Abstract
The impact of the Great Recession on health stands out due to its implications for the wellbeing of the population. The available empirical evidence suggests that macrosocial inequalities can be a central element in explaining differences in the impact of the crisis on the health of the population during its early years (2008–2011). Specifically, it is necessary to analyze the role played by the processes constituting a model of inequalities based on social exclusion. This study addresses the topic by using longitudinal data taken from the European Union statistics on income and living conditions (EU-SILC) survey ( n = 5.924), with a hierarchical structure of four measurement moments nested in 5,924 individuals nested in 17 regions. Variables from two levels of analysis are considered: individual and ecological (regional) variables. The findings show that personal socioeconomic status (income and education) are significantly associated with changes in self-rated health during the onset of the crisis. The findings for ecological variables show that the variables measuring exclusion (material deprivation and low work intensity) play a significant role in the explanation of inequalities in health and how they changed during the crisis. Both indicators are negatively associated with self-rated health, while the Gini index and the proportion of the population in long-term unemployment do not have a consistent significant effect. These findings support the hypothesis that there are higher risks to wellbeing in more unequal societies compared with more equal societies.
Highlights
The impact of economic crisis on health is a highly significant topic in contemporary discussions regarding the determinants of wellbeing
In the case of population studies, the most commonly used inequality indicators are unemployment and/or belonging to disadvantaged ethnic groups. These are measures that do not capture the complexity of inequality in contemporary societies or the impact of the crisis on the consolidation of a model of inequality based on social exclusion processes (Dagdeviren et al, 2017; Mercille & Murphy, 2016)
When the level-3 social exclusion dimensions were added, a negative relationship appeared between self-rated health (SRH) and percentages of the population in situations of material deprivation and living in a household with low work intensity
Summary
The impact of economic crisis on health is a highly significant topic in contemporary discussions regarding the determinants of wellbeing. One group of studies has used individual variables to evaluate the impact of the crisis on alcohol consumption (Harhay et al, 2014), health and mental illness (Bartoll et al, 2014; Gili et al, 2013) and self-rated health (Reile et al, 2014) This line of research generally points to the Great Recession having a negative impact on individual health indicators, with few exceptions (Latif, 2020). A second group of papers is characterized by the use of ecological, group, and/or aggregated data and indicators in order to analyze the relationship between health and the Great Recession These studies analyzed the impact of the crisis on general and cause-specific mortality rates.
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