Austerity and health in Europe: disentangling the causal links

Forster, Timon; Kentikelenis, Alexander

doi:10.1093/eurpub/cky249

Cited by 18 publications

(14 citation statements)

References 5 publications

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“…1 The change in the expenditures of the national and local governments and the suicide rate per 100,000 in Japan between 2001 and 2014, as the year of 2000 as a baseline (=100). Note: Data on the amount of expenditures were adjusted for inflation Our study improves upon previous studies on the role of government expenditures on suicide by focusing on different time horizons and types and levels of policymaking [25]. First, the evidence presented here does not concern only the government reaction to a single event, such as the studies focusing on the Great Recession of 2008.…”

Section: Introductionmentioning

confidence: 93%

Government spending, recession, and suicide: evidence from Japan

2020

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Backgrounds: Austerity has been shown to have an adverse influence on people's mental health and suicide rates. Most existing studies have focused on the governments' reactions to a single event, for example, the Great Recession of 2008. Methods: This study focused on significant changes in fiscal policy between 2001 and 2014 in Japan. The size of expenditures by national and local governments decreased dramatically between 2001 and 2006 under the neoliberal reform and then increased after the global economic crisis and the Great East Japan Earthquake. Using the data from 47 prefectures between 2001 and 2014, we tested whether more spending by the local governments was associated with a lower suicide rate in their jurisdiction. We also investigated whether this relationship was particularly salient during a more severe recession. Results: Our analysis revealed that an increase of 1% in the per capita local government expenditures was associated with a decrease of 0.2% in the suicide rates among males and females aged between 40 and 64 and that this correlation was strengthened as the unemployment rate increased, particularly among males. Conclusions: Government's reaction to economic crises can either exacerbate or mitigate the negative impact of the economic recession on people's mental health and suicide rates.

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Section: Introductionmentioning

confidence: 93%

Government spending, recession, and suicide: evidence from Japan

2020

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“…However, limitations in current policies surrounding healthcare provision have been described as being underequipped to deal with more “unpredictable” factors, such as the onset of illness and disability [ 9 ], which place significant demands on individuals in terms of health literacy. Evidence from a European survey “Health Inequalities in Europe: Setting The Stage for Progressive Policy Action” [ 10 ] suggests that Ireland’s two-tiered healthcare system may also contribute to the gap of health inequity, insofar as a proportion of the population on low incomes are above the income threshold of entitlement for the General Medical Scheme (GMS), pay out-of-pocket for medical expenses, and cannot afford private medical insurance [ 10 , 11 ]. This report also noted that Ireland is one of the only countries in the European Union without universal healthcare coverage for all citizens [ 10 ], and this is now a key focus of the Sláintecare reform.…”

Section: Introductionmentioning

confidence: 99%

“…Evidence from a European survey “Health Inequalities in Europe: Setting The Stage for Progressive Policy Action” [ 10 ] suggests that Ireland’s two-tiered healthcare system may also contribute to the gap of health inequity, insofar as a proportion of the population on low incomes are above the income threshold of entitlement for the General Medical Scheme (GMS), pay out-of-pocket for medical expenses, and cannot afford private medical insurance [ 10 , 11 ]. This report also noted that Ireland is one of the only countries in the European Union without universal healthcare coverage for all citizens [ 10 ], and this is now a key focus of the Sláintecare reform. It is clear that the health and social care system in Ireland is complex and, like many countries, also presents a particular challenge in terms of health literacy and public health, insofar as those most in need are also those who are likely to lack the health literacy skills to navigate the system and engage fully in programmes and interventions to improve health and wellbeing.…”

Section: Introductionmentioning

confidence: 99%

Increasing Health Literacy May Reduce Health Inequalities: Evidence from a National Population Survey in Ireland

Gibney

Bruton

Ryan

et al. 2020

IJERPH

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Background. Health literacy has been separately associated with socio-economic status and worse health status and outcomes. However, the magnitude of the associations between health literacy and health status and outcomes may not be evenly distributed across society. This study aims to estimate and compare the associations between health status, health behaviours, and healthcare utilisation within different levels of social status in the Irish population. Materials and methods. Data from Ireland collected as part of the 2011 European Health Literacy Survey were analysed. General health literacy was measured on a 0–50 scale, low to high. There were four binary outcomes: long-standing health conditions, smoking, hospital visits in the last 12 months, and self-rated health status. Logistic regression analysis was conducted to estimate the likelihood of each health outcome. Health literacy was treated as the main independent variable. Marginal effects were calculated using the delta method to demonstrate the change in likelihood of each outcome associated with a 5-point increase in health literacy score. The sample was grouped into tertiles based on self-reported social status, and models were replicated and compared for each tertile. Models were adjusted for known correlates of health literacy and health: age, gender, and education. Analysis was conducted using Stata V14. Results. Higher health literacy scores were associated with a lower probability of having a limiting illness within the low social status group only. Higher health literacy scores were associated with a lower probability of three or more hospital visits in the past 12 months in the low and middle social status groups. For people in the low and middle social status groups, higher health literacy levels were associated with a lower probability of being a current smoker. The associations between health literacy and self-rated health status were similar in each social status group. Conclusions: Improvement in population health literacy may reduce the prevalence of long-term chronic health conditions, reduce smoking levels, and result in fewer hospital visits. Whilst improved health literacy should improve behaviours and outcomes in all groups, it should have a more marked impact in lower social status groups, and hence contribute to reducing the observed social disparities in these health outcomes.

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“…Our study improves upon previous studies on the role of government expenditures on suicide by focusing on different time horizons and types and levels of policymaking [25]. First, the evidence presented here does not concern only the government reaction to a single event, such as the studies focusing on the Great Recession of 2008.…”

Section: Introductionmentioning

confidence: 51%

Government Spending, Recession, and Suicide: Evidence from Japan

Matsubayashi

Sekijima

Ueda

2019

Preprint

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Backgrounds Austerity has been shown to have an adverse influence on people’s mental health and suicide rates. Most existing studies have focused on the governments’ reactions to a single event, for example, the Great Recession of 2008.Methods This study focused on significant changes in fiscal policy between 2001 and 2014 in Japan. The size of expenditures by national and local governments decreased dramatically between 2001 and 2006 under the neoliberal reform and then increased after the global economic crisis and the Great East Japan Earthquake. Using the data from 47 prefectures between 2001 and 2014, we tested whether more spending by the local governments was associated with a lower suicide rate in their jurisdiction. We also investigated whether this relationship was particularly salient during a more severe recession.Results Our analysis revealed that an increase of 1% in the per capita local government expenditures was associated with a decrease of 0.2% in the suicide rates among males and females aged between 40 and 64 and that this correlation was strengthened as the unemployment rate increased, particularly among males.Conclusions Government’s reaction to economic crises can either exacerbate or mitigate the negative impact of the economic recession on people’s mental health and suicide rates.

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Austerity and health in Europe: disentangling the causal links

Cited by 18 publications

References 5 publications

Government spending, recession, and suicide: evidence from Japan

Government spending, recession, and suicide: evidence from Japan

Increasing Health Literacy May Reduce Health Inequalities: Evidence from a National Population Survey in Ireland

Government Spending, Recession, and Suicide: Evidence from Japan

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