What accounts for the rise of low self-rated health during the recent economic crisis in Europe?

Michal Brzezinski

doi:10.1186/s12939-019-0926-1

Abstract

BackgroundA growing literature investigates health effects of the recent economic crisis. This study examines how different economic mechanisms affected low self-rated health (SRH) in Europe over the crisis period (2008–2011). We measure changes in low SRH over 2008–2011 and analyze how they are accounted for by changes in household income levels and income distribution (income poverty, income inequality), labour market developments (increasing unemployment, falling employment, changes in labour market inactivity), and non-income poverty (material deprivation).MethodsWe use balanced panel data for 2008–2011 covering 26 European countries and 43,456 participants. The data come from longitudinal 2011 European Union Statistics on Income and Living Conditions (EU-SILC) database. Increases in low SRH incidence over time are decomposed into the contributions of changes in the distribution of covariates and changes in returns to the covariates. Main covariates include household income and its distribution, labour market developments, and non-income poverty (material deprivation). The decompositions are performed using a detailed non-linear multivariate regression-based decomposition methodology.ResultsLow SRH incidence increased in Europe during the crisis by almost 2 percentage points, and by 3.7 percentage points in case of the Baltic countries. Decomposition analysis shows that: 1) decreasing household incomes and changing income distribution had no impact on low SRH incidence, 2) rise of material deprivation accounts for a significant portion (12%) of the overall growth in low SRH rates (27% for the Baltic countries), 3) decreasing levels of full-time and part-time employment as well as transitions to unemployment, economic inactivity, disability, or retirement account jointly for about 21% of the rise in low SRH in Europe (73% for Baltic countries).ConclusionTogether, the recession-related economic factors account for about 33% of the increase in low SRH incidence in Europe during the crisis, and for about 100% of the increase in the Baltic countries. Public health policy during recessions should focus also on reducing material deprivation through free or subsidized access to public services, public housing, and other means.

Highlights

The recent economic crisis that started in 2008, often called the Great Recession (GR), was the worst global economic recession since the Great Depression of the 1930s
Using balanced panel data for 2008−2011 from the EU-SILC (European Union Statistics on Income and Living Conditions) and regression-based decomposition methodology (Oaxaca 1973; Blinder 1973; O'Donnell et al 2008; Yun 2005), we analyse how over-time increases in the society-wide low self-rated health (SRH) rates during the recession can be accounted for by three different economic mechanisms: changes in household income levels and income distribution, labour market developments, and non-income poverty
In case of all EU countries, we observe that the low SRH incidence grew over 2008−2011 by almost 2 percentage points

Summary

Introduction

The recent economic crisis that started in 2008, often called the Great Recession (GR), was the worst global economic recession since the Great Depression of the 1930s. Using balanced panel data for 2008−2011 from the EU-SILC (European Union Statistics on Income and Living Conditions) and regression-based decomposition methodology (Oaxaca 1973; Blinder 1973; O'Donnell et al 2008; Yun 2005), we analyse how over-time increases in the society-wide low SRH rates during the recession can be accounted for by three different economic mechanisms: changes in household income levels and income distribution (income poverty, income inequality), labour market developments (increasing unemployment, falling employment, changes in labour market inactivity), and non-income poverty (material deprivation) This approach allows to measure the strength of the association between different economic recession-related factors and low SRH in Europe. Our results may be useful from the perspective of a policymaker concerned with the incidence of low SRH in a society, as they suggest which economic mechanisms account most significantly for the worsening of the SRH distribution during the recession

Methods

Results

Discussion

Conclusion