BackgroundThe article explores in how far financial accessibility of healthcare (FAH) is restricted for low-income groups and identifies social protection policies that can supplement health policies in guaranteeing universal access to healthcare. The article is aimed to advance the literature on comparative European social epidemiology by focussing on income-related barriers of healthcare take-up.MethodThe research is carried out on the basis of multi-level cross-sectional analyses using 2012 EU-SILC data for 30 European countries. The social policy data stems from EU-SILC beneficiary information.ResultsIt is argued that unmet medical needs are a reality for many individuals within Europe – not only due to direct user fees but also due to indirect costs such as waiting time, travel costs, time not spent working. Moreover, low FAH affects not only the lowest income quintile but also the lower middle income class. The study observes that social allowance increases the purchasing power of both household types, thereby helping them to overcome financial barriers to healthcare uptake.ConclusionAlongside healthcare system reform aimed at improving the pro-poor availability of healthcare facilities and financing, policies directed at improving FAH should aim at providing a minimum income base to the low-income quintile. Moreover, categorical policies should address households exposed to debt which form the key vulnerable group within the low-income classes.

This study starts from the assumption that the context of opportunities for work-family balance affects individual attitudes toward gender roles, a main indicator of support for gender equality. Compared with extant research, the present study adopts a more articulated definition of “opportunity structure” that includes national income level and social norms on gender attitudes, measures of gender-mainstreaming policies implemented at the company level (flextime), and different work-family balance policies in support of the dual-earner/dual-caregiver family model (e.g., parental-leave schemes and childcare provisions). The effects of these factors are estimated by performing a cross-sectional multilevel analysis for the year 2014. Gender-role attitudes and micro-level controls are taken from the Eurobarometer for all 28 European Union (EU) members, while macro-indicators stem from Eurostat, European Quality of Work Survey, and the Organisation for Economic Cooperation and Development (OECD). Our results show that both institutional and workplace arrangements supporting the dual-earner/dual-caregiver family model are associated with more egalitarian gender-role attitudes This is particularly true concerning availability of formal childcare for 0- to 3-year-olds among institutional factors, as well as work-schedule flexibility among workplace factors, probably as they enable a combination of care and paid work for both men and women.

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The central aim of this paper is identifying the existing political leeway for the reduction of deprivation levels in Europe. The links between household and individual characteristics and risks of material deprivation have been abundantly researched, but what are the political institutions that modify and possibly buffer these odds? Welfare state differences have been portrayed in depth but their association with social outcomes such as deprivation is less clear. By identifying the impact of decommodification and defamilisation policies on deprivation exposure, we seek to fill this gap. Our results, based on European Union Statistics on Income and Living Conditions 2012 to 2013 cross-sectional micro data, reveal that social programmes that cover large segments of the population and follow a needs-based approach are linked to lower odds of being materially deprived. A significant number of European cross-country differences in deprivation rates can thus be traced back to varying levels of social assistance, as well as to differences in the provision of public healthcare. Defamilisation policies are, despite increased risks for (single parent) families, not yet addressing the problem of low living standards successfully. An extension of childcare services, however, seems promising for lowering deprivation among families, particularly in countries with high levels of involuntary part-time work.

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