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      The impact of the Great Recession on mental health and its inequalities: the case of a Southern European region, 1997–2013

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          Abstract

          Background

          Numerous studies have shown that macroeconomic changes have a great influence on health, prompting different concerns in recent literature about the effects of the current recession. The objetive of the study was to assess the changes in the mental health of the working-age population in the Basque Country (Spain) and its social inequalities following the onset of the 2008 recession, with special focus on the role of unemployment.

          Methods

          Repeated cross-sectional study on the population aged 16–64, using four Basque Health Surveys (1997–2013). Age-adjusted prevalences of poor mental health and incremental prevalence ratios (working status and social class adjusted) between years were calculated. Absolute/relative measures of social inequalities were also calculated.

          Results

          From 2008, there was a clear deterioration in the mental health, especially among men. Neither changes in employment status nor social class accounted for these changes. In men, the deterioration affected all working status categories, except the retired but significant changes occurred only among the employed. In women, poor mental health significantly increased among the unemployed. Students were also especially affected. Relative inequalities increased only in men.

          Conclusions

          The Great Recession is being accompanied by adverse effects on mental health, which cannot be fully explained by the increase of unemployment. Public health professionals should closely monitor the medium and long-term effects of the crisis as these may emerge only many years after the onset of recessions.

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          Most cited references31

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          Precarious employment: understanding an emerging social determinant of health.

          Employment precariousness is a social determinant that affects the health of workers, families, and communities. Its recent popularity has been spearheaded by three main developments: the surge in "flexible employment" and its associated erosion of workers' employment and working conditions since the mid-1970s; the growing interest in social determinants of health, including employment conditions; and the availability of new data and information systems. This article identifies the historical, economic, and political factors that link precarious employment to health and health equity; reviews concepts, models, instruments, and findings on precarious employment and health inequalities; summarizes the strengths and weaknesses of this literature; and highlights substantive and methodological challenges that need to be addressed. We identify two crucial future aims: to provide a compelling research program that expands our understanding of employment precariousness and to develop and evaluate policy programs that effectively put an end to its health-related impacts.
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            Propuestas de clase social neoweberiana y neomarxista a partir de la Clasificación Nacional de Ocupaciones 2011

            En España, la nueva Clasificación Nacional de Ocupaciones (CNO-2011), que ha variado sustancialmente respecto a la del año 1994, requiere la adaptación de la clase social ocupacional para ser utilizada en estudios de desigualdades en salud. En este artículo se presentan dos propuestas para medir la clase social: la nueva clasificación de clase social ocupacional (CSO-SEE12), basada en la CNO-2011, desde un enfoque neoweberiano, y una propuesta de clase social desde un enfoque neomarxista. La CSO-SEE12 se construye a partir de una revisión detallada de los códigos de la CNO-2011. Por su parte, la clase social neomarxista se establece a partir de variables sobre los bienes de capital, de organización y de cualificación. La CSO-SEE12 que se propone consta de siete clases sociales que pueden ser agrupadas en un número menor de categorías, según las necesidades del estudio. La clasificación neomarxista consta de 12 categorías, en las cuales las y los propietarios se dividen en tres categorías en función de los bienes de capital y las personas asalariadas en nueve categorías formadas a partir de los bienes de organización y cualificación. Estas propuestas se complementan con la proposición de una clasificación del nivel educativo que integra los diferentes planes de estudio en España, y ofrece las correspondencias con la Clasificación Internacional Normalizada de la Educación.
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              The health effects of economic decline.

              Political pronouncements and policy statements include much conjecture concerning the health and behavioral effects of economic decline. We both summarize empirical research concerned with those effects and suggest questions for future research priorities. We separate the studies into groups defined by questions asked, mechanisms invoked, and outcomes studied. We conclude that although much research shows that undesirable job and financial experiences increase the risk of psychological and behavioral disorder, many other suspected associations remain poorly studied or unsupported. The intuition that mortality increases when the economy declines, for example, appears wrong. We note that the research informs public health programming by identifying risk factors, such as job loss, made more frequent by economic decline. The promise that the research would identify health costs and benefits of economic policy choices, however, remains unfulfilled and will likely remain so without stronger theory and greater methodological agreement.
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                Author and article information

                Contributors
                (34) 94-6012339 , amaia.bacigalupe@ehu.eus
                sesnaola@euskadi.eus
                unai.martin@ehu.eus
                Journal
                Int J Equity Health
                Int J Equity Health
                International Journal for Equity in Health
                BioMed Central (London )
                1475-9276
                26 January 2016
                26 January 2016
                2016
                : 15
                : 17
                Affiliations
                [ ]Department of Sociology 2, University of the Basque Country (UPV/EHU), Barrio Sarriena s/n. 48940, Leioa, Spain
                [ ]Department of Health, Basque Government, Donostia-San Sebastian 1. 01010, Vitoria-Gasteiz, Spain
                Article
                283
                10.1186/s12939-015-0283-7
                4727262
                26810112
                bc07540f-f562-42ee-a36a-6923f3831af9
                © Bacigalupe et al. 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.

                History
                : 21 October 2015
                : 10 December 2015
                Funding
                Funded by: Ministry of Economy and Competitiveness of Spain
                Award ID: CSO2013-44886-R
                Award Recipient :
                Categories
                Research
                Custom metadata
                © The Author(s) 2016

                Health & Social care
                economic recession,spain,socioeconomic factors,mental health,unemployment
                Health & Social care
                economic recession, spain, socioeconomic factors, mental health, unemployment

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