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Benach J, Padilla-Pozo Á, Martínez-Herrera E, Molina-Betancur JC, Gutiérrez M, Pericàs JM, Gutiérrez-Zamora Navarro M, Zografos C. What do we know about the impact of economic recessions on mortality inequalities? A critical review. Soc Sci Med 2022; 296:114733. [DOI: 10.1016/j.socscimed.2022.114733] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 12/07/2021] [Accepted: 01/17/2022] [Indexed: 11/26/2022]
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Palència L, Ferrando J, Marí-Dell'Olmo M, Gotsens M, Morrison J, Dzurova D, Lustigova M, Costa C, Rodríguez-Sanz M, Bosakova L, Santana P, Borrell C. Socio-economic inequalities on cancer mortality in nine European areas: The effect of the last economic recession. Cancer Epidemiol 2020; 69:101827. [PMID: 33038640 DOI: 10.1016/j.canep.2020.101827] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 09/10/2020] [Accepted: 09/13/2020] [Indexed: 01/02/2023]
Abstract
BACKGROUND The effect of inequalities aggravated by economic recessions in the mortality rates of certain diseases has been previously described. In this study, we analyzed the relationship between socio-economic deprivation and cancer mortality. We focused on lung, colon, prostate, and breast cancers in nine European urban areas over three periods: two before (2000-2003 and 2004-2008) and one after (2009-2014) the onset of the 2008 financial crisis. METHODS This is an ecological study of trends. The units of analysis were small areas within nine European urban areas. We used a composite deprivation index as a socio-economic indicator. As a mortality indicator, we used the smoothed standardized mortality ratio, calculated using the hierarchical Bayesian model proposed by Besag, York and Mollié. To analyze the evolution of socio-economic inequalities, we fitted an ecological regression model that included the socio-economic indicator, the period of time, and the interaction between these terms. RESULTS In men, socio-economic inequalities in all-cancer and lung cancer mortality were observed in most of the cities studied, but did not increase after the onset of the economic crisis. In women, only two cities (Stockholm and London) showed socio-economic inequalities in all-cancer and lung cancer mortality; there was also no increase in inequalities. CONCLUSIONS Our results did not validate our hypothesis that inequalities increase in times of crisis. However, they emphasize the importance of socio-economic measurements for understanding mortality inequalities, and can be used to inform prevention strategies and help plan local health programs aimed at reducing health inequalities.
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Affiliation(s)
- Laia Palència
- Agència de Salut Pública de Barcelona, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Institut d'Investigació Biomèdica (IIB Sant Pau), Barcelona, Spain.
| | | | - Marc Marí-Dell'Olmo
- Agència de Salut Pública de Barcelona, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Institut d'Investigació Biomèdica (IIB Sant Pau), Barcelona, Spain.
| | - Mercè Gotsens
- Agència de Salut Pública de Barcelona, Barcelona, Spain; Institut d'Investigació Biomèdica (IIB Sant Pau), Barcelona, Spain
| | - Joana Morrison
- Institute of Health Equity at the Research Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Dagmar Dzurova
- Department of Social Geography and Regional Development, Faculty of Science, Charles University, Prague, Czechia
| | - Michala Lustigova
- Department of Social Geography and Regional Development, Faculty of Science, Charles University, Prague, Czechia
| | - Claudia Costa
- Centre of Studies in Geography and Spatial Planning, University of Coimbra, Coimbra, Portugal
| | - Maica Rodríguez-Sanz
- Agència de Salut Pública de Barcelona, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Institut d'Investigació Biomèdica (IIB Sant Pau), Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain
| | - Lucia Bosakova
- Department of Health Psychology and Research Methodology, Medical Faculty, P. J. Safarik University in Kosice, Kosice, Slovak Republic; Olomouc University Social Health Institute (OUSHI), Palacky University in Olomouc, Olomouc, Czech Republic
| | - Paula Santana
- Centre of Studies in Geography and Spatial Planning, University of Coimbra, Coimbra, Portugal
| | - Carme Borrell
- Agència de Salut Pública de Barcelona, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Institut d'Investigació Biomèdica (IIB Sant Pau), Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain
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Palència L, Gotsens M, Marí-Dell'Olmo M, Bosakova L, Burström B, Costa C, Deboosere P, Dzurova D, Lustigova M, Morrison J, Santana P, Borrell C. Effect of the recent economic crisis on socioeconomic inequalities in mortality in nine urban areas in Europe. GACETA SANITARIA 2020; 34:253-260. [PMID: 31983478 DOI: 10.1016/j.gaceta.2019.11.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 10/31/2019] [Accepted: 11/05/2019] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To analyse socioeconomic inequalities in all-cause mortality among men and women in nine European urban areas during the recent economic crisis, and to compare the results to those from two periods before the crisis. METHOD This is an ecological study of trends based on three time periods (2000-2003, 2004-2008 and 2009-2014). The units of analysis were the small areas of nine European urban areas. We used a composite deprivation index as a socioeconomic indicator, along with other single indicators. As a mortality indicator, we used the smoothed standardized mortality ratio, calculated using the hierarchical Bayesian model proposed by Besag, York and Mollié. To analyse the evolution of socioeconomic inequalities, we fitted an ecological regression model that included the socioeconomic indicator, the period of time, and the interaction between these terms. RESULTS We observed significant inequalities in mortality among men for almost all the socioeconomic indicators, periods, and urban areas studied. However, no significant changes occurred during the period of the economic crisis. While inequalities among women were less common, there was a statistically significant increase in inequality during the crisis period in terms of unemployment and the deprivation index in Prague and Stockholm, respectively. CONCLUSIONS Future analyses should also consider time-lag in the effect of crises on mortality and specific causes of death, and differential effects between genders.
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Affiliation(s)
- Laia Palència
- Agència de Salut Pública de Barcelona, Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Institut d'Investigació Biomèdica Sant Pau, Barcelona, Spain.
| | - Mercè Gotsens
- Agència de Salut Pública de Barcelona, Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Institut d'Investigació Biomèdica Sant Pau, Barcelona, Spain
| | - Marc Marí-Dell'Olmo
- Agència de Salut Pública de Barcelona, Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Institut d'Investigació Biomèdica Sant Pau, Barcelona, Spain
| | - Lucia Bosakova
- Department of Health Psychology, Medical Faculty, P.J. Safarik University in Kosice, Kosice, Slovak Republic; Olomouc University Social Health Institute, Palacky University in Olomouc, Olomouc, Czech Republic
| | - Bo Burström
- Department of Public Health Sciences, Equity and Health Policy Research Group, Karolinska Institutet, Stockholm, Sweden
| | - Cláudia Costa
- Centre of Studies in Geography and Spatial Planning, University of Coimbra, Coimbra, Portugal
| | - Patrick Deboosere
- Interface Demography, Section Social Research, Vrije Universiteit Brussels, Brussels, Belgium
| | - Dagmar Dzurova
- Department of Social Geography and Regional Development, Faculty of Science, Charles University, Prague, Czech Republic
| | - Michala Lustigova
- Department of Social Geography and Regional Development, Faculty of Science, Charles University, Prague, Czech Republic
| | - Joana Morrison
- Research Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Paula Santana
- Centre of Studies in Geography and Spatial Planning, University of Coimbra, Coimbra, Portugal; Department of Geography and Tourism, Humanities Faculty, University of Coimbra, Coimbra, Portugal
| | - Carme Borrell
- Agència de Salut Pública de Barcelona, Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Institut d'Investigació Biomèdica Sant Pau, Barcelona, Spain
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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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Loureiro A, Santana P, Nunes C, Almendra R. The Role of Individual and Neighborhood Characteristics on Mental Health after a Period of Economic Crisis in the Lisbon Region (Portugal): A Multilevel Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16152647. [PMID: 31344971 PMCID: PMC6696374 DOI: 10.3390/ijerph16152647] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 07/18/2019] [Accepted: 07/21/2019] [Indexed: 12/28/2022]
Abstract
Mental health is an intrinsic dimension of health influenced by individual and contextual factors. This cross-sectional study analyzes the association between the individual, neighborhood characteristics, and one’s self-assessed mental health status in the Lisbon region after an economic crisis. Via the application of multilevel regression models, the study assesses the link between one’s neighborhood environment—deprivation, low self-assessed social capital, and low self-assessed satisfaction with the area of residence—and mental health regardless of one’s individual characteristics. Constraints related to the economic crisis play an important role in the explanation of poor mental health.
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Affiliation(s)
- Adriana Loureiro
- Centre of Studies on Geography and Spatial Planning (CEGOT), Faculty of Arts and Humanities, Colégio de São Jerónimo, University of Coimbra, 3004-530 Coimbra, Portugal.
| | - Paula Santana
- Centre of Studies on Geography and Spatial Planning (CEGOT) and Department of Geography and Tourism, Faculty of Arts and Humanities, Colégio de São Jerónimo, University of Coimbra, 3004-530 Coimbra, Portugal
| | - Carla Nunes
- Centre for Research in Public Health and National School of Public Health, Nova University of Lisbon, Avenida Padre Cruz, 1600-560 Lisbon, Portugal
| | - Ricardo Almendra
- Centre of Studies on Geography and Spatial Planning (CEGOT), Faculty of Arts and Humanities, Colégio de São Jerónimo, University of Coimbra, 3004-530 Coimbra, Portugal
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Heggebø K, Tøge AG, Dahl E, Berg JE. Socioeconomic inequalities in health during the Great Recession: A scoping review of the research literature. Scand J Public Health 2018; 47:635-654. [DOI: 10.1177/1403494818801637] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Aims: The so-called ‘Great Recession’ in Europe triggered widespread concerns about population health, as reflected by an upsurge in empirical research on the health impacts of the economic crisis. A growing body of empirical studies has also been devoted to socioeconomic inequalities in health during the Great Recession. The aim of the current study is to summarise this health inequality literature by means of a scoping review. Methods: We have performed a scoping review of the research literature (English language) published in the years 2012–2017. Only empirical papers with (a) health status measured on the individual level, (b) information on socioeconomic position (i.e. employment status, educational level, income/wealth, and/or occupational class), and (c) data from European countries in both pre- and post-crisis years were considered relevant. In total, 49 empirical studies fulfilled these inclusion criteria. Results: The empirical findings in the 49 included studies predominantly show that socioeconomic inequalities in health either increased or remained stable from pre- to post-crisis years. Two-thirds (65%) of the studies found evidence of either increasing or partially increasing health inequalities. Thus, people in lower socioeconomic strata fared worse overall in terms of health during the Great Recession, compared to people with higher socioeconomic status. Conclusions: The Great Recession in Europe tends to be followed by increasing socioeconomic inequalities in health. Policymakers should take note of this finding. Widening socioeconomic inequalities in health is a major cause of concern, in particular if health deterioration among ‘vulnerable groups’ is caused by accelerating cumulative disadvantages.
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Affiliation(s)
| | - Anne Grete Tøge
- Work Research Institute (AFI), Oslo Metropolitan University, Norway
| | - Espen Dahl
- Department of Social Work, Child Welfare and Social Policy, Oslo Metropolitan University, Norway
| | - John Erik Berg
- Department of Occupational Therapy, Oslo Metropolitan University, Norway
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Examining the socioeconomic effects on third molar maturation in a Portuguese sample of children, adolescents and young adults. Int J Legal Med 2016; 131:235-242. [DOI: 10.1007/s00414-016-1476-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Accepted: 10/11/2016] [Indexed: 10/20/2022]
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Affiliation(s)
- Maria Inês Varela-Silva
- a Centre for Global Health and Human Development , School of Sport, Exercise and Health Sciences, Loughborough University , Loughborough , UK
| | - Cristina Santinho
- b Centre for Research in Anthropology (CRIA), University Institute of Lisbon - ISCTE , Lisbon , Portugal
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