Health related social exclusion in Europe: a multilevel study of the role of welfare generosity

Abstract

IntroductionThe aim of this paper was to investigate the association between health, social position, social participation and the welfare state. Extending recent research on the social consequences of poor health, we asked whether and how welfare generosity is related to the risk of social exclusion associated with combinations of poor health, low education and economic inactivity.MethodsOur analyses are based on data from the European Social Survey, round 3 (2006/7), comprising between 21,205 and 21,397 individuals, aged 25–59 years, within 21 European welfare states. The analyses were conducted by means of multilevel logistic regression analysis in STATA 12.ResultsThe results demonstrated that the risk of non-participation in social networks decreased as welfare generosity increased. The risk of social exclusion, i.e. non-participation in social networks among disadvantaged groups, seldom differed from the overall association, and in absolute terms it was invariably smaller in more generous welfare state contexts.ConclusionsThe results showed that there were no indications of higher levels of non-participation among disadvantaged groups in more generous welfare states. On the contrary, resources made available by the welfare state seemed to matter to all individuals in terms of overall lower levels of non-participation. As such, these results demonstrate the importance of linking health related social exclusion to the social policy context.

Individual-level changes in self-rated health before and during the economic crisis in Europe

“…Welfare generosity refers to the yearly sum of social expenditure (purchasing power standard) per inhabitant on family/children, unemployment, sickness/healthcare/disability, and housing and social exclusion benefits, as there is more variation in the overall generosity than in how the spending is prioritised (see Additional file 1 ). This sum is divided by the inverse of the employment rate among those 20–64 years old [ 25 ]. We used the average welfare generosity scores in 2004 and 2006 for the pre-crisis period and the average scores in 2008 and 2010 for the during-crisis period.…”

Late-Life Loneliness in 11 European Countries: Results from the Generations and Gender Survey

“…Both current and prior research associates a higher national level of welfare generosity with less loneliness among older people (e.g., Fokkema et al 2012;Sundstrom et al 2009). Similarly, the findings presented and reviewed by Saltkjel et al (2013) show that a comprehensive welfare state is positively associated with social participation (both formally and informally). It appears that in countries with generous social security schemes, where per capita public expenditure on health and welfare services is among the highest in Europe, people enjoy better social and psychological well-being than in countries where the state provides less.…”

“…One emphasizes that generous welfare states may promote better conditions for social integration and self-reliance and thus enable and stimulate social participation, in particular among individuals with health limitations or low socioeconomic resources (Hvinden 2010). The other perspective, the crowding-out hypothesis, warns that strong welfare states may decrease civic engagement by taking over tasks traditionally carried out by families, local communities, and social networks (Saltkjel et al 2013;van Oorschot and Arts 2005).…”

Immigrants’ support for social spending, self‐interest and the role of the group: A comparative study of immigrants in The Netherlands

“…This scale refers to the country of origin's public investment in labour force‐related social security programmes and social assistance. This is measured by dividing the percentage of gross domestic product spent on these social expenditures by the labour force's unemployment rate, following Saltkjel, Dahl and Van der Wel (), Asian Development Bank (), International Labour Office () and Organisation for Economic Co‐operation and Development (). In this way, we controlled for the level of need in the targeted countries and thus for the level of generosity of the social insurance expenditures (Luttmer & Singhal, ); see Table in the appendix for the calculation procedure.…”