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Martinez PR, Lirola FV. Intersectionality on the perception of health in two cross-national surveys (WVS and EVS). Heliyon 2024; 10:e29319. [PMID: 38628763 PMCID: PMC11019233 DOI: 10.1016/j.heliyon.2024.e29319] [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: 11/06/2023] [Revised: 03/18/2024] [Accepted: 04/04/2024] [Indexed: 04/19/2024] Open
Abstract
This article focuses on the health perceptions of people across social strata and nations using the combined dataset of the World Values Survey and the European Values Study (EVS/WVS). An intercategorical intersectional analysis model was developed to examine the social determinants underlying differences in health perceptions. Using logistic regression of the interactions between sex, age, level of educational attainment and income, we calculated the impact of these variables (main effects) and their interactions within the intersecting categories on health perceptions. The group with the best perception of their health includes men aged 16-49, with a high income and an upper-middle level of education. Comparative analysis has been carried out to identify differences in the influence of intersectional categories across countries. Of particular relevance is the number of Eastern European countries where the perception of people aged 50 and over with low income is very poor.
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Affiliation(s)
- Pilar Rodriguez Martinez
- University of Almeria, Department of Geography, History and Humanities, Professor of Sociology, Director of the Research Group Investigación Internacional Comparada (HUM1028), Spain
| | - Francisco Villegas Lirola
- University of Almeria, Department of Education, Investigator of the Research Group Diversity, Disability and Needs educational Specials (HUM782), Spain
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Toffolutti V, Plach S, Maksimovic T, Piccitto G, Mascherini M, Mencarini L, Aassve A. The association between COVID-19 policy responses and mental well-being: Evidence from 28 European countries. Soc Sci Med 2022; 301:114906. [PMID: 35313221 PMCID: PMC8920116 DOI: 10.1016/j.socscimed.2022.114906] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 02/27/2022] [Accepted: 03/11/2022] [Indexed: 12/12/2022]
Abstract
This study assesses how the implementation and lifting of non-pharmaceutical policy interventions (NPIs), deployed by most governments, to curb the COVID-19 pandemic, were associated with individuals' mental well-being (MWB) across 28 European countries. This is done both for the general population and across key-groups. We analyze longitudinal data for 15,147 respondents from three waves of the Eurofound-"Living, Working and COVID-19" survey, covering the period April 2020-March 2021. MWB is measured by the WHO-5 index. Our evidence suggests that restriction on international travel, private gatherings, and contact tracing (workplace closures) were negatively (positively) associated with MWB by about, respectively, -0.63 [95% CI: -0.79 to -0.47], -0.24 [95% CI: -0.38 to -0.10], and -0.22 [95% CI: -0.36 to -0.08] (0.29 [95% CI: 0.11 to 0.48]) points. These results correspond to -3.9%, -1.5%, and -1.4% (+1.8%) changes compared to pre-pandemic levels. However, these findings mask important group-differences. Women compared to men fared worse under stay-at-home requirements, internal movement restrictions, private gatherings restrictions, public events cancellation, school closures, and workplace closures. Those residing with children below 12, compared to those who do not, fared worse under public events cancellation, school closures and workplace closures. Conversely, those living with children 12-17, compared to those who do not, fared better under internal movement restrictions and public events cancelling. Western-Europeans vis-à-vis Eastern-Europeans fared better under NPIs limiting their mobility and easing their debts, whereas they fared worse under health-related NPIs. This study provides timely evidence of the rise in inequalities during the COVID-19 pandemic and offers strategies for mitigating them.
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Affiliation(s)
- Veronica Toffolutti
- Centre for Health Economics & Policy Innovation, Department of Economics & Public Policy, Imperial College London - Business School, Exhibition Road, South Kensington, London, SW7 2AZ, United Kingdom; "Carlo F. Dondena" Centre for Research on Social Dynamics and Public Policies, Bocconi University, Via G. Roentgen, 1, 20136, Milano, Italy.
| | - Samuel Plach
- "Carlo F. Dondena" Centre for Research on Social Dynamics and Public Policies, Bocconi University, Via G. Roentgen, 1, 20136, Milano, Italy.
| | - Teodora Maksimovic
- "Carlo F. Dondena" Centre for Research on Social Dynamics and Public Policies, Bocconi University, Via G. Roentgen, 1, 20136, Milano, Italy.
| | - Giorgio Piccitto
- "Carlo F. Dondena" Centre for Research on Social Dynamics and Public Policies, Bocconi University, Via G. Roentgen, 1, 20136, Milano, Italy.
| | - Massimiliano Mascherini
- European Foundation for the Improvement of Living and Working Conditions, Wyattville Road, Loughlinstown, Co. Dublin, D18 KP65, Ireland.
| | - Letizia Mencarini
- "Carlo F. Dondena" Centre for Research on Social Dynamics and Public Policies, Bocconi University, Via G. Roentgen, 1, 20136, Milano, Italy; Department of Social and Political Science, Bocconi University, Via G. Roentgen, 1, 20136, Milano, Italy.
| | - Arnstein Aassve
- "Carlo F. Dondena" Centre for Research on Social Dynamics and Public Policies, Bocconi University, Via G. Roentgen, 1, 20136, Milano, Italy; Department of Social and Political Science, Bocconi University, Via G. Roentgen, 1, 20136, Milano, Italy.
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Balbo N, Carapella P, Toffolutti V. Trends in the use of mind-altering drugs among European adolescents during the Great Recession. Health Policy 2020; 124:568-574. [PMID: 32223916 DOI: 10.1016/j.healthpol.2020.03.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 03/06/2020] [Accepted: 03/10/2020] [Indexed: 11/16/2022]
Abstract
Despite the growing evidence of health-responses to macroeconomic fluctuations, little research has been carried out on the economic reflexes of licit and illicit drug-consumption, especially among teenagers. This paper uses data on adolescents between 15 and 17 years old from 25 European countries to test, if and how, the substance-use pattern has changed during the Great Recession. The data come from two cross-sectional waves (2007 and 2011) of the European School Survey Project on Alcohol and Other Drugs (ESPAD) (n = 137,989 individuals). One percentage point increase in the unemployment rate is associated with an increase [decrease] in the probability of having tried inhalants and cocaine [ecstasy] at least once, by about 0.005 (95 % CI: 0.004, 0.006) and 0.001 (95 % CI: 0.0001, 0.001) [-0.001 (95 % CI: -0.001, -0.001)] respectively. Social protection expenditure reduces the use of inhalants, whereas ecstasy consumption rises. The pattern for cocaine is unclear.
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Affiliation(s)
- Nicoletta Balbo
- "Carlo F. Dondena" Centre for Research on Social Dynamics and Public Policies, Bocconi University, Via Roentgen, 1, 20136, Milan, Italy; Department of Social and Political Sciences, Bocconi University, Via Roentgen, 1, 20136, Milan, Italy
| | - Piergiorgio Carapella
- "Carlo F. Dondena" Centre for Research on Social Dynamics and Public Policies, Bocconi University, Via Roentgen, 1, 20136, Milan, Italy; Confindustria Economic Research Department, Viale dell'Astronomia, 30, 00144, Rome, Italy
| | - Veronica Toffolutti
- "Carlo F. Dondena" Centre for Research on Social Dynamics and Public Policies, Bocconi University, Via Roentgen, 1, 20136, Milan, Italy; Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, United Kingdom.
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Energy poverty and health: Trends in the European Union before and during the economic crisis, 2007-2016. Health Place 2020; 67:102294. [PMID: 33526205 DOI: 10.1016/j.healthplace.2020.102294] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 12/24/2019] [Accepted: 01/31/2020] [Indexed: 01/01/2023]
Abstract
The aim of this study is to analyse the time trends in the European Union (EU) before and during the economic crisis in 1) the energy poverty (EP) prevalence; 2) the association between EP and health and 3) the impact of EP on health. We analyse trends among women and men in two EU macro regions, defined by a novel index of structural vulnerability to EP. The study shows how EP and its impact on health worsened during the economic crisis and identifies groups at higher risk such as women and people living in Mediterranean and Eastern European countries, which have been found to be countries with higher structural vulnerability to EP.
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Abstract
Importance US life expectancy has not kept pace with that of other wealthy countries and is now decreasing. Objective To examine vital statistics and review the history of changes in US life expectancy and increasing mortality rates; and to identify potential contributing factors, drawing insights from current literature and an analysis of state-level trends. Evidence Life expectancy data for 1959-2016 and cause-specific mortality rates for 1999-2017 were obtained from the US Mortality Database and CDC WONDER, respectively. The analysis focused on midlife deaths (ages 25-64 years), stratified by sex, race/ethnicity, socioeconomic status, and geography (including the 50 states). Published research from January 1990 through August 2019 that examined relevant mortality trends and potential contributory factors was examined. Findings Between 1959 and 2016, US life expectancy increased from 69.9 years to 78.9 years but declined for 3 consecutive years after 2014. The recent decrease in US life expectancy culminated a period of increasing cause-specific mortality among adults aged 25 to 64 years that began in the 1990s, ultimately producing an increase in all-cause mortality that began in 2010. During 2010-2017, midlife all-cause mortality rates increased from 328.5 deaths/100 000 to 348.2 deaths/100 000. By 2014, midlife mortality was increasing across all racial groups, caused by drug overdoses, alcohol abuse, suicides, and a diverse list of organ system diseases. The largest relative increases in midlife mortality rates occurred in New England (New Hampshire, 23.3%; Maine, 20.7%; Vermont, 19.9%) and the Ohio Valley (West Virginia, 23.0%; Ohio, 21.6%; Indiana, 14.8%; Kentucky, 14.7%). The increase in midlife mortality during 2010-2017 was associated with an estimated 33 307 excess US deaths, 32.8% of which occurred in 4 Ohio Valley states. Conclusions and Relevance US life expectancy increased for most of the past 60 years, but the rate of increase slowed over time and life expectancy decreased after 2014. A major contributor has been an increase in mortality from specific causes (eg, drug overdoses, suicides, organ system diseases) among young and middle-aged adults of all racial groups, with an onset as early as the 1990s and with the largest relative increases occurring in the Ohio Valley and New England. The implications for public health and the economy are substantial, making it vital to understand the underlying causes.
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Affiliation(s)
- Steven H Woolf
- Center on Society and Health, Department of Family Medicine and Population Health, Virginia Commonwealth University School of Medicine, Richmond
| | - Heidi Schoomaker
- Center on Society and Health, Virginia Commonwealth University School of Medicine, Richmond
- Now with Eastern Virginia Medical School, Norfolk
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