#Health #outcomes during the 2008 #financial #crisis in #Europe: systematic literature review (BMJ, abstract)

[Source: British Medical Journal, full page: (LINK). Abstract, edited.]


Health outcomes during the 2008 financial crisis in Europe: systematic literature review

BMJ 2016; 354 / doi: http://dx.doi.org/10.1136/bmj.i4588 / (Published 06 September 2016) /  Cite this as: BMJ 2016;354:i4588

Divya Parmar, 1, Charitini Stavropoulou, 1, John P A Ioannidis, 2

Author affiliations: 1School of Health Sciences, City University London, London EC1V 0HB, UK; 2School of Medicine, Stanford University, Stanford, CA, USA

Correspondence to: C Stavropoulou C.Stavropoulou@city.ac.uk

Accepted 20 July 2016




To systematically identify, critically appraise, and synthesise empirical studies about the impact of the 2008 financial crisis in Europe on health outcomes.

Design Systematic literature review.

Data sources Structural searches of key databases, healthcare journals, and organisation based websites.

Review methods 

Empirical studies reporting on the impact of the financial crisis on health outcomes in Europe, published from January 2008 to December 2015, were included. All selected studies were assessed for risk of bias. Owing to the heterogeneity of studies in terms of study design and analysis and the use of overlapping datasets across studies, studies were analysed thematically per outcome, and the evidence was synthesised on different health outcomes without formal meta-analysis.


41 studies met the inclusion criteria, and focused on suicide, mental health, self rated health, mortality, and other health outcomes. Of those studies, 30 (73%) were deemed to be at high risk of bias, nine (22%) at moderate risk of bias, and only two (5%) at low risk of bias, limiting the conclusions that can be drawn. Although there were differences across countries and groups, there was some indication that suicides increased and mental health deteriorated during the crisis. The crisis did not seem to reverse the trend of decreasing overall mortality. Evidence on self rated health and other indicators was mixed.


Most published studies on the impact of financial crisis on health in Europe had a substantial risk of bias; therefore, results need to be cautiously interpreted. Overall, the financial crisis in Europe seemed to have had heterogeneous effects on health outcomes, with the evidence being most consistent for suicides and mental health. There is a need for better empirical studies, especially those focused on identifying mechanisms that can mitigate the adverse effects of the crisis.

Keywords: Research; Abstracts; Society; Public Health; Economic Recession.


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Giuseppe Michieli

I am an Italian blogger, active since 2005 with main focus on emerging infectious diseases such as avian influenza, SARS, antibiotics resistance, and many other global Health issues. Other fields of interest are: climate change, global warming, geological and biological sciences. My activity consists mainly in collection and analysis of news, public services updates, confronting sources and making decision about what are the 'signals' of an impending crisis (an outbreak, for example). When a signal is detected, I follow traces during the entire course of an event. I started in 2005 my blog ''A TIME'S MEMORY'', now with more than 40,000 posts and 3 millions of web interactions. Subsequently I added an Italian Language blog, then discontinued because of very low traffic and interest. I contributed for seven years to a public forum (FluTrackers.com) in the midst of the Ebola epidemic in West Africa in 2014, I left the site to continue alone my data tracking job.