Regional inequalities in self-reported conditions and non-communicable diseases in European countries: Findings from the European Social Survey (2014) special module on the social determinants of health

Thomson, Katie; Renneberg, Ann-Christin; McNamara, Courtney L.; Akhter, Nasima; Reibling, Nadine; Bambra, Clare

doi:10.1093/eurpub/ckw227

Cited by 22 publications

(20 citation statements)

References 17 publications

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“…The data used in the study originates from the nationally representative 2014 South African Social Attitudes Survey (SASAS), which fielded the survey module on social determinants of health in the European Social Survey (ESS7) in a developing country context [27]. This survey module on the social determinants of health has been extensively used to document health inequalities in European countries [38–40], including disparities in mental health [41–43], emphasising its suitability for this study. SASAS 2014 received ethical clearance from the HSRC and face-to-face interviews were conducted with a cross-sectional sample of 3108 consenting individuals aged 16 years and older.…”

Section: Methodsmentioning

confidence: 99%

Subjective social status and inequalities in depressive symptoms: a gender-specific decomposition analysis for South Africa

Mutyambizi

Booysen

Stornes

et al. 2019

Int J Equity Health

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Background Inequalities in mental health are a notable and well documented policy concern in many countries, including South Africa. Individuals’ perception of their position in the social hierarchy is strongly and negatively related to their mental health, whilst the global burden of poor mental health is greater amongst women. This paper offers a first glimpse of the factors that shape gender-based health inequalities across subjective social status. Methods This study employs the cross-sectional 2014 South African Social Attitudes Survey (SASAS). The prevalence of depressive symptoms is measured with the aid of the CES-D 8-item scale, with analyses disaggregated by gender. Concentration indices (CI) are used to measure inequalities in depressive symptoms related to subjective social status. The study applies the Wagstaff decomposition to determine the factors that contribute to these gender-based inequalities. Results More than 26% of the study sample had depressive symptoms (95% CI 24.92–28.07). The prevalence of depressive symptoms is significantly more pronounced in females (28.46% versus 24.38%; p = 0.011). The concentration index for depressive symptoms is − 0.276 (95% CI -0.341 – − 0.211), showing large inequalities across subjective social status. The observed SSS-related inequality in depressive symptoms however is higher for males (CI = -0.304) when compared to females (CI = -0.240) ( p = 0.056). The most important contributor to SSS-related inequalities in depressive symptoms, at 61%, is subjective social status itself (contributing 82% in females versus 44% in males). Other variables that make large contributions to the inequalities in depressive symptoms at 11% each are race (contributing 2% in females versus 25% in males) and childhood conflict (contributing 17% in females versus 4% in males). Conclusion Policy makers should target a reduction in the positive contribution of SSS to depression via the implementation of programmes that improve social welfare. Given the much greater contribution to inequalities among females, these policies should target women. Policies that protect children and especially the girl child from conflict can also be useful in reducing inequalities in depression related to subjective social status during adulthood. Overall, there is need for a multi-sectoral approach to address these inequalities.

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Section: Methodsmentioning

confidence: 99%

Subjective social status and inequalities in depressive symptoms: a gender-specific decomposition analysis for South Africa

Mutyambizi

Booysen

Stornes

et al. 2019

Int J Equity Health

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“…All regional data were classified at the second Nomenclature of Territorial Units for Statistics (NUTS-2) level (with a typical population of 800,000 to 3 million) apart from Germany and United Kingdom, as for these countries the ESS data were only available at the NUTS-1 level (population 3–7 million). The NUTS is a hierarchical system for dividing up the economic territory of the European Union based on population, country administrative divisions or geographical units ( Thomson et al, 2017 ). The regional data were matched with the individual level ESS data using the corresponding NUTS code.…”

Section: Methodsmentioning

confidence: 99%

“…We included a range of health outcomes present in Round 7 of the ESS, these included: self-reported heart or circulation problems, high blood pressure, diabetes, self-rated health, depression and obesity. The regional distribution for these outcomes has been described previously ( Thomson et al, 2017 ). As a falsification test we also tested an outcome (allergies) that we did not expect to be associated with individual or regional level employment.…”

Section: Methodsmentioning

confidence: 99%

Regional employment and individual worklessness during the Great Recession and the health of the working-age population: Cross-national analysis of 16 European countries

Thomson

Bambra

Pearce

2020

Social Science & Medicine

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Studies from single countries suggest that local labour market conditions, including rates of employment, tend to be associated with the health of the populations residing in those areas, even after adjustment for individual characteristics including employment status. The aim of this study is to strengthen the cross-national evidence base on the influence of regional employment levels and individual worklessness on health during the period of the Great Recession. We investigate whether higher regional employment levels are associated with better health over and above individual level employment. Individual level data (N = 23,078 aged 15–64 years) were taken from 16 countries (Austria, Belgium, Czech Republic, Denmark, Finland, France, Germany, Hungary, Ireland, Netherlands, Norway, Poland, Portugal, Spain, Sweden and United Kingdom) participating in the 2014 European Social Survey. Regional employment rates were extracted from Eurostat, corresponding with the start (2008) and end (2013) of the Great Recession. Health outcomes included self-reported heart or circulation problems, high blood pressure, diabetes, self-rated health, depression, obesity and allergies (as a falsification test). We calculated multilevel Poisson regression models, which included individuals nested within regions, controlling for potential confounding variables and country fixed effects. After adjustment for individual level socio-demographic factors, higher average regional employment rates (from 2008 to 2013) were associated with better health outcomes. Individual level worklessness was associated with worsened health outcomes, most strongly with poor self-rated health. In models including both individual worklessness and the average regional employment rate, regional employment remained associated with heart and circulation problems, depression and obesity. There was evidence of an interaction between individual worklessness and regional employment for poor self-rated health and depression. The findings suggest that across 16 European countries, for some key outcomes, higher levels of employment in the regional labour market may be beneficial for the health of the local population.

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“…Earlier analyses indicated somewhat higher parental socio‐economic status (SES) among the participating families compared to the national mean . Norway is a highly egalitarian society , and SES‐based differences in parental and young people's health‐related behaviour are generally small compared to other European countries . However, further studies on more SES‐diverse samples are warranted.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

The genetic and environmental architecture of substance use development from early adolescence into young adulthood: a longitudinal twin study of comorbidity of alcohol, tobacco and illicit drug use

2017

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Regional inequalities in self-reported conditions and non-communicable diseases in European countries: Findings from the European Social Survey (2014) special module on the social determinants of health

Cited by 22 publications

References 17 publications

Subjective social status and inequalities in depressive symptoms: a gender-specific decomposition analysis for South Africa

Subjective social status and inequalities in depressive symptoms: a gender-specific decomposition analysis for South Africa

Regional employment and individual worklessness during the Great Recession and the health of the working-age population: Cross-national analysis of 16 European countries

The genetic and environmental architecture of substance use development from early adolescence into young adulthood: a longitudinal twin study of comorbidity of alcohol, tobacco and illicit drug use

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