Population health and the economy: Mortality and the Great Recession in Europe

Granados, José A. Tapia; Ionides, Edward L.

doi:10.1002/hec.3495

Cited by 68 publications

(82 citation statements)

References 93 publications

(133 reference statements)

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“…25 However, the evidence around the impact of economic recession on health and mortality of populations, rather than individuals, is complex and contested. 26 The response to this financial crisis, across many countries, was to implement a range of austerity policies whereby public spending was reduced in the pursuit of balanced budgets. As a result many public services experienced substantial reductions in their budgets and public sector wages and income transfers to lower income groups were frequently reduced in real terms.…”

Section: Meaningexplanations and Implicationsmentioning

confidence: 99%

Recent adverse mortality trends in Scotland: comparison with other high-income countries

Fenton

Minton

Ramsay

et al. 2019

Preprint

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ObjectiveGains in life expectancy have faltered in several high-income countries in recent years. We aim to compare life expectancy trends in Scotland to those seen internationally, and to assess the timing of any recent changes in mortality trends for Scotland. Setting MethodsWe used life expectancy data from the Human Mortality Database (HMD) to calculate the mean annual life expectancy change for 24 high-income countries over five-year periods from 1992 to 2016, and the change for Scotland for five-year periods from 1857 to 2016. One-and two-break segmented regression models were applied to mortality data from National Records of Scotland (NRS) to identify turning points in age-standardised mortality trends between 1990 and 2018. ResultsIn 2012-2016 life expectancies in Scotland increased by 2.5 weeks/year for females and 4.5 weeks/year for males, the smallest gains of any period since the early 1970s. The improvements in life expectancy in 2012-2016 were smallest among females (<2.0 weeks/year) in Northern Ireland, Iceland, England & Wales and the USA and among males (<5.0 weeks/year) in Iceland, USA, England & Wales and Scotland. Japan, Korea, and countries of Eastern Europe have seen substantial gains in the same period. The best estimate of when mortality rates changed to a slower rate of improvement in Scotland was the year to 2012 Q4 for males and the year to 2014 Q2 for females. ConclusionLife expectancy improvement has stalled across many, but not all, high income countries. The recent change in the mortality trend in Scotland occurred within the period 2012-2014. Further research is required to understand these trends, but governments must also take timely action on plausible contributors.

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Section: Meaningexplanations and Implicationsmentioning

confidence: 99%

Recent adverse mortality trends in Scotland: comparison with other high-income countries

Fenton

Minton

Ramsay

et al. 2019

Preprint

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“…In 2015, COPD was associated with 241.4 years of life lost among 100 000 individuals (all sexes), which was, however, considerably lower than the national average [63]. Additionally, a recent Greek study has reported that mortality from respiratory diseases has declined during the crisis, in contrast with its increasing trend before [64]. However, conflicting studies have indicated that economic downturns are historically associated with increases in mortality, mainly attributable to psychosocial stress due to unemployment [65] or intentional violence [6].…”

Section: Respiratory Mortality In Greece Amid An Economic Crisismentioning

confidence: 99%

Impact of the financial crisis on COPD burden: Greece as a case study

et al. 2018

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Poverty and low socioeconomic status have been associated with chronic obstructive pulmonary disease (COPD). The current financial crisis has forced millions back into poverty. Greece is one of the countries hit the hardest, and is in the middle of a deep ongoing collapse. There have been early reports stating the apparent effects of the Greek downturn on respiratory health. This review summarises the overall impact of the financial crisis on COPD burden throughout the period of economic downturn by analysing the case study of Greece. In all levels of the healthcare system, current economic restrictions have reduced the capacity to prevent, diagnose and treat COPD in parallel with current higher detection rates of COPD. Remarkably, expenditure on healthcare has been reduced by >25%, resulting in major healthcare equipment shortages. Lower wages (by up to 20%) and higher co-payments of up to 25% of a drug's purchase price have led to patients struggling to afford inhaled medications. Treatment nonadherence has been reported, resulting in 11.5% more exacerbations and 14.1% more hospitalisations annually, while the mean cost per severe COPD exacerbation has been approximated as €2600. Greece is a noteworthy example illustrating how COPD burden, quality of care and patients' outcome can be affected by economic crisis.

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“…Much existing research has focused on the relationship between the economic downturn, rises in unemployment and worsening mental health outcomes 3 4. Mirroring historical trends, in the aftermath of the recession there was an improvement in all-cause mortality across Europe,5 paradoxically accompanied by a sharp rise in suicide rates which disproportionately impacted men 6…”

Section: Introductionmentioning

confidence: 99%

Trends in gender and socioeconomic inequalities in mental health following the Great Recession and subsequent austerity policies: a repeat cross-sectional analysis of the Health Surveys for England

Thomson

Katikireddi

2018

BMJ Open

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ObjectiveIt is known that mental health deteriorated following the 2008 global financial crisis, and that subsequent UK austerity policies post-2010 disproportionately impacted women and those in deprived areas. We aimed to assess whether gender and socioeconomic inequalities in poor mental health have changed since the onset of austerity policies.DesignRepeat cross-sectional analysis of survey data.SettingEngland.ParticipantsNationally and regionally representative samples of the working-age population (25–64 years) from the Health Survey for England (1991–2014).Outcome measuresPopulation-level poor mental health was measured by General Health Questionnaire-12 (GHQ) caseness, stratified by gender and socioeconomic position (area-level deprivation and highest educational attainment).ResultsThe prevalence of age-adjusted male GHQ caseness increased by 5.9% (95% CI 3.2% to 8.5%, p<0.001) from 2008 to 2009 in the immediate postrecession period, but recovered to prerecession levels after 2010. In women, there was little change in 2009 or 2010, but an increase of 3.0% (95% CI 1.0% to 5.1%, p=0.004) in 2012 compared with 2008 following the onset of austerity. Estimates were largely unchanged after further adjustment for socioeconomic position, employment status and household income as potential mediators. Relative socioeconomic inequalities in GHQ caseness narrowed from 2008 to 2010 immediately following the recession, with Relative Index of Inequality falling from 2.28 (95% CI 1.89 to 2.76, p<0.001) to 1.85 (95% CI 1.43 to 2.38, p<0.001), but returned to prerecession levels during austerity.ConclusionsGender inequalities in poor mental health narrowed following the Great Recession but widened during austerity, creating the widest gender gap since 1994. Socioeconomic inequalities in poor mental health narrowed immediately postrecession, but this trend may now be reversing. Austerity policies could contribute to widening mental health inequalities.

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Population health and the economy: Mortality and the Great Recession in Europe

Cited by 68 publications

References 93 publications

Recent adverse mortality trends in Scotland: comparison with other high-income countries

Recent adverse mortality trends in Scotland: comparison with other high-income countries

Impact of the financial crisis on COPD burden: Greece as a case study

Trends in gender and socioeconomic inequalities in mental health following the Great Recession and subsequent austerity policies: a repeat cross-sectional analysis of the Health Surveys for England

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