The impact of financial crisis and austerity policies in Andalusia, Spain: disentangling the mechanisms of social inequalities in health through the perceptions and experiences of experts and the general population

Auxiliadora Gonzalez-Portillo,Gloria Martinez-Cousinou,Javier Alvarez-Galvez,Eider Muniategui-Azkona,Victor Suarez-Lledo

doi:10.1186/s12939-019-1013-3

Auxiliadora Gonzalez-Portillo, Gloria Martinez-Cousinou + Show 3 more

Open Access

https://doi.org/10.1186/s12939-019-1013-3

Copy DOI

Abstract

BackgroundAndalusia has been one of the regions most damaged by the economic crisis in Spain. A qualitative study of the effects of the economic crisis and austerity policies in this region has been conducted within the framework of the IMPACT-A project. This research seeks to analyse the perceived impact of the crisis upon the health of the Andalusian population through the first-hand discourses of professionals from the health and social sectors on the one hand, and citizens of different socioeconomic status (SES) on the other.MethodsA total of five focus groups and ten semi-structured interviews were conducted and analysed following an inductive process based on Grounded Theory (GT).ResultsOur results show a general perception among professionals: the financial crisis has either directly or indirectly affected population health in Andalusia, though mostly impacting low-income individuals who were already at risk of social exclusion. Professionals’ perceptions have been confirmed through the discourses of citizens of a lower SES, which differ from those of middle and upper SES.ConclusionFindings reveal some of the most salient consequences on the socially vulnerable groups and people at risk of social exclusion. In particular, our study highlights the importance of addressing three areas of priority action: mental health, unmet (basic and medical) needs, and decline in the health system.

Highlights

Andalusia has been one of the regions most damaged by the economic crisis in Spain
Background all European countries have been affected by the recent financial crisis [1,2,3], the impact has been greater for Mediterranean countries such as Greece, Italy or Spain [4]
Perceptions of professionals from the health system and social services we analyse the discourse of focus groups 4 and 5, as well as the semi-structured interviews held with health professionals: a General Practitioner (GP), an NGO manager, a caregiver, and a university professor, who is an expert in the field of public health (I1 to I4)

Summary

Introduction

Andalusia has been one of the regions most damaged by the economic crisis in Spain. A qualitative study of the effects of the economic crisis and austerity policies in this region has been conducted within the framework of the IMPACT-A project. In Spain, this greater impact stems from the coincidence of the global financial crisis with the end of the so called “real estate bubble”, which had been one of the main economic forces in the country [4]. Together with the Canary Islands and Extremadura, Andalusia has been the Spanish region that most severely suffered the consequences of the crisis in terms of employment. During these years, Andalusia has been at the forefront of the Spanish regions in terms of the percentage of the population living in severe material poverty according data from the National Institute of Statistics [6]. Analysis of the health budget drawn up by the Andalusian Government for the years 2009 and 2015 shows that there was a drop of 1,400 million euros, representing a fall of 13.9% compared to the average 9% for Spain as a whole

Objectives

Results

Discussion

Conclusion