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Economic crisis and health inequalities: evidence from the European Union

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      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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      Most cited references 37

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      Convergence

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        Financial crisis, austerity, and health in Europe.

        The financial crisis in Europe has posed major threats and opportunities to health. We trace the origins of the economic crisis in Europe and the responses of governments, examine the effect on health systems, and review the effects of previous economic downturns on health to predict the likely consequences for the present. We then compare our predictions with available evidence for the effects of the crisis on health. Whereas immediate rises in suicides and falls in road traffic deaths were anticipated, other consequences, such as HIV outbreaks, were not, and are better understood as products of state retrenchment. Greece, Spain, and Portugal adopted strict fiscal austerity; their economies continue to recede and strain on their health-care systems is growing. Suicides and outbreaks of infectious diseases are becoming more common in these countries, and budget cuts have restricted access to health care. By contrast, Iceland rejected austerity through a popular vote, and the financial crisis seems to have had few or no discernible effects on health. Although there are many potentially confounding differences between countries, our analysis suggests that, although recessions pose risks to health, the interaction of fiscal austerity with economic shocks and weak social protection is what ultimately seems to escalate health and social crises in Europe. Policy decisions about how to respond to economic crises have pronounced and unintended effects on public health, yet public health voices have remained largely silent during the economic crisis. Copyright © 2013 Elsevier Ltd. All rights reserved.
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            Author and article information

            Affiliations
            [1 ]Center for Research in Health and Economics (CRES), Universitat Pompeu Fabra, C/Ramon Trias Fargas, 25-27, Mercè Rodoreda Building, 08005 Barcelona, Spain
            [2 ]Research Group on Statistics, Econometrics and Health (GRECS), Universitat de Girona, Campus de Montilivi, 17071 Girona, Spain
            [3 ]CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
            Contributors
            ORCID: http://orcid.org/0000-0002-0447-2959, laia.maynou@gmail.com
            +34-972-418338 , marc.saez@udg.edu
            Journal
            Int J Equity Health
            Int J Equity Health
            International Journal for Equity in Health
            BioMed Central (London )
            1475-9276
            1 September 2016
            1 September 2016
            2016
            : 15
            : 1
            27586144
            5009665
            425
            10.1186/s12939-016-0425-6
            © The Author(s). 2016

            Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

            Funding
            Funded by: Subprogram Crisis and Health, CIBERESP and Compositional and Spatial Analysis (COSDA), AGAUR, Generalitat de Catalunya, 2014SGR551
            Categories
            Research
            Custom metadata
            © The Author(s) 2016

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