Unemployment, public-sector healthcare spending and stomach cancer mortality in the European Union, 1981–2009

Maruthappu, Mahiben; Painter, Annabelle; Watkins, Johnathan; Williams, Cheyenne; Ali, Raghib; Zeltner, Thomas; Faiz, Omar; Sheth, Hemant

doi:10.1097/meg.0000000000000201

Cited by 8 publications

(5 citation statements)

References 41 publications

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“…Unemployed people are often vulnerable to the poor health effects of economic recession because of government budget austerity in health and social welfare spending during these periods 33 . Other studies have reported that mortality due to stomach cancer 34 and cerebrovascular diseases 35 among unemployed people increased, possibly because of reductions in health care expenditure. In contrast, mortality rates for cancers and ischaemic heart disease in unemployed people have steadily reduced, even during Japan’s economic crisis.…”

Section: Discussionmentioning

confidence: 98%

Inequality in mortality by occupation related to economic crisis from 1980 to 2010 among working-age Japanese males

Wada

Gilmour

2016

Sci Rep

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The mortality rate for Japanese males aged 30–59 years in managerial and professional spiked in 2000 and remains worse than that of other occupations possibly associated with the economic downturn of the 1990s and the global economic stagnation after 2008. The present study aimed to assess temporal occupation-specific mortality trends from 1980 to 2010 for Japanese males aged 30–59 years for major causes of death. We obtained data from the Occupation-specific Vital Statistics. We calculated age-standardized mortality rates for the four leading causes of death (all cancers, suicide, ischaemic heart disease, and cerebrovascular disease). We used a generalized estimating equation model to determine specific effects of the economic downturn after 2000. The age-standardized mortality rate for the total working-age population steadily declined up to 2010 in all major causes of death except suicide. Managers had a higher risk of mortality in all leading causes of death compared with before 1995. Mortality rates among unemployed people steadily decreased for all cancers and ischaemic heart disease. Economic downturn may have caused the prolonged increase in suicide mortality. Unemployed people did not experience any change in mortality due to suicide and cerebrovascular disease and saw a decline in cancer and ischemic heart disease mortality, perhaps because the basic properties of Japan’s social welfare system were maintained even during economic recession.

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Section: Discussionmentioning

confidence: 98%

Inequality in mortality by occupation related to economic crisis from 1980 to 2010 among working-age Japanese males

Wada

Gilmour

2016

Sci Rep

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“…As EMR treatment can be used only in the early stage of gastric cancer, we inferred that low-income status leads to lower probability for early diagnosis of cancer. This delayed detection consequently leads to a higher mortality rate [16][17][18][19][20][21]. Carstairs index is an indicator for neighborhood deprivation; a positive, higher score on the index denotes greater deprivation EMR endoscopic mucosal/submucosal resection Relationship between socioeconomic status and accessibility for endoscopic resection among… 65…”

Section: Discussionmentioning

confidence: 99%

Relationship between socioeconomic status and accessibility for endoscopic resection among gastric cancer patients: using National Health Insurance Cohort in Korea: poverty and endoscopic resection

Kim

Choi

et al. 2016

Gastric Cancer

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Background Gastric cancer is one of the most common types of cancer among patients in Korea. We measured the inequity in accessibility to endoscopic mucosal/submucosal resection (EMR) for early and curable gastric cancer treatment among different income classes in patients diagnosed from late 2011 to 2013. Methods Data were obtained from the National Health Insurance Cooperation Claim Data from patients diagnosed from late 2011 until the end of 2013, to provide a total of 1,671 patients with newly diagnosed carcinoma in situ of gastric and gastric cancer among 1,025,340 enrollees. Multiple logistic regression analysis was conducted to investigate the associations between independent variables and the rate of treatment with EMR. Results Among 1671 gastric cancer patients, 317 (19.0 %) subjects were treated with EMR. The 'lowest' income group was associated with a statistically significant lower rate of EMR treatment [odds ratio (OR) = 0.55, 95 % confidence index (CI) 0.34-0.89] compared to the 'highest' income group. The ORs for the 'low-middle' and 'middle-high' income groups were both higher than for the reference group, although these were not significantly different. According to the subgroup analysis by gender, rate of EMR treatment of 'lowest' income group (OR = 0.37, 95 % CI 0.18-0.74) was significantly lower only among men. Conclusion In conclusion, we suggest that although universal health insurance in Korea has covered EMR treatment since August 2011, patients from the lowest income group are less likely to receive this treatment. Thus, we need to detect more eligible early-stage gastric cancer and treatment for individuals of low socioeconomic status.

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“…The expenditure measure was total national health expenditure in eight studies, [46][47][48][49][50][51][52][53] public sector or government spending on health in three studies, [54][55][56] per incident case cancer spending in two studies, 3,57 and per capita cancer drug spending in one study. 58 Four studies included both developed and developing countries across five continents, [48][49][50][51] while the rest focused primarily on developed countries in North America and Europe.…”

Section: International Comparisons Of Spending and Outcomesmentioning

confidence: 99%

“…51 Four studies on international comparisons used a time series design with country-level fixed effects, and all found higher spending to be associated with lower mortality. [54][55][56][57] The most salient evidence on the cross-country comparisons comes from an individual-level, longitudinal analysis of cancer registries from 11 countries. 3 The authors found that from 1995 to 1999, each $20,000 increase in spending per patient with cancer was associated with an additional 2.3 years of life expectancy after diagnosis for the average patient with cancer.…”

Section: International Comparisons Of Spending and Outcomesmentioning

confidence: 99%

Association Between Spending and Outcomes for Patients With Cancer

Lakdawalla

Goldman

2020

JCO

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Unemployment, public-sector healthcare spending and stomach cancer mortality in the European Union, 1981–2009

Cited by 8 publications

References 41 publications

Inequality in mortality by occupation related to economic crisis from 1980 to 2010 among working-age Japanese males

Inequality in mortality by occupation related to economic crisis from 1980 to 2010 among working-age Japanese males

Relationship between socioeconomic status and accessibility for endoscopic resection among gastric cancer patients: using National Health Insurance Cohort in Korea: poverty and endoscopic resection

Association Between Spending and Outcomes for Patients With Cancer

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