Welfare states, the Great Recession and health

Detalhes bibliográficos
Autor(a) principal: Leão, Teresa
Data de Publicação: 2018
Outros Autores: Campos-Matos, Inês, Bambra, Clare, Russo, Giuliano, Perelman, Julian
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://doi.org/10.1371/journal.pone.0193165
Resumo: Background Although socioeconomic inequalities in health have long been observed in Europe, few studies have analysed their recent patterning. In this paper, we examined how educational inequalities in self-reported health have evolved in different European countries and welfare state regimes over the last decade, which was troubled by the Great Recession. Methods We used cross-sectional data from the EU-SILC survey for adults from 26 European countries, from 2005 to 2014 (n = 3,030,595). We first calculated education-related absolute (SII) and relative (RII) inequalities in poor self-reported health by country-year, adjusting for age, sex, and EU-SILC survey weights. We then regressed the year- and country-specific RII and SII on a yearly time trend, globally and by welfare regime, adjusting for country fixed effects. We further adjusted the analysis for the economic cycle using GDP growth, unemployment, and income inequality. Results Overall, absolute inequalities persisted and relative inequalities slightly widened (betaRII = 0.0313, p<0.05). There were substantial differences by welfare regime: Anglo-Saxon countries experienced the largest increase in absolute inequalities (betaSII = 0.0032, p<0.05), followed by Bismarkian countries (betaSII = 0.0024, p<0.001), while they reduced in Post-Communist countries (betaSII = -0.0022, p<0.001). Post-Communist countries also experienced a widening in relative inequalities (betaRII = 0.1112, p<0.001), which were found to be stable elsewhere. Adjustment for income inequality only explained such trend in Anglo-Saxon countries. Conclusions Educational inequalities in health have overall persisted across European countries over the last decade. However, there is considerable variation across welfare regimes, possibly related to underpinning social safety nets and to austerity measures implemented during this 10-year period.
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spelling Welfare states, the Great Recession and healthTrends in educational inequalities in self-reported health in 26 European countriesBiochemistry, Genetics and Molecular Biology(all)Agricultural and Biological Sciences(all)SDG 10 - Reduced InequalitiesBackground Although socioeconomic inequalities in health have long been observed in Europe, few studies have analysed their recent patterning. In this paper, we examined how educational inequalities in self-reported health have evolved in different European countries and welfare state regimes over the last decade, which was troubled by the Great Recession. Methods We used cross-sectional data from the EU-SILC survey for adults from 26 European countries, from 2005 to 2014 (n = 3,030,595). We first calculated education-related absolute (SII) and relative (RII) inequalities in poor self-reported health by country-year, adjusting for age, sex, and EU-SILC survey weights. We then regressed the year- and country-specific RII and SII on a yearly time trend, globally and by welfare regime, adjusting for country fixed effects. We further adjusted the analysis for the economic cycle using GDP growth, unemployment, and income inequality. Results Overall, absolute inequalities persisted and relative inequalities slightly widened (betaRII = 0.0313, p<0.05). There were substantial differences by welfare regime: Anglo-Saxon countries experienced the largest increase in absolute inequalities (betaSII = 0.0032, p<0.05), followed by Bismarkian countries (betaSII = 0.0024, p<0.001), while they reduced in Post-Communist countries (betaSII = -0.0022, p<0.001). Post-Communist countries also experienced a widening in relative inequalities (betaRII = 0.1112, p<0.001), which were found to be stable elsewhere. Adjustment for income inequality only explained such trend in Anglo-Saxon countries. Conclusions Educational inequalities in health have overall persisted across European countries over the last decade. However, there is considerable variation across welfare regimes, possibly related to underpinning social safety nets and to austerity measures implemented during this 10-year period.Centro de Investigação em Saúde Pública (CISP/PHRC)Instituto de Higiene e Medicina Tropical (IHMT)Escola Nacional de Saúde Pública (ENSP)RUNLeão, TeresaCampos-Matos, InêsBambra, ClareRusso, GiulianoPerelman, Julian2018-04-13T22:20:10Z2018-02-012018-02-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://doi.org/10.1371/journal.pone.0193165eng1932-6203PURE: 3909472http://www.scopus.com/inward/record.url?scp=85042536276&partnerID=8YFLogxKhttps://doi.org/10.1371/journal.pone.0193165info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2024-03-11T04:18:55Zoai:run.unl.pt:10362/34518Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T03:30:11.387860Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Welfare states, the Great Recession and health
Trends in educational inequalities in self-reported health in 26 European countries
title Welfare states, the Great Recession and health
spellingShingle Welfare states, the Great Recession and health
Leão, Teresa
Biochemistry, Genetics and Molecular Biology(all)
Agricultural and Biological Sciences(all)
SDG 10 - Reduced Inequalities
title_short Welfare states, the Great Recession and health
title_full Welfare states, the Great Recession and health
title_fullStr Welfare states, the Great Recession and health
title_full_unstemmed Welfare states, the Great Recession and health
title_sort Welfare states, the Great Recession and health
author Leão, Teresa
author_facet Leão, Teresa
Campos-Matos, Inês
Bambra, Clare
Russo, Giuliano
Perelman, Julian
author_role author
author2 Campos-Matos, Inês
Bambra, Clare
Russo, Giuliano
Perelman, Julian
author2_role author
author
author
author
dc.contributor.none.fl_str_mv Centro de Investigação em Saúde Pública (CISP/PHRC)
Instituto de Higiene e Medicina Tropical (IHMT)
Escola Nacional de Saúde Pública (ENSP)
RUN
dc.contributor.author.fl_str_mv Leão, Teresa
Campos-Matos, Inês
Bambra, Clare
Russo, Giuliano
Perelman, Julian
dc.subject.por.fl_str_mv Biochemistry, Genetics and Molecular Biology(all)
Agricultural and Biological Sciences(all)
SDG 10 - Reduced Inequalities
topic Biochemistry, Genetics and Molecular Biology(all)
Agricultural and Biological Sciences(all)
SDG 10 - Reduced Inequalities
description Background Although socioeconomic inequalities in health have long been observed in Europe, few studies have analysed their recent patterning. In this paper, we examined how educational inequalities in self-reported health have evolved in different European countries and welfare state regimes over the last decade, which was troubled by the Great Recession. Methods We used cross-sectional data from the EU-SILC survey for adults from 26 European countries, from 2005 to 2014 (n = 3,030,595). We first calculated education-related absolute (SII) and relative (RII) inequalities in poor self-reported health by country-year, adjusting for age, sex, and EU-SILC survey weights. We then regressed the year- and country-specific RII and SII on a yearly time trend, globally and by welfare regime, adjusting for country fixed effects. We further adjusted the analysis for the economic cycle using GDP growth, unemployment, and income inequality. Results Overall, absolute inequalities persisted and relative inequalities slightly widened (betaRII = 0.0313, p<0.05). There were substantial differences by welfare regime: Anglo-Saxon countries experienced the largest increase in absolute inequalities (betaSII = 0.0032, p<0.05), followed by Bismarkian countries (betaSII = 0.0024, p<0.001), while they reduced in Post-Communist countries (betaSII = -0.0022, p<0.001). Post-Communist countries also experienced a widening in relative inequalities (betaRII = 0.1112, p<0.001), which were found to be stable elsewhere. Adjustment for income inequality only explained such trend in Anglo-Saxon countries. Conclusions Educational inequalities in health have overall persisted across European countries over the last decade. However, there is considerable variation across welfare regimes, possibly related to underpinning social safety nets and to austerity measures implemented during this 10-year period.
publishDate 2018
dc.date.none.fl_str_mv 2018-04-13T22:20:10Z
2018-02-01
2018-02-01T00:00:00Z
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PURE: 3909472
http://www.scopus.com/inward/record.url?scp=85042536276&partnerID=8YFLogxK
https://doi.org/10.1371/journal.pone.0193165
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