Abstract
BackgroundThe objective of this study was to estimate changes over time in health status and selected health behaviours during the Great Recession, in the period 2011/12, in Spain, both overall, and according to socioeconomic position and gender.MethodsWe applied a before-after estimation on data from four editions of the Spanish National Health Survey: 2001, 2003/04, 2006/07 and 2011/12. This involved applying linear probability regression models accounting for time-trends and with robust standard errors, using as outcomes self-reported health and health behaviours, and as the main explanatory variable a dummy “Great Recession” for the 2011/12 survey edition. All the computations were run separately by gender. The final sample consisted of 47,156 individuals aged between 25 and 64 years, economically active at the time of the interview. We also assessed the inequality of the effects across socio-economic groups.ResultsThe probability of good self-reported health increased for women (men) by 9.6 % (7.6 %) in 2011/12, compared to the long term trend. The changes are significant for all educational levels, except for the least educated. Some healthy behaviours also improved but results were rather variable. Adverse dietary changes did, however, occur among men (though not women) who were unemployed (e.g., the probability of declaring eating fruit daily changed by −12.1 %), and among both men (−21.8 %) and women with the lowest educational level (−15.1 %).ConclusionsSocioeconomic inequalities in health and health behaviour have intensified, in the period 2011/12, in at least some respects, especially regarding diet. While average self-reported health status and some health behaviours improved during the economic recession, in 2011/12, this improvement was unequal across different socioeconomic groups.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-2204-5) contains supplementary material, which is available to authorized users.
Highlights
The objective of this study was to estimate changes over time in health status and selected health behaviours during the Great Recession, in the period 2011/12, in Spain, both overall, and according to socioeconomic position and gender
According to our descriptive statistics, employment status was strongly affected by the Great Recession: the proportion of unemployment rose to 23.2 % for men and 22.8 % for women in 2011/12, compared to 7.9 % on average in 2007
Health behaviours and risk factors In general we found that behaviours improved during the recession, i.e., in the period 2011/12, our evidence suggests that the general improvement masks an exacerbation of some health behaviours during the recession in lower socio-economic groups
Summary
The objective of this study was to estimate changes over time in health status and selected health behaviours during the Great Recession, in the period 2011/12, in Spain, both overall, and according to socioeconomic position and gender. Over the same period real household incomes declined by 18.1 % on average, and the proportion of people at risk of poverty increased by 3.7 %, up to a level of 28.2 %, i.e., well above the European Union (EU-27) average (24.7 %) [2, 3] This recession has been the most severe since the start of democracy in the late 1970s, there is currently little evidence about the extent to which this worsening of economic conditions may have affected the health and health behaviours of the Spanish population. The literature on the health effects of economic recessions reports mixed results for the population as a whole: while health behaviours and the majority of mortality indicators are not affected or improve (e.g., traffic accidents [10]); those of mental health or infectious diseases worsen [11]. Other studies indicate that being at risk of unemployment reduces the consumption of fruits and vegetables and increases the consumption of unhealthy foods, including snacks and fast food [23]
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