European health inequality through the 'Great Recession': social policy matters.

Kjetil A Van Der Wel,Wen‐Hao Chen,Knut Halvorsen,Espen Dahl,Therese Saltkjel

doi:10.1111/1467-9566.12723

Kjetil A Van Der Wel, Wen‐Hao Chen + Show 3 more

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https://doi.org/10.1111/1467-9566.12723

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Abstract

This paper investigates the association between the Great Recession and educational inequalities in self-rated general health in 25 European countries. We investigate four different indicators related to economic recession: GDP; unemployment; austerity and a 'crisis' indicator signifying severe simultaneous drops in GDP and welfare generosity. We also assess the extent to which health inequality changes can be attributed to changes in the economic conditions and social capital in the European populations. The paper uses data from the European Social Survey (2002-2014). The analyses include both cross-sectional and lagged associations using multilevel linear regression models with country fixed effects. This approach allows us to identify health inequality changes net of all time-invariant differences between countries. GDP drops and increasing unemployment were associated with decreasing health inequalities. Austerity, however, was related to increasing health inequalities, an association that grew stronger with time. The strongest increase in health inequality was found for the more robust 'crisis' indicator. Changes in trust, social relationships and in the experience of economic hardship of the populations accounted for much of the increase in health inequality. The paper concludes that social policy has an important role in the development of health inequalities, particularly during times of economic crisis.

Highlights

The 2008 financial crisis and the ensuing ‘Great Recession’ experienced by many European countries led to longstanding high levels of unemployment
Unlike most studies, we used four different ‘crisis’-measures, one of which was based on a fuzzy-set classification. We argue that this measurement represents a theoretically and methodologically advanced way of analysing the effects of the economic recession in comparison to unidimensional and linear approaches, like using gross domestic product (GDP) or the UE rate
This study concludes that the Great Recession in Europe was associated with widening educational inequalities in selfrated general health (SRH)

Summary

Introduction

The 2008 financial crisis and the ensuing ‘Great Recession’ experienced by many European countries led to longstanding high levels of unemployment. Commission and the Member states are called upon by the European Parliament to ‘press ahead with their efforts to tackle socio-economic inequalities’ (European Parliament 2011: 4). Against this backdrop, understanding the development of European health inequalities through the Great Recession and the role of social policy is important. The aim of this paper is twofold: we investigate to what extent deteriorating economic conditions, rising unemployment and austerity were associated with changes in health inequalities in Europe during the Great Recession. In order to shed some light on the pathways involved, we research whether the observed recession-related changes in health inequality can be explained by changes in economic conditions and social capital in the population

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