1.28) to 1.32 (95% CI: 1.26-1.37), and from 1.74 (95% CI: 1.61-1.88) to 2.03 (95% CI: 1.87-2.21) during the same period. CONCLUSION Japan has the unique feature that approximately 50% of the survey respondents rated their self-rated health as fair, but with important variations over time and between socioeconomic groups. In-depth studies of the role of socioeconomic conditions may shed light on the reasons for the high prevalence of poor self-rated health in Japan.
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Affiliation(s)
- Hirokazu Tanaka
- Department of Public Health, Erasmus University Medical Center, 3000, CA, Rotterdam, The Netherlands
- Department of Public Health and Occupational Medicine, Graduate School of Medicine, Mie University, Tsu, Mie, 514-8507, Japan
- Department of Public Health, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Johan P Mackenbach
- Department of Public Health, Erasmus University Medical Center, 3000, CA, Rotterdam, The Netherlands
| | - Yasuki Kobayashi
- Department of Public Health, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, 113-0033, Japan.
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Miyamoto Y, Ryff CD. Culture and Health: Recent Developments and Future Directions
1. JAPANESE PSYCHOLOGICAL RESEARCH 2021; 64:90-108. [PMID: 35509718 PMCID: PMC9060271 DOI: 10.1111/jpr.12378] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Evidence of cultural differences in relationships and emotions has accumulated over the past few decades. As findings on cultural differences in psychological processes have accumulated, there has been growing interest in investigating whether they have implications for other phenomena such as health. Using scientific advances from the MIDUS and MIDJA studies, both publicly available, we examine links between culture and health. We first briefly review the accumulated evidence on cultural influences on health correlates of psychosocial factors. We then feature two recent developments - a more micro-level perspective on biological factors that may be involved in the culture and health linkage, and a more macro-level view of socioeconomic inequality, which also matters for health. Both perspectives inform the pathways through which health effects occur. Finally, we conclude our review by highlighting the changing historical contexts surrounding these cross-cultural investigations. Specifically, we draw attention to widening of economic inequality across cultures and the world-wide COVID-19 pandemic. These happenings bring notable implications for future research on health across cultural contexts.
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The 2008 Financial Crisis and Changes in Lifestyle-Related Behaviors in Italy, Greece, Spain, and Portugal: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168734. [PMID: 34444482 PMCID: PMC8392284 DOI: 10.3390/ijerph18168734] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 08/12/2021] [Accepted: 08/14/2021] [Indexed: 12/17/2022]
Abstract
Italy, Greece, Spain, and Portugal have all been strongly affected by the 2008 financial crisis, which has had a negative impact on health. We systematically evaluated the effects of the crisis on lifestyle and socioeconomic inequalities. We conducted a literature search using MEDLINE, Embase, the Cochrane Library, and health economics databases for studies reporting quantitative comparisons before and after (or during) the crisis on the following risk behaviors: alcohol consumption, smoking habit, healthy diet, physical activity, and psychotropic drugs and substance abuse, without setting any age restrictions. We selected 34 original articles published between 2011 and 2020. During/after the crisis, alcohol consumption and substance abuse decreased, while psychotropic drug use increased. We also observed a deterioration in healthy eating behavior, with a reduction in fruit and vegetable consumption. Smoking habit and physical activity showed a more complex, controversial trend. Socioeconomic inequalities were affected by the recession, and the negative effects on unhealthy lifestyle tended to be more pronounced among the disadvantaged. These results suggest the need to implement health policies and interventions aimed at monitoring risk behaviors, with special regard to disadvantaged people, and considering the potential additional impact of the COVID-19 pandemic.
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Jiang Y, Boylan JM, Zilioli S. Effects of the Great Recession on Educational Disparities in Cardiometabolic Health. Ann Behav Med 2021; 56:428-441. [PMID: 34323265 DOI: 10.1093/abm/kaab065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Macroeconomic crises can exaggerate existing educational disparities in health. Few studies, however, have examined whether macroeconomic crises get under the skin to affect educational disparities in health-related biological processes. PURPOSE This study aimed to examine the effect of the economic recession of 2008 (i.e., Great Recession) on educational disparities in cardiometabolic risk and self-reported psychological distress. METHODS Data were drawn from two subsamples of the Midlife in the United States (MIDUS) study: the second wave of the MIDUS sample (pre-recession cohort, N = 985) and the refresher sample (post-recession cohort, N = 863). Educational attainment was categorized into high school education or less, some college, and bachelor's degree or higher. Outcomes included metabolic syndrome, C-reactive protein, and interleukin-6, as well as self-reported perceived stress, depressive symptoms, and financial distress. RESULTS Results showed that having a bachelor's degree or higher (compared to having a high school education or less) was more strongly associated with decreased metabolic syndrome symptoms in the post-recession cohort than the pre-recession cohort, above and beyond demographic, health, and behavioral covariates. These findings did not extend to systemic inflammation or psychological distress. CONCLUSIONS Our findings suggest that chronic macroeconomic stressors may widen the educational gap in physical health, particularly cardiometabolic health, by modifying biological and anthropometric risk factors implicated in metabolic syndrome.
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Affiliation(s)
- Yanping Jiang
- Department of Psychology, Wayne State University, Detroit, MI, USA
| | | | - Samuele Zilioli
- Department of Psychology, Wayne State University, Detroit, MI, USA.,Department of Family Medicine and Public Health Sciences, Wayne State University, Detroit, MI, USA
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Ortega-Loubon C, Ruiz López Del Prado G, Muñoz-Moreno MF, Gómez-Sánchez E, López-Herrero R, Sánchez-Quirós B, Lorenzo-Lopez M, Gómez-Pesquera E, Jorge-Monjas P, Bustamante-Munguira J, Álvarez FJ, Resino S, Tamayo E, Heredia-Rodríguez M. Impact of the Economic Crisis on Endocarditis Mortality in Spain: A Nationwide Study. INTERNATIONAL JOURNAL OF HEALTH SERVICES 2021; 52:383-391. [PMID: 33913368 DOI: 10.1177/00207314211012357] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Economic recession has dire consequences on overall health. None have explored the impact of economic crisis (EC) on infective endocarditis (IE) mortality. We conducted a retrospective, nationwide, temporal trend study analyzing mortality trends by age, sex, and adverse outcomes in patients diagnosed with IE in Spain from 1997 to 2014. Data were divided into two subperiods: pre-EC (January 1997-August 2008) and post-EC (September 2008-December 2014). A total of 25 952 patients presented with IE. The incidence increased from 301.4 to 365.1 per 10 000 000 habitants, and the mortality rate rose from 24.3% to 28.4%. Those aged >75 years experienced more adverse outcomes. Complications due to sepsis, shock, acute kidney injury requiring dialysis, and heart failure increased after the EC onset, and expenditures soared to €16 216. Expenditure per community was related to mortality (P < .001). The EC resulted as an independent predictor for mortality (hazard ratio 1.06; 95% confidence interval 1.01-1.11). Incidence and mortality rate in patients with IE after the onset of the EC have increased as a result of rising adverse outcomes despite an overall increased investment.
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Affiliation(s)
- Christian Ortega-Loubon
- Clinic University Hospital of Valladolid, Valladolid, Spain.,Group for Biomedical Research in Critical Care Medicine (BioCritic), Valladolid, Spain
| | | | | | - Esther Gómez-Sánchez
- Clinic University Hospital of Valladolid, Valladolid, Spain.,Group for Biomedical Research in Critical Care Medicine (BioCritic), Valladolid, Spain
| | - Rocío López-Herrero
- Clinic University Hospital of Valladolid, Valladolid, Spain.,Group for Biomedical Research in Critical Care Medicine (BioCritic), Valladolid, Spain
| | - Belén Sánchez-Quirós
- Clinic University Hospital of Valladolid, Valladolid, Spain.,Group for Biomedical Research in Critical Care Medicine (BioCritic), Valladolid, Spain
| | - Mario Lorenzo-Lopez
- Clinic University Hospital of Valladolid, Valladolid, Spain.,Group for Biomedical Research in Critical Care Medicine (BioCritic), Valladolid, Spain
| | - Estefanía Gómez-Pesquera
- Clinic University Hospital of Valladolid, Valladolid, Spain.,Group for Biomedical Research in Critical Care Medicine (BioCritic), Valladolid, Spain
| | - Pablo Jorge-Monjas
- Clinic University Hospital of Valladolid, Valladolid, Spain.,Group for Biomedical Research in Critical Care Medicine (BioCritic), Valladolid, Spain
| | | | - F Javier Álvarez
- Group for Biomedical Research in Critical Care Medicine (BioCritic), Valladolid, Spain.,16782University of Valladolid, Valladolid, Spain
| | - Salvador Resino
- Group for Biomedical Research in Critical Care Medicine (BioCritic), Valladolid, Spain.,38176Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - Eduardo Tamayo
- Clinic University Hospital of Valladolid, Valladolid, Spain.,Group for Biomedical Research in Critical Care Medicine (BioCritic), Valladolid, Spain
| | - María Heredia-Rodríguez
- Clinic University Hospital of Valladolid, Valladolid, Spain.,Group for Biomedical Research in Critical Care Medicine (BioCritic), Valladolid, Spain
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Dhungel B, Murakami T, Wada K, Gilmour S. Mortality risks among blue- and white-collar workers: A time series study among Japanese men aged 25-64 years from 1980 to 2015. J Occup Health 2021; 63:e12215. [PMID: 33837627 PMCID: PMC8035635 DOI: 10.1002/1348-9585.12215] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 02/16/2021] [Accepted: 02/25/2021] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE We aimed to analyse age-standardised mortality trends in Japan among blue- and white-collar male workers aged 25-64 years, by major causes of mortality from 1980 to 2015. METHODS Five-yearly mortality data were extracted from occupation-specific vital statistics maintained by the Japanese Ministry of Health, Labour and Welfare. A time series study was conducted among employed men aged 25-64 years. Age-standardised mortality trends by occupational category were calculated separately for all cancers, ischaemic heart disease, cerebrovascular disease and suicide. Poisson regression analysis was performed to analyse mortality trends by occupational category for each cause. RESULTS Mortality rates for all cancers and ischaemic heart disease were higher among white-collar workers than blue-collar workers throughout the 35-year study period. The gap in the mortality rates for all four causes of death among blue- and white-collar workers widened in 2000 after Japan's economic bubble burst in the late 1990s. Simultaneously, suicide mortality rates among white-collar workers increased sharply and have remained higher than among blue-collar workers. CONCLUSIONS White-collar male workers in Japan have a higher risk of mortality than male blue-collar workers. However, despite substantial differences, significant progress has been made in recent years in reducing mortality across all occupations in Japan.
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Affiliation(s)
- Bibha Dhungel
- Graduate School of Public HealthSt. Luke's International UniversityTokyoJapan
- Department of Health PolicyNational Centre for Child Health and DevelopmentTokyoJapan
| | - Tomoe Murakami
- Graduate School of Public HealthInternational University of Health and WelfareTokyoJapan
| | - Koji Wada
- Graduate School of Public HealthInternational University of Health and WelfareTokyoJapan
| | - Stuart Gilmour
- Graduate School of Public HealthSt. Luke's International UniversityTokyoJapan
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9
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Takaku R. Reversal pattern of health inequality: New evidence from a large-scale national survey in Japan. Health Policy 2020; 124:1254-1262. [DOI: 10.1016/j.healthpol.2020.08.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 08/10/2020] [Accepted: 08/17/2020] [Indexed: 01/11/2023]
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10
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Thompson K, Wagemakers A, van Ophem J. Assessing health outcomes in the aftermath of the great recession: a comparison of Spain and the Netherlands. Int J Equity Health 2020; 19:84. [PMID: 32503561 PMCID: PMC7275523 DOI: 10.1186/s12939-020-01203-6] [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: 02/20/2020] [Accepted: 05/26/2020] [Indexed: 11/26/2022] Open
Abstract
Background Across time and space, financial security has been shown to impact health outcomes, with the acute loss of financial security being particularly detrimental. We compare financial security’s association with health in Spain and the Netherlands. These countries respectively exemplify low and high levels of financial security, general trends that have been exacerbated by the Great Recession of the 2010s. Methods We exploit the Spanish (n = 1001) and Dutch (n = 1010) editions of the European Social Survey 7, conducted in 2014, and condense relevant financial security- and health-related survey questions into latent variables using factor analyses. Using the component loadings as quasi-weightings, we generate one financial security variable and three health variables (mental, physical and social). Then, we run ordinary least squares regressions interacting financial security and nationality, for each of the three health outcomes. Results In unadjusted models, we find that financial security (p < 0.01) is positively associated with the three health outcomes, while being Spanish relative to being Dutch (p < 0.01) is associated with worse health outcomes. However, the results of the interaction term show that being Spanish relative to being Dutch weakens the relationship between physical health and social health, although not mental health. Conclusions We find evidence that financial security’s influence on health outcomes may vary in different contexts. This may be an important aspect of determining the Great Recession’s influence on health outcomes. Our study is a first step in understanding how the relationships between financial security and health may differ in countries with different experiences of the Great Recession.
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Affiliation(s)
- Kristina Thompson
- Department of Health Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Annemarie Wagemakers
- Health and Society Group, Wageningen University & Research, Wageningen, the Netherlands.
| | - Johan van Ophem
- Urban Economics Group, Wageningen University & Research, Wageningen, the Netherlands
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Association between Cardiovascular Mortality and Economic Development: A Spatio-Temporal Study for Prefectures in Japan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17041311. [PMID: 32085501 PMCID: PMC7068662 DOI: 10.3390/ijerph17041311] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 02/10/2020] [Accepted: 02/11/2020] [Indexed: 12/22/2022]
Abstract
In this paper, we use a bivariate choropleth map to investigate the relationship between mortality from cardiovascular disease (CVD) and gross domestic product (GDP) per capita, by sex, in Japanese prefectures from 1996 to 2015. The overall results show a decline in age-standardized CVD mortality rates in all prefectures, for both men and women, and suggest that GDP per capita has varied over the period. We also observed that the relationship between CVD mortality rates and GDP per capita at the prefecture level does not have an overall pattern of the same or inverse association, but is instead a heterogeneous relationship. We argue that this study provides useful clues to policy makers for establishing effective measures for public health planning and the prevention of deaths from CVD. As demonstrated by this study, mapping of the CVD burden in Japan helps to clarify regional differences in life expectancy and health status across regions and identify prefectures where more targeted policy attention may be needed.
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12
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Thompson K, Ophem JV, Wagemakers A. Studying the impact of the Eurozone's Great Recession on health: Methodological choices and challenges. ECONOMICS AND HUMAN BIOLOGY 2019; 35:162-184. [PMID: 31376735 DOI: 10.1016/j.ehb.2019.06.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 06/13/2019] [Accepted: 06/17/2019] [Indexed: 06/10/2023]
Abstract
Europe's Great Recession provides an opportunity to study the impact of increased financial insecurity on health. A number of studies explored the impact of the Recession on health, but they often reached different conclusions. To understand the root of this debate, we undertook a systematic literature review. Articles were analysed thematically based on: geography, data type, operationalisations of wealth and health, and study design. A critical appraisal was also undertaken. Forty-two studies, published from January 2010 to October 2018, were included in our review. Twenty-six of the forty-two studies found that the Great Recession worsened physical health indicators in the Eurozone. In terms of geography, a large concentration of studies focussed on Spain and Greece, indicating that there may be a gap in understanding the health consequences for EU countries with less severe experiences of the Recession. Regarding data type, nearly all studies used secondary datasets, possibly meaning that studies were constrained by the data available. In terms of operationalisations of wealth and health, a majority of studies used single/simple measures of both, so that these multi-faceted concepts were not fully reflected. Further, fewer than half included studies used panel data, with the remaining studies unable to undertake more causal analyses. The results of the critical appraisal showed that lower-quality studies tended to not find a negative impact of the Recession on health, whereas higher quality studies generally did. In future, we recommend conducting cross-country comparisons, using (inter)nationally-representative panel data conducted over a minimum of a ten-year time horizon, and employing multi-faceted operationalisations of wealth and health. This could provide more common ground across studies, and a clearer indication of whether the Recession impacted health.
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Affiliation(s)
- Kristina Thompson
- Department of Health Sciences, Vrije Universiteit Amsterdam, De Boelelaan 1085, 1081 HV Amsterdam, the Netherlands.
| | - Johan van Ophem
- Chair Group Urban Economics, Department of Social Sciences, Wageningen University and Research, Hollandseweg 1, 6706KN Wageningen, the Netherlands
| | - Annemarie Wagemakers
- Chair Group Health and Society, Department of Social Sciences, Wageningen University and Research, Hollandseweg 1, 6706KN Wageningen, the Netherlands
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13
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Lahelma E, Pietiläinen O, Pentala-Nikulainen O, Helakorpi S, Rahkonen O. 36-year trends in educational inequalities in self-rated health among Finnish adults. SSM Popul Health 2019; 9:100504. [PMID: 31720362 PMCID: PMC6838467 DOI: 10.1016/j.ssmph.2019.100504] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 06/27/2019] [Accepted: 10/16/2019] [Indexed: 12/29/2022] Open
Abstract
Health inequalities exist across countries and populations, but little is known about their long-term trends and even less about factors shaping the trends. We examined the magnitude of absolute and relative educational inequalities in self-rated health over 36 years among Finnish adults, considering individual covariates and macro-economic fluctuations. Our data were derived from representative annual cross-sectional surveys in 1979-2014 conducted among adult men and women. Participants aged 25-64 were included and nine periods used (n = 8870-14235). Our health outcome was less-than-good self-rated health (SRH) and our socioeconomic indicator was completed years of education as a continuous variable. Educational inequalities in self-rated health were analysed using the relative index of inequality (RII) and the slope index of inequality (SII). Nine time-variant sociodemographic and health-related covariates were included in the analyses. Linear trends suggested stable or slightly curvilinear overall trends in both absolute and relative health equalities over 36 years. Among men, absolute and relative inequalities narrowed immediately after economic recession in Finland in 1993-1994. Among women, inequalities narrowed during financial crisis in 2008-2009. Adjusting for most covariates reduced the magnitude of inequalities throughout the nine periods, but affected little the temporal patterning of health inequalities. Educational inequalities in self-rated health remained during 36 years in Finland. While among men and women health inequalities narrowed during and after recessions, they widened soon back to the pre-recession level. The perseverance of the trends calls for novel and powerful measures to tackle health inequalities.
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Affiliation(s)
- Eero Lahelma
- Department of Public Health, P.O.Box 20 (Tukholmankatu 8 2B), 00014, University of Helsinki, Finland
| | - Olli Pietiläinen
- Department of Public Health, P.O.Box 20 (Tukholmankatu 8 2B), 00014, University of Helsinki, Finland
| | | | - Satu Helakorpi
- National Institute for Health and Welfare (THL), Helsinki, Finland
| | - Ossi Rahkonen
- Department of Public Health, P.O.Box 20 (Tukholmankatu 8 2B), 00014, University of Helsinki, Finland
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14
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Sanz-Barbero B, Rico Gómez A, Ayala A, Recio P, Sarriá E, Díaz-Olalla M, Zunzunegui MV. Impact of self-reported bank fraud on self-rated health, comorbidity and pain. Int J Public Health 2019; 65:165-174. [PMID: 31705149 DOI: 10.1007/s00038-019-01312-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 09/12/2019] [Accepted: 10/29/2019] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVES As reported in other high-income countries, around the 2008 Great Recession the Spanish banking sector engaged abusive practices that satisfy the definition of fraud. Our objective is to examine the association between self-reported bank fraud and physical health, using a gender perspective. METHODS With data from the 2017 Madrid Health Survey, we examined the association between the economic impact of fraud and poor self-rated health (SRH), comorbidity and pain (N = 4425). Interactions of time since fraud and sex with economic impact were tested by Poisson regression models with robust variance. RESULTS In total, 11% of adults in Madrid reported bank fraud since 2006. Among men, those who experienced frauds with severe economic impact were more likely to report adverse health than those who did not experience fraud (PR comorbidity: 1.46; PR pain conditions: 2.17). Among men time elapsed since fraud strengthened the association between severe economic impact and poor SRH (p = 0.022; p = 0.006, respectively). Among women, associations did not reach statistical significance. CONCLUSIONS Bank frauds are an emerging phenomenon which is likely to damage public health. Stricter regulation to protect people from fraudulent bank practices is needed.
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Affiliation(s)
- Belén Sanz-Barbero
- National School of Public Health, Institute of Health Carlos III, Avda. Monforte de Lemos nº5, pabellón 7, 28029, Madrid, Spain.
- CIBER of Epidemiology and Public Health (CIBERESP), Avenida Monforte de Lemos nº5, Madrid, Spain.
- Joint Research Institute National Distance Education University and Health Institute Carlos III (IMIENS), Avenida Monforte de Lemos nº5, Madrid, Spain.
| | - Ana Rico Gómez
- National School of Public Health, Institute of Health Carlos III, Avda. Monforte de Lemos nº5, pabellón 7, 28029, Madrid, Spain
| | - Alba Ayala
- National School of Public Health, Institute of Health Carlos III, Avda. Monforte de Lemos nº5, pabellón 7, 28029, Madrid, Spain
| | - Patricia Recio
- Joint Research Institute National Distance Education University and Health Institute Carlos III (IMIENS), Avenida Monforte de Lemos nº5, Madrid, Spain
- National Distance Education University (UNED), Calle Juan del Rosal 10, Madrid, Spain
| | - Encarnación Sarriá
- Joint Research Institute National Distance Education University and Health Institute Carlos III (IMIENS), Avenida Monforte de Lemos nº5, Madrid, Spain
- National Distance Education University (UNED), Calle Juan del Rosal 10, Madrid, Spain
| | - Manuel Díaz-Olalla
- Institute of Public Health, Madrid Salud, City Council of Madrid, Avenida Mediterraneo 62, Madrid, Spain
| | - María Victoria Zunzunegui
- National School of Public Health, Institute of Health Carlos III, Avda. Monforte de Lemos nº5, pabellón 7, 28029, Madrid, Spain
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15
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Misawa J, Ichikawa R, Shibuya A, Maeda Y, Arai I, Hishiki T, Kondo Y. The impact of uncertainty in society on the use of traditional, complementary and alternative medicine: a comparative study on visits to alternative/traditional/folk health care practitioners. Altern Ther Health Med 2019; 19:251. [PMID: 31500604 PMCID: PMC6734350 DOI: 10.1186/s12906-019-2662-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 08/29/2019] [Indexed: 12/31/2022]
Abstract
Background While traditional, complementary and alternative medicine (TCAM) is gaining increased interest worldwide, the structural factors associated with the usage of TCAM at the social level have not been sufficiently explored. We aim to understand the social structure of uncertainty in society that affects the TCAM usage for men and women. Methods We studied 32 countries using data from the International Social Survey Programme and the World Bank. In this study, we defined TCAM usage as visits to an alternative/traditional/folk health care practitioner during the past 12 months. We performed a correlation analysis and used a generalized linear model . Results The prevalence of TCAM usage in terms of visits to practitioners was 26.1% globally, while usage varied across the 32 countries. Generalized linear models showed that unemployment rate was associated with the prevalence of TCAM usage in terms of visits to practitioners. Conclusions At the social-structural level TCAM usage involving visits to practitioners was related to job insecurity. Job insecurity led to a decrease in TCAM usage regarding visits to practitioners. These findings suggest that it is necessary to consider the social-structural factors of uncertainty in society when designing health policies related to TCAM. Electronic supplementary material The online version of this article (10.1186/s12906-019-2662-x) contains supplementary material, which is available to authorized users.
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16
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Health-related quality of life in adult population before and after the onset of financial crisis: the case of Athens, Greece. Qual Life Res 2019; 28:3237-3247. [PMID: 31463726 DOI: 10.1007/s11136-019-02281-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE Trends of person-oriented indices with respect to the general population have not been adequately investigated. In Athens, two Health Surveys in 2003 and 2016 provide the opportunity to analyze HRQL in the general adult population. The objectives of this study were to investigate changes in HRQL of adults in the broader area of Athens between 2003 and 2016 and their association with certain socio-demographic determinants. METHODS We compared participants from pre- and during-crisis cross-sectional surveys. We used data from 982 and 1060 adult residents of Athens from 2003 and 2016 surveys, respectively. Income-related missing data were treated using three alternative methods. Subscale and summary component SF-36 scores were compared with Mann-Whitney tests and linear regression analyses were used to estimate the effect of demographic and socio-economic variables on HRQL before and after the onset of crisis. RESULTS The analysis was based on the results of the procedure of handling missing income data as a separate income group and showed that physical component summary score (PCS) has improved and Mental Component Summary score has deteriorated. The most important predictors of HRQL were being widowed and during the crisis not being employed. Additionally, socio-demographic characteristics explained a higher proportion of variance of HRQL after the onset of crisis, especially for PCS. CONCLUSION Decline in mental and improvement in physical HRQL were observed between 2003 and 2016. HRQL has been certainly affected by the recession, but it is difficult to estimate the exact impact of the financial crisis on HRQL.
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Yokoyama Y, Hakulinen T, Sugimoto M, Silventoinen K, Kalland M. Maternal subjective well-being and preventive health care system in Japan and Finland. Eur J Public Health 2019; 28:652-657. [PMID: 29272457 DOI: 10.1093/eurpub/ckx211] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background Maternal well-being is an important issue not only for mothers but also for their offspring and whole families. This study aims to clarify differences in subjective well-being for mothers with infants and associated factors by comparing Japanese and Finnish mothers. Methods In Finland, 101 mothers with infants who received health check-ups at child's age 4 months participated in the study. In Japan, 505 mothers with infants who should receive health check-ups at child's age 4 months and, whose age, age of the infant and number of children matched with the Finnish mothers were selected. The factors associated with maternal subjective well-being were explored by the linear regression analysis. All Finnish mothers had individual infant health check-ups by nurses in Child Health Clinics nearly monthly. The same nurse was responsible for following up the family throughout the years. All Japanese participants received group health check-up once at child's age 3 to 4 months, and a nurse did not cover same child and their mother. Results Finnish mothers showed significantly better subjective well-being compared with Japanese mothers. Whereas 85% of Finnish mothers responded that they had obtained childcare information from public health nurses, significantly fewer Japanese mothers indicated the same response (8%). Linear regression analyses disclosed that mothers' subjective well-being was associated with country, mothers' stress and age. Conclusion Finnish mothers had better subjective well-being than Japanese mothers. Our results may indicate that the Finnish health care system supports mothers better than the Japanese health care system does.
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Affiliation(s)
- Yoshie Yokoyama
- Department of Public Health Nursing, Osaka City University, Osaka, Japan
| | - Tuovi Hakulinen
- Children, Adolescence and Families Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - Masako Sugimoto
- Department of Public Health Nursing, Osaka City University, Osaka, Japan
| | - Karri Silventoinen
- Department of Social Research, University of Helsinki, Helsinki, Finland
| | - Mirjam Kalland
- Swedish School of Social Science, University of Helsinki, Helsinki, Finland
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18
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Spijker and Gumà confirm that during the economic crisis there was an improvement in health indicators in Spain. Salud Colect 2019; 14:685-687. [PMID: 30726445 DOI: 10.18294/sc.2018.1987] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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19
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Suicide Mortality Patterns in Greek Work Force before and during the Economic Crisis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16030469. [PMID: 30736267 PMCID: PMC6388265 DOI: 10.3390/ijerph16030469] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Revised: 01/30/2019] [Accepted: 02/01/2019] [Indexed: 12/03/2022]
Abstract
Background: The global recession of 2007 has attracted research attention in regard to a possible increase of deaths by suicide among employed populations. The aim of the current study was to update the first Greek study on suicide mortality among broad occupational groups during 2000–2009, with the last available data covering the first period of economic crisis and recession in Greece. Methods: Data on suicide deaths for the age groups of 15–39, 40–49 and 50–59, between 2000–2013 were retrieved from the national statististical authority of Greece, ELSTAT. The coding of suicide used was X60–X84 (intentional self-harm), based on the 10th International Classification of Diseases (ICD-10). Comparative mortality ratio (CMR) and exact 95% confidence intervals (CI) are presented. Results: Males and females in the occupational group of clerks exhibited high and increased CMRs during the crisis period (2010–2013). Although high ratios for males in elementary, agricultural and fishery and armed forces occupational groups were monitored during the whole period, a decrease was evident during the crisis period. Increased trends in CMRs during the crisis were monitored for both males and females in the broad occupational group of members including managers, executives and directors. In addition, females especially in the 50–59 age group showed increased ratios and trends in several occupational groups during the crisis, especially in technologists and associate professionals, plant and machine operators and assemblers, professionals, and craft and related trade workers. Conclusions: Austerity-related stress should alert key stakeholders and provide mental health and suicide prevention interventions for employed occupations.
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Misawa J, Ichikawa R, Shibuya A, Maeda Y, Hishiki T, Kondo Y. The prevalence of mental distress before the Great East Japan Earthquake and the associated impact of an aged society: An ecological study. PLoS One 2018; 13:e0203985. [PMID: 30256822 PMCID: PMC6157873 DOI: 10.1371/journal.pone.0203985] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 09/02/2018] [Indexed: 11/18/2022] Open
Abstract
Various studies have determined that the Great East Japan Earthquake (GEJE) caused mental distress among residents in affected areas. However, previous studies had not considered the prevalence of mental distress before the GEJE, and ignored the impact of an aged society on mental distress. Therefore, we aimed to describe the prevalence of mental distress before the GEJE in Miyagi Prefecture, Japan and elucidate the effect of an aged society on mental distress. We conducted an ecological study, using municipality in Miyagi Prefecture as the study unit. We used the cross-sectional mail survey data conducted in February 2011. We performed a correlation analysis in each of the 39 municipalities in Miyagi Prefecture. The prevalence of serious mental distress was 9.1%. The proportion of the population aged 65 years or older was related to the prevalence of serious mental distress in municipalities with a low proportion of all workers engaged in primary industry and with a high estimated number of inpatients with mental illness. We found that residents in Miyagi Prefecture suffered from poor mental health before the GEJE. Aged society was related to serious mental distress in the areas with advanced industrial structure and more patients with mental illness. We should approach mental health problems in the context of social structure, particularly in an aged society, based on facts about mental distress before the GEJE.
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Affiliation(s)
- Jimpei Misawa
- Department of Health Care Services Management, Nihon University School of Medicine, Itabashi, Tokyo, Japan
- * E-mail:
| | - Rie Ichikawa
- Department of Health Care Services Management, Nihon University School of Medicine, Itabashi, Tokyo, Japan
- Department of Pediatrics and Child Health, Nihon University School of Medicine, Itabashi, Tokyo, Japan
| | - Akiko Shibuya
- Department of Health Care Services Management, Nihon University School of Medicine, Itabashi, Tokyo, Japan
| | - Yukihiro Maeda
- Department of Health Care Services Management, Nihon University School of Medicine, Itabashi, Tokyo, Japan
| | - Teruyoshi Hishiki
- Department of Information Science, Faculty of Science, Toho University, Funabashi, Chiba, Japan
| | - Yoshiaki Kondo
- Department of Health Care Services Management, Nihon University School of Medicine, Itabashi, Tokyo, Japan
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21
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Moncho J, Pereyra-Zamora P, Tamayo-Fonseca N, Giron M, Gómez-Beneyto M, Nolasco A. Is recession bad for your mental health? The answer could be complex: evidence from the 2008 crisis in Spain. BMC Med Res Methodol 2018; 18:78. [PMID: 30001696 PMCID: PMC6044068 DOI: 10.1186/s12874-018-0538-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Accepted: 07/05/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND We explored the impact of 2008 recession on the prevalence of mental health problems in Spain. METHODS Repeated cross-sectional survey design. Datasets from 2006 and 2011 were used, and temporal change was examined. The study was conducted on the economically active population (16-64 years old). The two surveys included 29,478 and 21,007 people, obtaining a 96 and 89.6% response rate, respectively. Multiple logistic regression models were adjusted to identify poor mental health risk factors. A standardisation analysis was performed to estimate the prevalence of people at risk of poor mental health (GHQ+). RESULTS The prevalence of GHQ+ following the crisis increased in men and decreased in women. Two logistic regression analyses identified GHQ+ risk factors. From 2006 to 2011, unemployment rose and income fell for both men and women, and there was a decline in the prevalence of somatic illness and limitations, factors associated with a higher prevalence of GHQ+. After controlling for age, the change in employment and income among men prompted an increase in the prevalence of GHQ+, while the change in somatic illness and limitations tended to mitigate this effect. After the recession, unemployed men showed a better level of somatic health. The same effects were not detected in women. CONCLUSIONS The economic recession exerted a complex effect on mental health problems in men. The reduction of prevalence in women was not associated with changes in socioeconomic factors related to the economic crisis nor with changes in somatic health.
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Affiliation(s)
- Joaquín Moncho
- Research Unit for the Analysis of Mortality and Health Statistics, University of Alicante, Campus de San Vicente del Raspeig s/n, Ap. 99, 03080, Alicante, Spain
| | - Pamela Pereyra-Zamora
- Research Unit for the Analysis of Mortality and Health Statistics, University of Alicante, Campus de San Vicente del Raspeig s/n, Ap. 99, 03080, Alicante, Spain.
| | - Nayara Tamayo-Fonseca
- Research Unit for the Analysis of Mortality and Health Statistics, University of Alicante, Campus de San Vicente del Raspeig s/n, Ap. 99, 03080, Alicante, Spain
| | - Manuel Giron
- Research Unit for the Analysis of Mortality and Health Statistics, University of Alicante, Campus de San Vicente del Raspeig s/n, Ap. 99, 03080, Alicante, Spain.,CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain
| | - Manuel Gómez-Beneyto
- CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain.,Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, Valencia, Spain
| | - Andreu Nolasco
- Research Unit for the Analysis of Mortality and Health Statistics, University of Alicante, Campus de San Vicente del Raspeig s/n, Ap. 99, 03080, Alicante, Spain
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Roman Pais Seles BM, Lopes de Sousa Jabbour AB, Chiappetta Jabbour CJ, Jugend D. “In sickness and in health, in poverty and in wealth?”. JOURNAL OF ORGANIZATIONAL CHANGE MANAGEMENT 2018. [DOI: 10.1108/jocm-05-2017-0159] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
“Economic crises” and “corporate social responsibility (CSR) initiatives” are two issues that dominate the modern business agenda. Although related, these issues have been analysed separately, and so a significant gap is perpetuated between the two. What are the effects of economic crises on CSR initiatives? Can organisational social initiatives withstand economic crises? The purpose of this paper is to answer these questions.
Design/methodology/approach
An integrative literature review was conducted, considering: the economic and geographical context in which the research was conducted; the focus of each piece of research; the adopted research methods; organisational theories of analytical support; the sectors analysed; and the effects of economic crises on CSR initiatives and environmental management.
Findings
Some of the findings were as follows: most of the studies analysed reported that CSR helps companies to cope with economic crises by increasing the efficiency of investments and establishing better relations with stakeholders and markets; environmental practices are related to negative environmental performance in periods of economic crises; and CSR relates positively to financial performance in periods of economic crises.
Originality/value
This is one of the first integrative literature reviews to investigate what happens to the relationship between businesses and sustainable change management in periods of crises. This paper also offers a future research agenda for the issue, with 12 questions still unanswered by the latest research.
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Campos-Matos I, Russo G, Gonçalves L. Shifting determinants of health inequalities in unstable times: Portugal as a case study. Eur J Public Health 2018; 28:4-9. [PMID: 29346662 DOI: 10.1093/eurpub/ckx080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background We explore how health inequalities (HI) changed in Portugal over the last decade, considering it is one of the most unequal European countries and has gone through major economic changes. We describe how inequalities in limitations changed considering different socioeconomic determinants, in order to understand what drove changes in HI. Methods We used cross-sectional waves from the European Survey on Income and Living Conditions database to determine how inequalities in health limitations changed between 2004 and 2014 in Portugal in residents aged 16 years and over. We calculated prevalence estimates of limitations and differences between income terciles, the concentration index for each year and its decomposition and multiple logistic regressions to estimate the association between socioeconomic determinants and limitations. Results The prevalence of health limitations increased in Portugal since 2004, especially after 2010, from 35 to 47%. But the difference between top and bottom income terciles decreased from 23 to 10 percentage points, as richer people experienced a steeper increase. This was driven by an increase in prevalence among economically active people, who, from 2011 onwards, had more limitations (OR and 95% CI were 2.42 [2.13-2.75] in 2004 and 0.71 [0.65-0.78] in 2014). Conclusion These results suggest worsening health in Portugal in the last decade, possibly connected to periods of economic instability. However, absolute HI decreased considerably in the same period. We discuss the possible role of diverse adaptation capacity of socioeconomic groups, and of high emigration rates of young, healthier people, reflecting another side of the 'migrant health effect'.
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Affiliation(s)
- Inês Campos-Matos
- Instituto de Higiene e Medicina Tropical, Nova University of Lisbon, Lisbon, Portugal.,Centro de Investigação em Saúde Pública, Lisbon, Portugal
| | - Giuliano Russo
- Department of Primary Care and Public Health, Queen Mary University of London, London, UK
| | - Luzia Gonçalves
- Instituto de Higiene e Medicina Tropical, Nova University of Lisbon, Lisbon, Portugal.,Centro de Estatística e Aplicações da Universidade de Lisboa, Lisbon, Portugal
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Rathmann K, Pförtner TK, Elgar FJ, Hurrelmann K, Richter M. The Great Recession, Adolescent Smoking, and Smoking Inequalities: What Role Does Youth Unemployment Play in 24 European Countries? Nicotine Tob Res 2018; 19:1284-1291. [PMID: 27794036 DOI: 10.1093/ntr/ntw298] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2016] [Accepted: 10/25/2016] [Indexed: 11/14/2022]
Abstract
Introduction Conflicting evidence has been reported on smoking behavior among adults during times of economic downturn. No study has yet investigated young people's smoking and inequalities in smoking during economic recessions. This study examines the association between country-level youth unemployment due to the economic recession and adolescent smoking and smoking inequalities in Europe. Methods The WHO collaborative "Health Behaviour in School-aged Children" study in 2009/2010 included 15-year-old adolescents from 24 European countries (N = 43 093). Socioeconomic position (SEP) was measured by the Family Affluence Scale. Logistic multilevel models were conducted. The absolute rate of youth unemployment in 2010 (during the recession) and the relative change rate in youth unemployment (2005/2006-2009/2010) were regressed on smoking and SEP inequalities in smoking in 2010, respectively. Results Youth unemployment rates were not significantly associated with overall smoking in adolescents. A higher absolute youth unemployment rate in 2010 related to lower likelihoods of smoking among middle (OR: 0.99; 95% CI: 0.98-0.99) and low affluent adolescents (OR: 0.99; 95% CI: 0.98-0.99) compared to high affluent adolescents. In contrast, an increase in youth unemployment (2005/2006-2009/2010) was not associated with overall likelihoods of smoking and inequalities in smoking. Conclusions Our findings indicate that an increase in youth unemployment was not related to smoking and smoking inequalities. However, higher absolute levels of youth unemployment are related to lower likelihoods of smoking in lower SEP adolescents. Thus, smoking among vulnerable groups is more linked to the overall insecure circumstances and the affordability of cigarettes rather than to the economic recession itself. Implications Economic recessions have often led to increases in adult and youth unemployment rates. Conflicting evidence has been reported on smoking behavior among adults during times of economic downturn. This study examines for the first time the impact of the economic recession on young people's smoking and socioeconomic inequalities in smoking. Findings highlight that rather than an increase in youth unemployment, the overall country-level youth unemployment rate is related to young people's tobacco use and particularly to lower odds in smoking among less affluent adolescents across Europe, a finding which is likely to be linked to the affordability of tobacco use.
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Affiliation(s)
- Katharina Rathmann
- Institute of Medical Sociology, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle, Germany
| | - Timo-Kolja Pförtner
- Institute of Medical Sociology, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle, Germany.,Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Faculty of Human Sciences and the Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Frank J Elgar
- Institute for Health and Social Policy, McGill University, Montreal, QC, Canada
| | | | - Matthias Richter
- Institute of Medical Sociology, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle, Germany
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Sugisawa H, Harada K, Sugihara Y, Yanagisawa S, Shinmei M. Socioeconomic status disparities in late-life disability based on age, period, and cohort in Japan. Arch Gerontol Geriatr 2017; 75:6-15. [PMID: 29161682 DOI: 10.1016/j.archger.2017.11.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 09/26/2017] [Accepted: 11/10/2017] [Indexed: 01/24/2023]
Abstract
INTRODUCTION Effects of disparities in socioeconomic status (SES) on late-life disabilities have been reported around the world. However, there are only a few studies that have examined age, period, and cohort dependent influences of SES disparities on late-life disabilities. We investigated associations between SES disparities and late-life disability based on the Age-Period-Cohort. We also investigated how macro-economic conditions unique to a period, or a cohort might explain the period or the cohort trends. METHODS Data were obtained from people aged 65 and over that responded to the Comprehensive Survey of Living Conditions, which had been conducted every three years from 1989 to 2013. SES was assessed via household income. Disability was assessed as disabilities in performing Basic Activities of Daily Living (BADL). Income disparities were evaluated by the slope index of inequality (SII) and the relative index of inequality (RII). Each Age-Period-Cohort dimension was simultaneously controlled using a model for cross-classification of random effects. RESULTS Differences in BADL disabilities due to income disparities decreased with age and reversed after approximately 80 years of age. Income disparities in BADL disability changed across periods, by increasing in periods with a high unemployment rate, which started two to four years before the period. Moreover, results of using SII and RII were nearly identical. CONCLUSIONS Higher mortality in elderly with lower income might be related to a reduction of income disparities in BADL disability in Japan. Furthermore, exposure to harsh economic conditions might contribute to increased disparities in BADL disability a few years later.
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Affiliation(s)
- Hidehiro Sugisawa
- J.F. Oberlin University, 3758 Tokiwa-machi, Machida-shi, Tokyo 194-0294, Japan.
| | - Ken Harada
- Jissen Women's University, 1-1-49 Higashi, Shibuya-ku, Tokyo 150-8538, Japan.
| | - Yoko Sugihara
- Tokyo Metropolitan University, 1-1 Minami-Osawa, Hachioji-shi, Tokyo 192-0397, Japan.
| | - Shizuko Yanagisawa
- Tokushima University, 3-18-15 Kuramoto-cho, Tokushima-shi, Tokushima 770-8503, Japan.
| | - Masaya Shinmei
- J.F. Oberlin University, 3758 Tokiwa-machi, Machida-shi, Tokyo 194-0294, Japan.
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Economou M, Souliotis K, Peppou LE, Agapidaki I, Tzavara C, Stefanis CN. Major depression in Cyprus amid financial crisis: prevalence and correlates. ACTA ACUST UNITED AC 2017. [DOI: 10.1080/17542863.2017.1364283] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Marina Economou
- Community Mental Health Centre, University Mental Health Research Institute (UMHRI), Athens, Greece
- First Department of Psychiatry, Medical School, National & Kapodistrian University, Athens, Greece
| | - Kyriakos Souliotis
- Faculty of Social and Political Sciences, University of Peloponnese, Corinth, Greece
- Centre for Health Services Research, Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National & Kapodistrian University, Athens, Greece
| | - Lily Evangelia Peppou
- Community Mental Health Centre, University Mental Health Research Institute (UMHRI), Athens, Greece
| | - Irene Agapidaki
- Centre for Health Services Research, Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National & Kapodistrian University, Athens, Greece
| | - Chara Tzavara
- Community Mental Health Centre, University Mental Health Research Institute (UMHRI), Athens, Greece
| | - Costas N. Stefanis
- Community Mental Health Centre, University Mental Health Research Institute (UMHRI), Athens, Greece
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Sigursteinsdóttir H, Rafnsdóttir GL, Jónsdóttir GA. Changes in occupational mental and physical health and health symptoms during the economic recession. Work 2017; 56:603-615. [PMID: 28372340 DOI: 10.3233/wor-172523] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND In 2008, many Western countries faced a great economic recession, the result of which was increased unemployment and reduced public expenditure. OBJECTIVE This article focuses on changes in the self-reported mental and physical health and health symptoms of the remaining employees of Icelandic municipalities who worked within the educational system and the care service during the economic recession. We examine gender differences in health and differences between downsized workplaces and workplaces where no downsizing occurred and differences between workplaces with heavy workload and light workload. METHODS The study is based on a balanced panel online survey and focus groups. RESULTS The main finding is that both the mental and physical health of employees deteriorated year by year between 2010, 2011 and 2013 in all workplaces although the downsized workplaces and workplaces with heavy workloads fared worse. At the same time, public expenditure on the health care system was reduced. CONCLUSIONS We hope that our results encourage further studies in the field and that they will be taken into account when dealing with prevention and rehabilitation initiatives.
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Bonnie Lee C, Liao CM, Lin CM. The impacts of the global financial crisis on hospitalizations due to depressive illnesses in Taiwan: A prospective nationwide population-based study. J Affect Disord 2017. [PMID: 28633047 DOI: 10.1016/j.jad.2017.06.028] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND In the third quarter of 2008, a major financial crisis hit many developed countries. Taiwan suffered its own share: a rise in unemployment and a severe decline in gross domestic product. This study is to address the health consequences of this crisis on different socioeconomic populations in Taiwan. METHODS A sample of 6,225,766 men and 5,417,651 women, was obtained and their admissions data over 2007-2012 were retrieved. Stratified into three income levels, the sample was examined on the 147,921 episodes of hospitalization due to depressive illnesses (DIs) over that period by an interrupted time series analysis for monthly incidence rates of DI hospitalizations RESULTS: The adjusted incidence rates of hospitalization (AIRH) for DIs among the low income were 10 times that of the high income group. The AIRHs were generally higher in all of three female income groups than they were in the three male income groups. The low income men and women showed increases (of 18.0% and 14.2%, respectively) beginning in April 2008 that sustained for two years. The high income women exhibited a 5.0% monthly rise in the rate of DI hospitalizations. LIMITATIONS Our time series models can control some confounding factors, but the ecological fallacy remained. CONCLUSIONS This study provides evidence that the economic recession resulted in increased rates of DI hospitalization in Taiwan, especially among the low income population. Women of higher incomes may have suffered a more enduring impact.
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Affiliation(s)
- Chiachi Bonnie Lee
- Department of Health Services Administration, College of Public Health, China Medical University, Taichung, Taiwan
| | - Chen-Mao Liao
- Department of Applied Statistics and Information Science, Ming Chuan University, Taoyuan, Taiwan
| | - Chih-Ming Lin
- Department of Healthcare Information and Management, Ming Chuan University, Taoyuan, Taiwan.
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Kanchanachitra C, Tangcharoensathien V. Health inequality across prefectures in Japan. Lancet 2017; 390:1471-1473. [PMID: 28734671 DOI: 10.1016/s0140-6736(17)31792-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 06/10/2017] [Indexed: 01/04/2023]
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Tanaka H, Toyokawa S, Tamiya N, Takahashi H, Noguchi H, Kobayashi Y. Changes in mortality inequalities across occupations in Japan: a national register based study of absolute and relative measures, 1980-2010. BMJ Open 2017; 7:e015764. [PMID: 28877942 PMCID: PMC5588999 DOI: 10.1136/bmjopen-2016-015764] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVE Changes in mortality inequalities across socioeconomic groups have been a substantial public health concern worldwide. We investigated changes in absolute/relative mortality inequalities across occupations, and the contribution of different diseases to inequalities in tandem with the restructuring of the Japanese economy. METHODS Using complete Japanese national death registries from 5 year intervals (1980-2010), all cause and cause specific age standardised mortality rates (ASMR per 100 000 people standardised using the Japanese standard population in 1985, aged 30-59 years) across 12 occupations were computed. Absolute and relative inequalities were measured in ASMR differences (RDs) and ASMR ratios (RRs) among occupations in comparison with manufacturing workers (reference). We also estimated the changing contribution of different diseases by calculating the differences in ASMR change between 1995 and 2010 for occupations and reference. RESULTS All cause ASMRs tended to decrease in both sexes over the three decades except for male managers (increased by 71% points, 1995-2010). RDs across occupations were reduced for both sexes (civil servants 233.5 to -1.9 for men; sales workers 63.3 to 4.5 for women) but RRs increased for some occupations (professional workers 1.38 to 1.70; service workers 2.35 to 3.73) for men and decreased for women from 1980 to 2010. Male relative inequalities widened among farmer, fishery and service workers, because the percentage declines were smaller in these occupations. Cerebrovascular disease and cancer were the main causes of the decrease in mortality inequalities among sexes but the incidence of suicide increased among men, thereby increasing sex related inequalities. CONCLUSIONS Absolute inequality trends in mortality across occupations decreased in both sexes, while relative inequality trends were heterogeneous in Japan. The main drivers of narrowing and widening mortality inequalities were cerebrovascular disease and suicide, respectively. Future public health efforts will benefit from eliminating residual inequalities in mortality by considering the contribution of the causes of death and socioeconomic status stratification.
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Affiliation(s)
- Hirokazu Tanaka
- Department of Public Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Satoshi Toyokawa
- Department of Public Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Nanako Tamiya
- Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Hideto Takahashi
- Research Managing Director, National Institute of Public Health, Wako, Japan
| | - Haruko Noguchi
- Faculty of Political Science and Economics, Waseda University, Tokyo, Japan
| | - Yasuki Kobayashi
- Department of Public Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Malard L, Chastang JF, Niedhammer I. Évolution des comportements et indicateurs de santé mentale entre 2006 et 2010 dans la population au travail en France. Rev Epidemiol Sante Publique 2017. [DOI: '10.1016/j.respe.2017.04.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023] Open
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Malard L, Chastang JF, Niedhammer I. [Changes in behaviors and indicators of mental health between 2006 and 2010 in the French working population]. Rev Epidemiol Sante Publique 2017; 65:309-320. [PMID: 28601504 DOI: 10.1016/j.respe.2017.04.056] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Revised: 12/02/2016] [Accepted: 04/03/2017] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND The 2008 economic crisis may have had an impact on mental health but the studies on this topic are sparse, in particular among the working population. However, mental health at work is a crucial issue involving substantial costs and consequences. The aim of the study was to assess changes in behaviors and indicators of mental health in the French working population between 2006 and 2010, and to explore the differential changes according to age, origin, occupation, activity sector, public/private sector, self-employed/employee status and work contract. METHODS The data came from the prospective national representative Santé et itinéraire professionnel (SIP) survey, including a sample of 5600 French workers interviewed in 2006 and 2010. The behaviors and indicators of mental health studied were excessive alcohol consumption, smoking, sleep problems (sleep disorders and/or insufficient sleep duration), psychotropic drug use (antidepressants, anxiolytics and/or hypnotics), and poor self-reported health. Generalized estimating equations were used to analyze changes in behaviors and indicators of mental health, and the analyses were adjusted for age. Covariates (age, origin, occupation, activity sector, public/private sector, self-employed/employee status and type of contract) were added separately to assess differential changes. RESULTS Increases in excessive alcohol consumption among women, sleep problems among men, and smoking, insufficient sleep duration and poor self-reported health for both genders were observed in the French working population between 2006 and 2010. Some differential changes were observed, negative changes being more likely to affect young workers and workers with a permanent contract. CONCLUSION Prevention policies should consider that behavior and indicators of mental health may deteriorate in times of economic crisis, especially among some sub-groups of the working population, such as young workers and workers with a permanent contract. These changes might foreshadow a forthcoming increase in mental disorders.
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Affiliation(s)
- L Malard
- Inserm, UMR_S 1136, Institut Pierre-Louis d'épidémiologie et de santé publique, Équipe de recherche en épidémiologie sociale, 75013 Paris, France; Institut Pierre-Louis d'épidémiologie et de santé publique, Équipe de recherche en épidémiologie sociale, Sorbonne universités, UPMC université Paris 06, UMR S 1136, 75013 Paris, France; Université de Versailles-Saint-Quentin, 78000 Versailles, France
| | - J-F Chastang
- Inserm, UMR_S 1136, Institut Pierre-Louis d'épidémiologie et de santé publique, Équipe de recherche en épidémiologie sociale, 75013 Paris, France; Institut Pierre-Louis d'épidémiologie et de santé publique, Équipe de recherche en épidémiologie sociale, Sorbonne universités, UPMC université Paris 06, UMR S 1136, 75013 Paris, France
| | - I Niedhammer
- Inserm, UMR_S 1136, Institut Pierre-Louis d'épidémiologie et de santé publique, Équipe de recherche en épidémiologie sociale, 75013 Paris, France; Institut Pierre-Louis d'épidémiologie et de santé publique, Équipe de recherche en épidémiologie sociale, Sorbonne universités, UPMC université Paris 06, UMR S 1136, 75013 Paris, France.
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Casanova L, Carrier H, Martin de Vidales A, Cortaredona S, Verger P. [Trends in social inequities in diabetes care in the Provence-Alpes-Côte-d'Azur region of France between 2008 and 2011]. Rev Epidemiol Sante Publique 2017; 65:29-40. [PMID: 28089384 DOI: 10.1016/j.respe.2016.10.060] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Revised: 04/27/2016] [Accepted: 10/21/2016] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Social inequities in healthcare are known to exist for the management of many chronic diseases in France, including diabetes. The recession that began in 2008 has led to increased income disparities but has it also exacerbated health inequities. The aim of this study was to describe trends in inequities in diabetes-related healthcare between 2008 and 2011 in the PACA region (Provence-Alpes-Côte-d'Azur). METHODS This analysis used two sources of data: the regional national health insurance fund (PACA region) reimbursement database and the socio-demographic databases of the national statistics office (INSEE) for four full years (2008 to 2011). It included individuals who had been reimbursed for three purchases of oral diabetes drugs during the previous year and assessed the association between the median household income (weighted by number and age of household members) of each patient's municipality of residence and seven indicators of diabetes monitoring and care. Using adjusted mixed logistic models, including an interaction term between time (number of years) and the median household income of the municipality, we examined the performance of the indicators for each year. RESULTS The total number of patients with diabetes in the 941 municipalities of the PACA region varied by year from 142,055 to 164,929. Models showed that living in a town with a high or intermediate household income was significantly associated with better performance of the seven indicators and that the interaction term was significant for six of them. The effect of the municipal median income decreased significantly between 2008 and 2011 for five indicators: HbA1c, LDL-cholesterol, microalbuminuria, ophthalmoscopy and diabetes specialist visit. CONCLUSION Social inequities in diabetes-related healthcare persisted between 2008 and 2011 but appeared to be decreasing, despite the recession.
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Affiliation(s)
- L Casanova
- Aix-Marseille université, département de médecine générale, 13005 Marseille, France; Sciences économiques & sociales de la santé et traitement de l'information médicale (SESSTIM), Inserm, UMR_S 912, 13385 Marseille, France; ORS PACA, observatoire régional de la santé Provence-Alpes-Côte-d'Azur, 13006 Marseille, France.
| | - H Carrier
- Aix-Marseille université, département de médecine générale, 13005 Marseille, France; Sciences économiques & sociales de la santé et traitement de l'information médicale (SESSTIM), Inserm, UMR_S 912, 13385 Marseille, France; ORS PACA, observatoire régional de la santé Provence-Alpes-Côte-d'Azur, 13006 Marseille, France
| | - A Martin de Vidales
- Aix-Marseille université, département de médecine générale, 13005 Marseille, France
| | - S Cortaredona
- Sciences économiques & sociales de la santé et traitement de l'information médicale (SESSTIM), Inserm, UMR_S 912, 13385 Marseille, France; Aix-Marseille université, UMR_S 912, IRD, 13385 Marseille, France; ORS PACA, observatoire régional de la santé Provence-Alpes-Côte-d'Azur, 13006 Marseille, France
| | - P Verger
- Sciences économiques & sociales de la santé et traitement de l'information médicale (SESSTIM), Inserm, UMR_S 912, 13385 Marseille, France; Aix-Marseille université, UMR_S 912, IRD, 13385 Marseille, France; ORS PACA, observatoire régional de la santé Provence-Alpes-Côte-d'Azur, 13006 Marseille, France
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Gordeev VS, Goryakin Y, McKee M, Stuckler D, Roberts B. Economic shocks and health resilience: lessons from the Russian Federation. J Public Health (Oxf) 2016; 38:e409-e418. [PMID: 28158731 PMCID: PMC6092918 DOI: 10.1093/pubmed/fdv166] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background Despite extensive research on determinants of health, there is much less information on factors protecting health among those exposed to economic shocks. Using longitudinal data from the Russian Federation in the post-Soviet period, we examined individual-level factors that enhance resilience of health to economic shocks. Methods Logistic regression analysed factors associated with good self-assessed health (SAH) and health resilience, using pooled samples from the Russia Longitudinal Monitoring Survey-Higher School of Economics (1994–2012). Results The general population consistently reported ‘average’ SAH, indicating almost invariant trends over the years. Male gender was the strongest predictor of good SAH and health resilience. Other factors positively associated with good SAH were age, higher education, employment, residing in rural areas, living in a larger and/or non-poor household. Among unemployed and those remaining unemployed, residing in rural areas, living in a larger and/or non-poor household remained the strongest predictors of good SAH and health resilience. These same factors were also important for males with recent job loss. Conclusions Several factors predicting good SAH in the general population also influence health resilience factors among those remaining unemployed and experiencing a job loss. Such factors help to identify those most vulnerable and aid targeting assistance during economic crises.
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Affiliation(s)
| | - Yevgeniy Goryakin
- Norwich Medical School, University of East Anglia, Norwich NR4 7TJ, UK
| | - Martin McKee
- ECOHOST-Centre for Health and Social Change, London School of Hygiene and Tropical Medicine, London WC1H 9SH, UK
| | - David Stuckler
- Department of Sociology, Oxford University, Oxford OX1 3UQ, UK
| | - Bayard Roberts
- ECOHOST-Centre for Health and Social Change, London School of Hygiene and Tropical Medicine, London WC1H 9SH, UK
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Hanibuchi T, Nakaya T, Honjo K. Trends in socioeconomic inequalities in self-rated health, smoking, and physical activity of Japanese adults from 2000 to 2010. SSM Popul Health 2016; 2:662-673. [PMID: 29349178 PMCID: PMC5757786 DOI: 10.1016/j.ssmph.2016.09.002] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 09/04/2016] [Accepted: 09/06/2016] [Indexed: 11/29/2022] Open
Abstract
Health disparities in Japan are attracting increasing attention. Temporal trends in health disparities should be continuously monitored using multiple indices of socioeconomic status (SES) and health-related outcomes. We explored changes in socioeconomic differences in the health of Japanese adults during 2000–2010. The data was taken from the Japanese General Social Surveys, the cross-sectional surveys for nationally representative samples of Japanese adults. We used 14,193 samples (individuals of 20–64 years of age) in our analysis. We estimated age-adjusted prevalence ratios of the lowest SES group in comparison with the highest SES group using Poisson regression models with robust error variance. Relative index of inequality (RII) and slope index of inequality (SII) were also calculated. We examined the changes in the association between health-related outcomes (self-rated health (SRH), smoking, and physical activity) and SES indices (income, education, occupation, and subjective social class identification). The results showed temporally expanding trends for the associations of current smoking with SES, especially among women, in both relative and absolute measures. In contrast, no expanding trends were seen for SRH and physical activity. Although the smoking rates declined through the first decade of the 21st century, the socioeconomic disparities in smoking prevalence among Japanese adults expanded, especially among women. Researchers and policymakers should continuously monitor the trends that may cause future disparities in smoking-related morbidity and mortality. Associations of health indicators with socioeconomic status were observed in Japan. We identified increasing trends in smoking disparity from 2000 to 2010 in women. Increasing smoking disparities were seen in both relative and absolute measures. Expanding trends were not seen for self-rated health and physical activity.
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Affiliation(s)
- Tomoya Hanibuchi
- School of International Liberal Studies, Chukyo University, 101-2 Yagoto Honmachi, Showa-ku, Nagoya, Aichi 466-8666, Japan
| | - Tomoki Nakaya
- Department of Geography and Research Institute for Disaster Mitigation of Urban Cultural Heritage, Ritsumeikan University, 58 Komatsubara Kitamachi, Kita-ku, Kyoto 603-8341, Japan
| | - Kaori Honjo
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
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Maynou L, Saez M. Economic crisis and health inequalities: evidence from the European Union. Int J Equity Health 2016; 15:135. [PMID: 27586144 PMCID: PMC5009665 DOI: 10.1186/s12939-016-0425-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 08/25/2016] [Indexed: 11/21/2022] Open
Abstract
Background The recent economic crisis has been a major shock not only to the economic sector, but also to the rest of society. Our main objective in this paper is to show the impact of the economic crisis on convergence, i.e. the reduction or equalising of disparities, among the EU-27 countries in terms of health. The aim is to observe whether the economic crisis (from 2008 onwards) has in fact had an effect on health inequalities within the EU. Methods We estimate convergence by specifying a dynamic panel model with random-effects (time, regions and countries). We are particularly interested in σ-convergence. As dependent variables, we use life expectancy, total mortality and (cause-specific) mortality in the regions of the EU-27 countries over the period 1995–2011. Results The results of the analysis show that, in terms of health, there has been a catching-up process among the EU regions. However, we find no reduction, on average, in dispersion levels as the σ-convergence shows. The main finding of this paper has been the sharp increase in disparities in 2010 for all health outcomes (albeit less abrupt for cancer mortality). Conclusion This increase in disparities in 2010 coincides with the austerity measures implemented in the EU countries. Our main conclusion is that these austerity measures have had an impact on socioeconomic inequalities.
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Affiliation(s)
- Laia Maynou
- Center for Research in Health and Economics (CRES), Universitat Pompeu Fabra, C/Ramon Trias Fargas, 25-27, Mercè Rodoreda Building, 08005, Barcelona, Spain. .,Research Group on Statistics, Econometrics and Health (GRECS), Universitat de Girona, Campus de Montilivi, 17071, Girona, Spain. .,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.
| | - Marc Saez
- Center for Research in Health and Economics (CRES), Universitat Pompeu Fabra, C/Ramon Trias Fargas, 25-27, Mercè Rodoreda Building, 08005, Barcelona, Spain.,Research Group on Statistics, Econometrics and Health (GRECS), Universitat de Girona, Campus de Montilivi, 17071, Girona, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
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Rathmann K, Pförtner TK, Hurrelmann K, Osorio AM, Bosakova L, Elgar FJ, Richter M. The great recession, youth unemployment and inequalities in psychological health complaints in adolescents: a multilevel study in 31 countries. Int J Public Health 2016; 61:809-19. [PMID: 27502510 DOI: 10.1007/s00038-016-0866-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Revised: 07/12/2016] [Accepted: 07/15/2016] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES Little is known about the impact of recessions on young people's socioeconomic inequalities in health. This study investigates the impact of the economic recession in terms of youth unemployment on socioeconomic inequalities in psychological health complaints among adolescents across Europe and North America. METHODS Data from the WHO collaborative 'Health Behaviour in School-aged Children' (HBSC) study were collected in 2005/06 (N = 160,830) and 2009/10 (N = 166,590) in 31 European and North American countries. Logistic multilevel models were used to assess the contribution of youth unemployment in 2009/10 (enduring recession) and the change in youth unemployment (2005-2010) to adolescent psychological health complaints and socioeconomic inequalities in complaints in 2009/10. RESULTS Youth unemployment during the recession is positively related to psychological health complaints, but not to inequalities in complaints. Changes in youth unemployment (2005-2010) were not associated with adolescents' psychological health complaints, whereas greater inequalities in complaints were found in countries with greater increases in youth unemployment. CONCLUSIONS This study highlights the need to tackle the impact of increasing unemployment on adolescent health and health inequalities during economic recessions.
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Affiliation(s)
- Katharina Rathmann
- Institute of Medical Sociology, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.
| | - Timo-Kolja Pförtner
- Institute of Medical Sociology, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.,Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Faculty of Human Sciences and the Faculty of Medicine, University of Cologne, Cologne, Germany
| | | | - Ana M Osorio
- Department of Economics, Pontificia Universidad Javeriana Cali, Cali, Colombia
| | - Lucia Bosakova
- Health Psychology Unit, Institute of Public Health, Medical Faculty, P. J. Safarik University in Kosice, Kosice, Slovak Republic.,Department of Quantitative Methods, Faculty of Business Economy in Kosice, University of Economics in Bratislava, Kosice, Slovak Republic.,Olomouc University Social Health Institute (OUSHI), Palacky University in Olomouc, Olomouc, Czech Republic
| | - Frank J Elgar
- Institute for Health and Social Policy and Douglas Institute, McGill University, Montreal, QC, Canada
| | - Matthias Richter
- Institute of Medical Sociology, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
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Sugisawa H, Harada K, Sugihara Y, Yanagisawa S, Shinmei M. Socioeconomic status and self-rated health of Japanese people, based on age, cohort, and period. Popul Health Metr 2016; 14:27. [PMID: 27489510 PMCID: PMC4971645 DOI: 10.1186/s12963-016-0095-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Accepted: 07/25/2016] [Indexed: 12/31/2022] Open
Abstract
Background Differences in health resulting from differences in socioeconomic status (SES) have been identified around the world. Age, period, and cohort (A-P-C) differences in health are vital factors which are associated with disparities in SES. However, few studies have examined these differences simultaneously. Moreover, although self-rated health (SRH) has been frequently used as an indicator of health, biases in reporting SRH that depend on the socioeconomic characteristics of respondents have been scarcely adjusted in the previous studies. To overcome these limitations, we investigated the associations between disparities in SES and adjusted SRH based on A-P-C, by using a repeated, cross-sectional survey of a nationally representative sample of Japanese people. In addition, we further investigated how exogenous (macroeconomic) conditions unique to a period or cohort would explain trends across successive periods and cohorts. Methods Data were obtained from a sample of 653,132 Japanese people that responded to the Comprehensive Survey of Living Conditions (CSLC), which is a cross-sectional survey that had been conducted every three years from 1986 to 2013, on over 10 occasions. In the CSLC, SES has been assessed by household income. We simultaneously controlled for each A-P-C dimension by using the model for cross-classification of random effects, and adjusting SRH data for reporting biases caused by differences in income and A-P-C. Results Differences in adjusted SRH associated with income differences decreased with age and reversed after 76 years of age. Period differences indicated that income differences peaked in 1992 and 2007. Moreover, differences in adjusted SRH associated with income differences decreased in periods with high unemployment across all periods. Furthermore, there were no cohort differences in adjusted SRH that were associated with income differences. Conclusion In Japan, there are age and period variations associated with adjusted differences in SRH as assessed by income. Moreover, exogenous conditions in each period could help explain periodic trends across successive periods.
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Affiliation(s)
- Hidehiro Sugisawa
- Graduate School of Gerontology, J. F. Oberlin University, 3758 Tokiwa-machi, Machida-shi, Tokyo, 194-0294 Japan
| | - Ken Harada
- Jissen Women's University, 1-1-49 Higashi, Shibuya-ku, Tokyo, 150-8538 Japan
| | - Yoko Sugihara
- Tokyo Metropolitan University, 1-1 Minami-Osawa, Hachioji-shi, Tokyo, 192-0397 Japan
| | - Shizuko Yanagisawa
- Tokushima University, 3-18-15 Kuramoto-cho, Tokushima-shi, Tokushima 770-8503 Japan
| | - Masaya Shinmei
- Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo, 173-0015 Japan
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Barroso C, Abásolo I, Cáceres JJ. Health inequalities by socioeconomic characteristics in Spain: the economic crisis effect. Int J Equity Health 2016; 15:62. [PMID: 27067675 PMCID: PMC4827195 DOI: 10.1186/s12939-016-0346-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Accepted: 03/31/2016] [Indexed: 11/23/2022] Open
Abstract
Background An economic crisis can widen health inequalities between individuals. The aim of this paper is to explore differences in the effect of socioeconomic characteristics on Spaniards’ self-assessed health status, depending on the Spanish economic situation. Methods Data from the 2006–2007 and 2011–2012 National Health Surveys were used and binary logit and probit models were estimated to approximate the effects of socioeconomic characteristics on the likelihood to report good health. Results The difference between high and low education levels leads to differences in the likelihood to report good health of 16.00–16.25 and 18.15–18.22 percentage points in 2006–07 and 2011–12, respectively. In these two periods, the difference between employees and unemployed is 5.24–5.40 and 4.60–4.90 percentage points, respectively. Additionally, the difference between people who live in households with better socioeconomic conditions and those who are in worse situation reaches 5.37–5.46 and 3.63–3.74 percentage points for the same periods, respectively. Conclusions The magnitude of the contribution of socioeconomic characteristics to health inequalities changes with the economic cycle; but this effect is different depending on the socioeconomic characteristics indicator that is being measured. In recessive periods, health inequalities due to education level increase, but those linked to individual professional status and household living conditions are attenuated. When the joint effects of individuals’ characteristics are considered, the economic crisis brings about a slight increase in the inequalities in the probability of reporting good health between the two extreme profiles of individuals. The design of public policies aimed at preventing any worsening of health inequalities during recession periods should take into account these differential effects of socioeconomic characteristics indicators on health inequalities.
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Affiliation(s)
- Clara Barroso
- Departamento de Economía Aplicada y Métodos Cuantitativos, Facultad de Economía, Empresa y Turismo, Universidad de La Laguna, Campus de Guajara, 38071, La Laguna, Tenerife, Spain
| | - Ignacio Abásolo
- Departamento de Economía Aplicada y Métodos Cuantitativos, Facultad de Economía, Empresa y Turismo, Universidad de La Laguna, Campus de Guajara, 38071, La Laguna, Tenerife, Spain.
| | - José J Cáceres
- Departamento de Economía Aplicada y Métodos Cuantitativos, Facultad de Economía, Empresa y Turismo, Universidad de La Laguna, Campus de Guajara, 38071, La Laguna, Tenerife, Spain
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Age-period-cohort analysis of the suicide rate in Korea. J Affect Disord 2016; 194:16-20. [PMID: 26802502 DOI: 10.1016/j.jad.2016.01.021] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Revised: 10/02/2015] [Accepted: 01/10/2016] [Indexed: 11/21/2022]
Abstract
BACKGROUND The suicide rate has been increasing in Korea, and the country now has the highest rank in the world. This study aimed to present the long-term trends in Korea's suicide rate using Joinpoint analysis and age-period-cohort (APC) modeling. METHODS The population and the number of suicides for each five-year age group were obtained from the National Statistical Office for the period 1984-2013 for Koreans aged 10 years and older. We determined the changes in the trends in age-standardized mortality rates using Joinpoint. APC modeling was performed to describe the trends in the suicide rate using the intrinsic estimator method. RESULTS The age-standardized suicide rate in men rapidly increased from 1989 to 2004, and slightly increased thereafter, whereas the suicide rate in women increased from 1989 to 2009 and then decreased thereafter. Within the same period, the suicide rate was higher among the older age groups than in the younger groups. Within the same birth cohort, the suicide rate of the older groups was also higher than that in the younger groups. Within the same age group, the suicide rate of the younger cohorts was higher than it was in the older cohorts. In the APC modeling, old age, recent period, and having been born before 1924 were associated with higher suicide rates. LIMITATIONS The accuracy and completeness of the suicide rate data may lead to bias. CONCLUSIONS This study showed an increasing trend in the suicide rates for men and women after 1989. These trends may be mainly attributed to cohort effects.
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Frasquilho D, Matos MG, Salonna F, Guerreiro D, Storti CC, Gaspar T, Caldas-de-Almeida JM. Mental health outcomes in times of economic recession: a systematic literature review. BMC Public Health 2016; 16:115. [PMID: 26847554 PMCID: PMC4741013 DOI: 10.1186/s12889-016-2720-y] [Citation(s) in RCA: 256] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Accepted: 01/11/2016] [Indexed: 02/03/2023] Open
Abstract
Background Countries in recession experience high unemployment rates and a decline in living conditions, which, it has been suggested, negatively influences their populations’ health. The present review examines the recent evidence of the possible association between economic recessions and mental health outcomes. Methods Literature review of records identified through Medline, PsycINFO, SciELO, and EBSCO Host. Only original research papers, published between 2004 and 2014, peer-reviewed, non-qualitative research, and reporting on associations between economic factors and proxies of mental health were considered. Results One-hundred-one papers met the inclusion criteria. The evidence was consistent that economic recessions and mediators such as unemployment, income decline, and unmanageable debts are significantly associated with poor mental wellbeing, increased rates of common mental disorders, substance-related disorders, and suicidal behaviours. Conclusion On the basis of a thorough analysis of the selected investigations, we conclude that periods of economic recession are possibly associated with a higher prevalence of mental health problems, including common mental disorders, substance disorders, and ultimately suicidal behaviour. Most of the research is based on cross-sectional studies, which seriously limits causality inferences. Conclusions are summarised, taking into account international policy recommendations concerning the cost-effective measures that can possibly reduce the occurrence of negative mental health outcomes in populations during periods of economic recession.
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Affiliation(s)
| | | | - Ferdinand Salonna
- Institute of Active Lifestyle, Faculty of Physical Culture, Palacky University Olomouc, Olomouc, Czech Republic.
| | - Diogo Guerreiro
- Psychiatry Department, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Cláudia C Storti
- European Monitoring Centre for Drugs and Drug Addiction, Lisbon, Portugal
| | - Tânia Gaspar
- Aventura Social/ISAMB, University of Lisbon and Lisbon Lusíada University, Lisbon, Portugal
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Mayer A, Foster M. Understanding Recession and Self-Rated Health with the Partial Proportional Odds Model: An Analysis of 26 Countries. PLoS One 2015; 10:e0140724. [PMID: 26513660 PMCID: PMC4626113 DOI: 10.1371/journal.pone.0140724] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2015] [Accepted: 09/28/2015] [Indexed: 11/17/2022] Open
Abstract
Introduction Self-rated health is demonstrated to vary substantially by both personal socio-economic status and national economic conditions. However, studies investigating the combined influence of individual and country level economic indicators across several countries in the context of recent global recession are limited. This paper furthers our knowledge of the effect of recession on health at both the individual and national level. Methods Using the Life in Transition II study, which provides data from 19,759 individuals across 26 European nations, we examine the relationship between self-rated health, personal economic experiences, and macro-economic change. Data analyses include, but are not limited to, the partial proportional odds model which permits the effect of predictors to vary across different levels of our dependent variable. Results Household experiences with recession, especially a loss of staple good consumption, are associated with lower self-rated health. Most individual-level experiences with recession, such as a job loss, have relatively small negative effects on perceived health; the effect of individual or household economic hardship is strongest in high income nations. Our findings also suggest that macroeconomic growth improves self-rated health in low-income nations but has no effect in high-income nations. Individuals with the greatest probability of “good” self-rated health reside in wealthy countries ($23,910 to $50, 870 GNI per capita). Conclusion Both individual and national economic variables are predictive of self-rated health. Personal and household experiences are most consequential for self-rated health in high income nations, while macroeconomic growth is most consequential in low-income nations.
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Affiliation(s)
- Adam Mayer
- Department of Sociology, Colorado State University, Fort Collins, Colorado, United States of America
| | - Michelle Foster
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, Colorado, United States of America
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Bartoll X, Toffolutti V, Malmusi D, Palència L, Borrell C, Suhrcke M. Health and health behaviours before and during the Great Recession, overall and by socioeconomic status, using data from four repeated cross-sectional health surveys in Spain (2001-2012). BMC Public Health 2015; 15:865. [PMID: 26346197 PMCID: PMC4561448 DOI: 10.1186/s12889-015-2204-5] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Accepted: 09/01/2015] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND The objective of this study was to estimate changes over time in health status and selected health behaviours during the Great Recession, in the period 2011/12, in Spain, both overall, and according to socioeconomic position and gender. METHODS We applied a before-after estimation on data from four editions of the Spanish National Health Survey: 2001, 2003/04, 2006/07 and 2011/12. This involved applying linear probability regression models accounting for time-trends and with robust standard errors, using as outcomes self-reported health and health behaviours, and as the main explanatory variable a dummy "Great Recession" for the 2011/12 survey edition. All the computations were run separately by gender. The final sample consisted of 47,156 individuals aged between 25 and 64 years, economically active at the time of the interview. We also assessed the inequality of the effects across socio-economic groups. RESULTS The probability of good self-reported health increased for women (men) by 9.6 % (7.6 %) in 2011/12, compared to the long term trend. The changes are significant for all educational levels, except for the least educated. Some healthy behaviours also improved but results were rather variable. Adverse dietary changes did, however, occur among men (though not women) who were unemployed (e.g., the probability of declaring eating fruit daily changed by -12.1 %), and among both men (-21.8 %) and women with the lowest educational level (-15.1 %). CONCLUSIONS Socioeconomic inequalities in health and health behaviour have intensified, in the period 2011/12, in at least some respects, especially regarding diet. While average self-reported health status and some health behaviours improved during the economic recession, in 2011/12, this improvement was unequal across different socioeconomic groups.
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Affiliation(s)
- Xavier Bartoll
- Agència de Salut Pública de Barcelona, Barcelona, Spain.
- Institute of Biomedical Research (IIB-Sant Pau), Barcelona, Spain.
| | - Veronica Toffolutti
- Health Economics Group, Norwich Medical School, University of East Anglia, Norwich, United Kingdom.
| | - Davide Malmusi
- Agència de Salut Pública de Barcelona, Barcelona, Spain.
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
- Institute of Biomedical Research (IIB-Sant Pau), Barcelona, Spain.
| | - Laia Palència
- Agència de Salut Pública de Barcelona, Barcelona, Spain.
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
- Institute of Biomedical Research (IIB-Sant Pau), Barcelona, Spain.
| | - Carme Borrell
- Agència de Salut Pública de Barcelona, Barcelona, Spain.
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
- Universitat Pompeu Fabra, Barcelona, Spain.
- Institute of Biomedical Research (IIB-Sant Pau), Barcelona, Spain.
| | - Marc Suhrcke
- Centre for Health Economics, University of York, York, United Kingdom.
- Centre for Diet and Activity Research (CEDAR), Institute of Public Health, Cambridge, United Kingdom.
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Nakade M, Takagi D, Suzuki K, Aida J, Ojima T, Kondo K, Hirai H, Kondo N. Influence of socioeconomic status on the association between body mass index and cause-specific mortality among older Japanese adults: The AGES Cohort Study. Prev Med 2015; 77:112-8. [PMID: 26022771 DOI: 10.1016/j.ypmed.2015.05.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Revised: 05/07/2015] [Accepted: 05/16/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Many studies have suggested a U-shaped curve for the association between body size and mortality risks, i.e., mortality risks increase in those who are both overweight and underweight. The strength of the associations may vary according to socioeconomic statuses (SES), as they determine levels of access to healthcare and psychosocial stresses. We investigated the modifying effects of SES on the relationship between body mass index (BMI) and mortality. METHOD We used prospective cohort data of participants in the Aichi Gerontological Evaluation Study in 2003 (n=14,931), who were 65years or older and physically and cognitively independent at baseline, and residing in eight municipalities in Japan. Data on all-causes mortality and mortality from cancer, cardiovascular disease, and respiratory disease was obtained from municipal government registries. RESULTS Proportional hazard regression analyses showed that, among men, the associations between overweight (BMI≥25kg/m(2)) and higher mortality risks by any cause were stronger among lower income groups. Even adjusting for multiple confounding factors, hazard ratios (95% confidence intervals) for mortality by all causes among low income group (household income<1.5 million yen) were 1.96 (1.02-3.73) for overweight compared with BMIs between 23.0 and 24.9, whereas they were 0.94 (0.57-1.38) among men in high income group (income>3 million yen). The modifying effects of income were not marked among women. CONCLUSION Household income, which may directly reflect accessibility to healthcare and psychosocial stress among older Japanese men, may be an important modifying factor in the health risks attributable to overweight.
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Affiliation(s)
- Miyo Nakade
- Department of Health and Nutrition, Tokaigakuen University, 2-901 Nakahira, Tempaku-ku, Nagoya-shi, Aichi-ken 468-0014, Japan
| | - Daisuke Takagi
- Department of Health and Social Behavior, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Kayo Suzuki
- Department of Policy Studies, Aichi Gakuin University, 12 Araike, Iwasaki-cho, Nisshin-shi, Aichi-ken 470-0131, Japan
| | - Jun Aida
- Graduate School of Dentistry, Tohoku University, 4-1 Seiryo-cho, Aoba-ku, Sendai-shi, Miyagi-ken 980-8575, Japan
| | - Toshiyuki Ojima
- Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu-shi, Shizuoka-ken 431-3192, Japan
| | - Katsunori Kondo
- Center for Well-being and Society, Nihon Fukushi University, 5-22-35 Chiyoda, Naka-ku, Nagoya-shi, Aichi-ken 460-0012, Japan; Center for Preventive Medical Science, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba-ken 260-8670, Japan
| | - Hiroshi Hirai
- Department of Civil and Environmental Engineering, Iwate University, 4-3-5 Ueda, Morioka-shi, Iwate-ken 020-8551, Japan
| | - Naoki Kondo
- Department of Health and Social Behavior, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan.
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Work Content and Serious Mental Illness among Middle-Aged Men: Results from a 6-Year Longitudinal Study in Japan. PLoS One 2015; 10:e0131203. [PMID: 26121355 PMCID: PMC4487894 DOI: 10.1371/journal.pone.0131203] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2014] [Accepted: 05/30/2015] [Indexed: 11/19/2022] Open
Abstract
Objective The present study aimed to determine prospective associations between work content after a working life of more than 20 years and serious mental illness among Japanese men aged 50 to 59 years, using a nationwide population-based survey. Methods Data were extracted from a national longitudinal survey of middle-aged and elderly persons previously conducted by the Ministry of Health, Labour and Welfare in Japan. We analyzed data across 10 work content categories for Japanese men who had been working in the same job type or industry for over 20 years. As part pf the survey, participants completed the Kessler (K)6 scale each year to determine their level of psychological distress (with scores ≥13 indicating serious mental illness). Cox discrete time proposal hazard regression analysis was used to examine potential associations between work content and serious mental illness from 2005 to 2010. Further adjustments were made for other sociodemographic characteristics and lifestyle factors. Results The current study involved a total of 11,942 participants with a mean (± standard deviation [SD]) of follow-up was 3.4 (± 2.0) years, during which time 892 participants (7.5%) had been classified as having a new-onset serious mental illness. Men who had worked in service jobs and in manufacturing jobs at baseline were more likely to develop serious mental illness than those in managerial jobs (hazard ratio 1.37, 1.30, 95% confidence intervals 1.04–1.80, 1.02–1.65) after adjustment for confounding variables. Conclusion These findings suggest that Japanese men aged 50 to 59 years who have worked in service and manufacturing jobs after a working life of over 20 years have an increased risk of serious mental illness during follow-up. Identifying the most at-risk work content category after a working life of over 20 years would be an essential part of providing more effective interventions for psychological distress among Japanese men in this age group.
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Ennis KY, Chen MH, Smith GC, D'Amico AV, Zhang Y, Quinn SA, Ryemon SN, Goltz D, Harrison LB, Ennis RD. The Impact of Economic Recession on the Incidence and Treatment of Cancer. J Cancer 2015; 6:727-33. [PMID: 26185534 PMCID: PMC4504108 DOI: 10.7150/jca.11886] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Accepted: 05/04/2015] [Indexed: 12/02/2022] Open
Abstract
PURPOSE The impact of economic recessions on the incidence and treatment of cancer is unknown. We test the hypothesis that cancer incidence and treatment rates decrease during a recession, and that this relationship is more pronounced in cancers that present with mild, more easily ignored symptoms. METHODS AND MATERIALS Data on incidence and treatment for all cancers, and breast and pancreatic cancers specifically, from 1973-2008, were collected using Surveillance Epidemiology and End RESULTS (SEER). The data was adjusted for race, income, and education. Unemployment rate was used as the measure of economic recession. Data was log-transformed, and multivariate linear mixed regression was used. RESULTS Adjusting for socioeconomic factors, the data revealed a significant inverse correlation between unemployment and rates of cancer incidence and treatment. Every 1% increase in unemployment was associated with a 2.2% (95% CI: 1.6-2.8%, p<0.001) reduction in cancer incidence, a 2.0% (1.2-2.8%, p=0.0157) decrease in surgery, and a 9.1% (8.2-10.0% p<0.001) decrease in radiation therapy (RT). Breast cancer incidence and treatment had a dramatic inverse relationship - 7.2% (6.3-8.1%), 6.7% (5.7-7.6%), and 19.0% (18.1-19.8%), respectively (p<0.001 for all). The decrease in incidence was only significant for in situ and localized tumors, but not in regional or distant breast cancer. Compared to breast cancer, pancreatic cancer had a weaker relationship between unemployment and incidence: 2.6% (1.8-3.3%, p=0.0005), surgery: 2.4% (2.0-2.7%, p<0.001), and RT: 1.9% (1.5-2.2% p<0.001). CONCLUSIONS Increasing unemployment rates are associated with a decrease in the incidence and treatment of all cancers. This effect is exaggerated in breast cancer, where symptoms can more easily be ignored and where there are widely used screening tests relative to pancreatic cancer.
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Affiliation(s)
| | - Ming-Hui Chen
- 2. Department of Statistics, University of Connecticut
| | | | - Anthony V. D'Amico
- 3. Brigham and Women's Hospital, Dana Farber Cancer Institute, Harvard Medical School
| | | | - S. Aidan Quinn
- 5. Department of Pathology and Cell Biology, Columbia University
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Wada K, Higuchi Y, Smith DR. Socioeconomic status and self-reported health among middle-aged Japanese men: results from a nationwide longitudinal study. BMJ Open 2015; 5:e008178. [PMID: 26109119 PMCID: PMC4480028 DOI: 10.1136/bmjopen-2015-008178] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE To examine potential associations between socioeconomic factors and self-rated health among a national sample of Japanese men aged 50-59 years between 2005 and 2010, including the 2008 global financial crisis. DESIGN Prospective cohort study. SETTING Randomly selected 2515 census areas from a total of 1.8 million census areas in Japan. PARTICIPANTS This study utilised data from a national, longitudinal survey conducted by the Ministry of Health, Labour and Welfare. Starting in 2005, 16,738 Japanese men aged 50-59 years were recruited and sent a questionnaire each year. We analysed data for the 6-year period (2005-2010) from participants who had worked for over 20 years in the same industry (n=9727). MAIN OUTCOME MEASURES We focused on worsening self-rated health status by occupation, education and employment contract. RESULTS Working in the manufacturing industry was associated with worsening self-rated health scores when compared to those working in management (HR=1.19; 95% CI 1.04 to 1.37). A relationship between education level and worsening self-rated health was also identified as follows: junior high school (HR=1.49; 95% CI 1.31 to 1.69), high school (HR=1.29; 95% CI 1.17 to 1.42), and vocational college (HR=1.25; 95% CI 1.07 to 1.46), when compared with those holding university-level qualifications. Precarious employment (HR=1.17; 95% CI 1.00 to 1.37) was also associated with worsening self-rated health status in the current study. CONCLUSIONS This study suggests that working in manufacturing for more than 20 years and having lower education levels may have a significant impact on the self-rated health of middle-aged Japanese men. This may reflect a progressive decline in Japanese working conditions following the global financial crisis and/or the impact of lower socioeconomic status.
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Affiliation(s)
- Koji Wada
- International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yoshiyuki Higuchi
- Department of Health and Physical Education, Fukuoka University of Education, Fukuoka, Japan
| | - Derek R Smith
- Faculty of Health and Medicine, School of Health Sciences, University of Newcastle, Ourimbah, New South Wales, Australia
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Ueda P, Kondo N, Fujiwara T. The global economic crisis, household income and pre-adolescent overweight and underweight: a nationwide birth cohort study in Japan. Int J Obes (Lond) 2015; 39:1414-20. [PMID: 25982791 PMCID: PMC4564524 DOI: 10.1038/ijo.2015.90] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Accepted: 05/06/2015] [Indexed: 11/09/2022]
Abstract
Background: We hypothesized that children from lower income households and in households experiencing a negative income change in connection to the global economic crisis in 2008 would be at increased risk of adverse weight status during the subsequent years of economic downturn. Methods: Data were obtained from a nationwide longitudinal survey comprising all children born during 2 weeks of 2001. For 16,403 boys and 15,206 girls, information about anthropometric measurements and household characteristics was collected from 2001 to 2011 on multiple occasions. Interactions between the crisis onset (September 2008) and household income group, as well as the crisis onset and a >30% negative income change in connection to the crisis, were assessed with respect to risk of childhood over- and underweight. Results: Adjusted for household and parental characteristics, boys and girls in the lower household income quartiles had a larger increase in risk of overweight after the crisis onset relative to their peers in the highest income group. (Odds ratio (95% confidence interval) for interaction term in boys=1.23 (1.02–1.24); girls=1.35 (1.23–1.49) comparing the lowest with the highest income group.) Among girls, an interaction between the crisis onset and a >30% negative change in household income with respect to risk of overweight was observed (odds ratio for interaction term=1.23 (1.09–1.38)). Girls from the highest income group had an increased risk of underweight after the crisis onset compared with girls from the lowest income group. Conclusions: Boys and girls from lower household income groups and girls from households experiencing a negative income change in connection to the global economic crisis in 2008, may be at increased risk of overweight. Vulnerability to economic uncertainty could increase risk of overweight in preadolescence.
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Affiliation(s)
- P Ueda
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Global Health and Population, Harvard School of Public Health, Boston, MA, USA
| | - N Kondo
- Department of Health and Social Behaviour/Department of Health Education and Health Sociology, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - T Fujiwara
- Department of Social Medicine, National Research Institute for Child Health and Development, Tokyo, Japan
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A systematic review on health resilience to economic crises. PLoS One 2015; 10:e0123117. [PMID: 25905629 PMCID: PMC4408106 DOI: 10.1371/journal.pone.0123117] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Accepted: 02/18/2015] [Indexed: 12/03/2022] Open
Abstract
Background The health effects of recent economic crises differ markedly by population group. The objective of this systematic review is to examine evidence from longitudinal studies on factors influencing resilience for any health outcome or health behaviour among the general population living in countries exposed to financial crises. Methods We systematically reviewed studies from six electronic databases (EMBASE, Global Health, MEDLINE, PsycINFO, Scopus, Web of Science) which used quantitative longitudinal study designs and included: (i) exposure to an economic crisis; (ii) changes in health outcomes/behaviours over time; (iii) statistical tests of associations of health risk and/or protective factors with health outcomes/behaviours. The quality of the selected studies was appraised using the Quality Assessment Tool for Quantitative Studies. PRISMA reporting guidelines were followed. Results From 14,584 retrieved records, 22 studies met the eligibility criteria. These studies were conducted across 10 countries in Asia, Europe and North America over the past two decades. Ten socio-demographic factors that increased or protected against health risk were identified: gender, age, education, marital status, household size, employment/occupation, income/ financial constraints, personal beliefs, health status, area of residence, and social relations. These studies addressed physical health, mortality, suicide and suicide attempts, mental health, and health behaviours. Women’s mental health appeared more susceptible to crises than men’s. Lower income levels were associated with greater increases in cardiovascular disease, mortality and worse mental health. Employment status was associated with changes in mental health. Associations with age, marital status, and education were less consistent, although higher education was associated with healthier behaviours. Conclusions Despite widespread rhetoric about the importance of resilience, there was a dearth of studies which operationalised resilience factors. Future conceptual and empirical research is needed to develop the epidemiology of resilience.
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Glonti K, Gordeev VS, Goryakin Y, Reeves A, Stuckler D, McKee M, Roberts B. A systematic review on health resilience to economic crises. PLoS One 2015. [PMID: 25905629 DOI: 10.1371/jornal.pone.0123117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/26/2023] Open
Abstract
BACKGROUND The health effects of recent economic crises differ markedly by population group. The objective of this systematic review is to examine evidence from longitudinal studies on factors influencing resilience for any health outcome or health behaviour among the general population living in countries exposed to financial crises. METHODS We systematically reviewed studies from six electronic databases (EMBASE, Global Health, MEDLINE, PsycINFO, Scopus, Web of Science) which used quantitative longitudinal study designs and included: (i) exposure to an economic crisis; (ii) changes in health outcomes/behaviours over time; (iii) statistical tests of associations of health risk and/or protective factors with health outcomes/behaviours. The quality of the selected studies was appraised using the Quality Assessment Tool for Quantitative Studies. PRISMA reporting guidelines were followed. RESULTS From 14,584 retrieved records, 22 studies met the eligibility criteria. These studies were conducted across 10 countries in Asia, Europe and North America over the past two decades. Ten socio-demographic factors that increased or protected against health risk were identified: gender, age, education, marital status, household size, employment/occupation, income/ financial constraints, personal beliefs, health status, area of residence, and social relations. These studies addressed physical health, mortality, suicide and suicide attempts, mental health, and health behaviours. Women's mental health appeared more susceptible to crises than men's. Lower income levels were associated with greater increases in cardiovascular disease, mortality and worse mental health. Employment status was associated with changes in mental health. Associations with age, marital status, and education were less consistent, although higher education was associated with healthier behaviours. CONCLUSIONS Despite widespread rhetoric about the importance of resilience, there was a dearth of studies which operationalised resilience factors. Future conceptual and empirical research is needed to develop the epidemiology of resilience.
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Affiliation(s)
- Ketevan Glonti
- ECOHOST-The Centre of Health and Social Change, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Vladimir S Gordeev
- ECOHOST-The Centre of Health and Social Change, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Yevgeniy Goryakin
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Aaron Reeves
- Department of Sociology, Oxford University, Oxford, United Kingdom
| | - David Stuckler
- ECOHOST-The Centre of Health and Social Change, London School of Hygiene and Tropical Medicine, London, United Kingdom; Department of Sociology, Oxford University, Oxford, United Kingdom
| | - Martin McKee
- ECOHOST-The Centre of Health and Social Change, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Bayard Roberts
- ECOHOST-The Centre of Health and Social Change, London School of Hygiene and Tropical Medicine, London, United Kingdom
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