#Socioeconomic #status and #impact of the #economic #crisis on #dietary #habits in #Italy: results from the INHES study (J Public Health, abstract)

[Source: Journal of Public Health, full page: (LINK). Abstract, edited.]

Socioeconomic status and impact of the economic crisis on dietary habits in Italy: results from the INHES study

Marialaura Bonaccio, Augusto Di Castelnuovo, Americo Bonanni, Simona Costanzo, Mariarosaria Persichillo, Chiara Cerletti, Maria Benedetta Donati, Giovanni de Gaetano, Licia Iacoviello, on behalf of the INHES Study Investigators on behalf of the INHES Study Investigators

Journal of Public Health, https://doi.org/10.1093/pubmed/fdx144

Published: 08 November 2017 – Received: 11 May 2017 – Revision Received: 07 September 2017 – Accepted: 10 October 2017

Citation: Marialaura Bonaccio, Augusto Di Castelnuovo, Americo Bonanni, Simona Costanzo, Mariarosaria Persichillo, Chiara Cerletti, Maria Benedetta Donati, Giovanni de Gaetano, Licia Iacoviello, on behalf of the INHES Study Investigators; Socioeconomic status and impact of the economic crisis on dietary habits in Italy: results from the INHES study, Journal of Public Health, https://doi.org/10.1093/pubmed/fdx144

© 2017 Oxford University Press

 

Abstract

Background

There is lack of evidence about the likely impact of the economic crisis on dietary habits in Western societies. We aimed to assess dietary modifications that possibly occurred during the recession and to investigate major socioeconomic factors associated with such modifications.

Methods

Cross-sectional analysis on 1829 subjects from the general population recruited in the larger INHES study (n = 9319) a telephone-based survey on nutrition and health conducted in Italy from 2010 to 2013. Association of socioeconomic (education, household income, occupation) with self-reported impact of the economic crisis on dietary habits was tested by multivariable logistic regression analysis.

Results

Low-educated subjects (OR = 2.30; 95% CI: 1.39–3.80), those with poor income (OR = 5.71; 95% CI: 3.68–8.85), and unemployed (OR = 3.93; 95% CI: 1.62–9.56) had higher odds of reporting undesirable dietary changes due to recession. Adherence to the Mediterranean diet was lower in subjects reporting a negative impact of the crisis on diet as compared to those declaring no effect, whereas the quality of grocery items was higher in the latter.

Conclusions

Undesirable dietary changes due to the economic crisis were mainly reported by lower socioeconomic groups. Subjects perceiving a negative impact of the recession on their diet also showed a lower adherence to Mediterranean diet and reduced quality of grocery products.

epidemiology, food and nutrition, socioeconomics factors

Issue Section: Original Article

© The Author 2017. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Keywords: Society; Poverty; Public Health; Italy; Economic Recession.

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The Great #Recession and #inequalities in access to #healthcare: a study of #unemployment and unmet medical need in #Europe in the economic crisis (Int J Epidemiol., abstract)

[Source: International Journal of Epidemiology, full page: (LINK). Abstract, edited.]

The Great Recession and inequalities in access to health care: a study of unemployment and unmet medical need in Europe in the economic crisis

Joana Madureira-Lima, Aaron Reeves, Amy Clair, David Stuckler

International Journal of Epidemiology, dyx193, https://doi.org/10.1093/ije/dyx193

Published: 18 September 2017 – Revision Received: 09 August 2017 – Accepted: 25 August 2017

Citation: Joana Madureira-Lima, Aaron Reeves, Amy Clair, David Stuckler; The Great Recession and inequalities in access to health care: a study of unemployment and unmet medical need in Europe in the economic crisis, International Journal of Epidemiology, , dyx193, https://doi.org/10.1093/ije/dyx193

© 2017 Oxford University Press

 

Abstract

Background:

Unmet medical need (UMN) had been declining steadily across Europe until the 2008 Recession, a period characterized by rising unemployment. We examined whether becoming unemployed increased the risk of UMN during the Great Recession and whether the extent of out-of-pocket payments (OOP) for health care and income replacement for the unemployed (IRU) moderated this relationship.

Methods:

We used the European Survey on Income and Living Conditions (EU-SILC) to construct a pseudo-panel (n = 135 529) across 25 countries to estimate the relationship between unemployment and UMN. We estimated linear probability models, using a baseline of employed people with no UMN, to test whether this relationship is mediated by financial hardship and moderated by levels of OOP and IRU.

Results:

Job loss increased the risk of UMN [β = 0.027, 95% confidence interval (CI) 0.022–0.033] and financial hardship exacerbated this effect. Fewer people experiencing job loss lost access to health care in countries where OOPs were low or in countries where IRU is high. The results are robust to different model specifications.

Conclusions:

Unemployment does not necessarily compromise access to health care. Rather, access is jeopardized by diminishing financial resources that accompany job loss. Lower OOPs or higher IRU protect against loss of access, but they cannot guarantee it. Policy solutions should secure financial protection for the unemployed so that resources do not have to be diverted from health.

Health inequalities, unemployment, access to healthcare, out-of-pocket-payments, recession

Topic: health services accessibility – income – economics – unemployment

Issue Section: Original Article

Keywords: Society; Poverty; Economy.

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#Mortality #decrease according to #socioeconomic #groups during the #economic #crisis in #Spain: a cohort study of 36 million people (Lancet, abstract)

[Source: The Lancet, full page: (LINK). Abstract, edited.]

Articles

Mortality decrease according to socioeconomic groups during the economic crisis in Spain: a cohort study of 36 million people

Prof Enrique Regidor, PhD, Fernando Vallejo, PhD, José A Tapia Granados, PhD, Francisco J Viciana-Fernández, PhD, Luis de la Fuente, PhD, Gregorio Barrio, PhD

Article has an altmetric score of 2 / DOI: http://dx.doi.org/10.1016/S0140-6736(16)30446-9

© 2016 Elsevier Ltd. All rights reserved.

 

Summary

Background

Studies of the effect of macroeconomic fluctuations on mortality in different socioeconomic groups are scarce and have yielded mixed findings. We analyse mortality trends in Spain before and during the Great Recession in different socioeconomic groups, quantifying the change within each group.

Methods

We did a nationwide prospective study, in which we took data from the 2001 Census. All people living in Spain on Nov 1, 2001, were followed up until Dec 31, 2011. We included 35 951 354 people alive in 2001 who were aged between 10 and 74 years in each one of the four calendar years before the economic crisis (from 2004 to 2007) and in each one of the first four calendar years of the crisis (from 2008 to 2011), and analysed all-cause and cause-specific mortality in those people. We classified individuals by socioeconomic status (low, medium, or high) using two indicators of household wealth: household floor space (<72 m2, 72–104 m2, and >104 m2) and number of cars owned by the residents of the household (none, one, and two or more). We used Poisson regression to calculate the annual percentage reduction (APR) in mortality rates during 2004–07 (pre-crisis) and 2008–11 (crisis) in each socioeconomic group, as well as the effect size, measured by the APR difference between the pre-crisis and crisis period.

Findings

The annual decline in all-cause mortality in the three socioeconomic groups was 1·7% (95% CI 1·2 to 2·1) for the low group, 1·7% (1·3 to 2·1) for the medium group, and 2·0% (1·4 to 2·5) for the high group in 2004–07, and 3·0% (2·5 to 3·5) for the low group, 2·8% (2·5 to 3·2) for the medium group, and 2·1% (1·6 to 2·7) for the high group in 2008–11 when individuals were classified by household floor space. The annual decline in all-cause mortality when people were classified by number of cars owned by the household was 0·3% (–0·1 to 0·8) for the low group, 1·6% (1·2 to 2·0) for the medium group, and 2·2% (1·6 to 2·8) for the high group in 2004–07, and 2·3% (1·8 to 2·8) for the low group, 2·4% (2·0 to 2·7) for the medium group and 2·5% (1·9 to 3·0) for the high group in 2008–11. The low socioeconomic group showed the largest effect size for both wealth indicators.

Interpretation

In Spain, probably due to the decrease in exposure to risk factors, all-cause mortality decreased more during the economic crisis than before the economic crisis, especially in low socioeconomic groups.

Funding

None.

Keywords: Spain; Economic Recession; Society.

——

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

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

Research

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

 

Abstract

Objective 

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.

Results 

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.

Conclusions 

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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