European Welfare State Regimes Research Articles

Values and economic performance across European welfare state regimes: Direct and indirect effects through social capital, human capital and managerial skills.

The values that people hold are linked to their economic performance. These links can be either direct or indirect, operating through moderating variables such as social network participation, interpersonal trust, trust in institutions, human capital, managerial skills and hours worked. In this paper these effects are studied using structural equation modelling (SEM) methodology applied to European Social Survey data from 28 European countries in 2018. Schwartz classification of values is used, distinguishing between Self-Enhancement (Power, Achievement), Openness to Change (Self-Direction), Conservation (Tradition, Security, Conformity) and Self-Transcendence (Universalism, Benevolence) values. It is found that Power has the strongest positive direct effect on economic performance, further strengthened by a positive indirect structural effect through hours worked. Self-Direction is indirectly positively linked to economic performance through higher managerial skills and hours worked. Tradition has a strong negative direct effect on economic performance. Security is indirectly negatively linked with economic performance, owing to its negative effects on interpersonal trust, management skills and hours worked. Some of the identified effects are context-dependent and vary across European welfare state regimes. For example, Power is statistically significantly linked to economic performance only in the liberal and conservative regime. Values promoted by respective welfare state regimes are not necessarily associated with higher incomes within those regimes, e.g., Tradition and Security values promoted in the conservative and Mediterranean regime are associated with lower incomes. These findings may lead to a range of policy implications, particularly in relation to the policies on immigration, demographics, the labor market, and work-life balance. Unfortunately, due to the cross-sectional character of the dataset, causal relations among the variables of interest could not be identified.

Free Movement versus European Welfare States? Variations of the Fiscal Effects of EU Migrants across Welfare State Regimes

Strong claims have been made about the incompatibility between large-scale migration and advanced welfare states. The free movement of workers within the European Union (EU) offers an interesting case for the study of the fiscal effects of unrestricted labor migration in different types of welfare states This article therefore investigates the alleged tension between advanced welfare states and liberal migration policies by analyzing how the fiscal effects of EU migrants vary across European welfare state regimes. In contrast to arguments commonly made in public debates, we argue and explain why theoretical reasoning should lead us to expect limited differences in fiscal effects of EU migrants in different welfare states. The empirical analysis, covering twenty-nine countries during 2004–15, shows that the net fiscal impact of EU migrants in the different welfare state regimes of West European countries is positive, and we find no major differences in the fiscal impacts of EU migrants across Western regimes. These results from the EU case cast doubts on the claim that advanced welfare states are incompatible with large-scale immigration because of adverse fiscal effects, and on the idea that broad institutional characteristics of welfare states have substantial consequences for the fiscal impact of migration.

Sustainable and Inclusive Welfare States: Employment and Poverty Among Immigrants and People with Disabilities in Different Welfare State Regimes

In this article, we ask to what extent immigrants and people with disabilities are excluded from labor markets and to what extent they are exposed to poverty in different European welfare state regimes. Our starting points lie in the United Nation’s and European Union’s agendas for sustainable development, in research on welfare regimes, and in the social investment paradigm. We utilize the European Union Statistics on Income and Living Conditions (EU-SILC) to run multilevel random effect models to measure the extent to which there are regime-specific differences in risk of poverty and months out of work. Our results show that within-regime dif-ferences are often larger than between-regime differences. The implementation of the social in-vestment paradigm, emphasizing the role of a decent level of income transfers combined with extensive public services, fortifies the fiscal and social sustainability of the welfare state.

Self-Rated Health and Socioeconomic Status in Old Age: The Role of Gender and the Moderating Effect of Time and Welfare Regime in Europe

Research has shown that health status and self-rated health (SRH) are correlated not only with age and gender but also with socioeconomic determinants, such as income, education, and employment status, in the course of life and in late life. Much less investigated, however, are gender differences in the association between socioeconomic factors and SRH and how the connection differs among the European welfare state regimes. This study examines the association between SRH and socioeconomic status in later life and in relation to gender and welfare state regime characteristics. Using SHARE data, it builds an analytical sample of respondents aged 60–70 (1275 men, 1544 women) who participated in Wave 1 and, ten years later, in Wave 6. The analysis regresses SRH by gender on socioeconomic status, controlling for various sociodemographic, health, and socioeconomic variables, as well as welfare regime indicators, at two points in time. Past health variables are also controlled for in order to evaluate their effect on SRH at the time of the investigation. A significant gender gap in SRH is found from childhood to late life. The association of socioeconomic status with poorer SRH is significant over time and within welfare state regimes. Consequently, the relationship between gender and SRH, and the extent to which it varies by socioeconomic position, does appear to differ across welfare state regimes. In all regimes and all points in time, including retrospective childhood SRH, women report poorer health than men. The analysis underscores the association between SRH and socioeconomic status in relation to gender in late life and finds that it correlates differently for men and women. The odds of women experiencing poorer SRH are higher, although they become more moderate over time. Even under the most egalitarian welfare regimes, gender differences in the nexus of SRH and socioeconomic status do not favor women.

Precarious employment and mental health in European welfare state regimes: a multilevel approach

Abstract Background Precarious employment (PE) is a key social determinant of health that is, in turn, shaped by the broader institutional framework of the country in which it is embedded. At the same time, evidence sustains that welfare state regimes (WSRs) have a decisive role in determining people's health. However, the interaction effect between them is yet to be studied from a public health perspective. This article examines how WSRs, PE and mental health (MH) relate in Europe, and whether this relationship differs between women and men. Methods Data were derived from the European Working Conditions Survey 2015. PE was measured through the Employment Precariousness Scale for Europe (EPRES-E), validated for comparative research in 22 European countries, which were classified into five WSRs (Bismarckian, Anglo-Saxon, Scandinavian, Southern and Central-Eastern). MH was measured through the WHO-5 Well-Being Index. In a sample of 30,795 formal employees, we performed multilevel poisson regression models stratified by women and men. Results Results show a gradual association between PE quartiles and poor MH (PR Q2=1.37 CI95% [1.13-1.65], Q3=1.86[1.51-2.30], Q4=2.96[2.31-3.81] men; PR Q2=1.15[0.97-1.37], Q3=1.48[1.22-1.79], Q4=2.06[1.64-2.58] women) after adjusting for control variables. Further, the Scandinavian WSR displayed an overall protective effect for MH among men, as compared with the Bismarckian (PR = 0.58[0.34-0.99]). Regarding the interaction effects, these were only significant in the Central-Eastern WSR, which was found to boost the negative association between PE and MH among women (PR = 1.17[1.03-1.33]). Conclusions These findings point to a differential effect of WSRs on the negative relationship between PE and MH according to gender. Key messages European welfare state regimes unequally affect the negative association between precarious employment and mental health. This differential is also gender-based, since the Central-Eastern regime further deteriorates the mental health of precarious employees only among women, as compared to the Bismarckian.

Welfare state and the age distribution of public consumption and public transfers in the EU countries

The article extends the discussion of the welfare state in the literature by presenting a quantitative assessment of the age distribution of public resources. It investigates the differences in the distribution of public transfers between age groups in different European welfare state regimes using the National Transfer Accounts approach. There are two groups of countries that stand out in terms of the age patterns of their public transfers: three Scandinavian countries and Luxembourg have relatively high transfer levels, particularly for the older age group; while some of the Central and Eastern European countries have relatively low transfer levels. In the other European countries, the age profiles of public transfers are close to the EU average. Total public expenditures and revenues in the two distinct groups are changing in response to population ageing: i.e. they are expanding in the Scandinavian countries, and they are contracting in the CEE countries. These developments may lead to the further divergence of these welfare regimes.

Explaining oral health inequalities in European welfare state regimes: The role of health behaviours.

To assess the extent to which behavioural factors, including those related to dental care, account for oral health inequalities in different European welfare state regimes. Data from the Eurobarometer 2009 survey were analysed. Nationally representative samples of dentate adults aged ≥45years (n=9979) from 21 European countries classified into the five welfare regimes (Scandinavian, Anglo-Saxon, Bismarckian, Southern, Eastern) were considered. Inequalities in no functional dentition (having <20 natural teeth) by education and occupation were identified using the Relative and Slope Indices of Inequality (RII and SII, respectively). The percentage reduction in RII and SII was calculated from regression models before and after adjustment for behaviours, first one at a time and then all together. Behaviours explained 21.0% (95% CI 8.7, 31.4) and 13.1% (95% CI 7.9, 33.2) of educational inequalities in no functional dentition (RII) in the Scandinavian and Eastern regimes, respectively. For occupational inequalities, the attenuations in RII in these welfare regimes were 19.3% (95% CI 7.1, 24.2) and 10.5% (95% CI 3.4, 22.5), respectively. Attenuations were weaker and nonsignificant in the Bismarckian, Anglo-Saxon and Southern regimes. Among the behaviours analysed, alcohol consumption was particularly relevant in explaining inequalities in the Scandinavian regime, and this was confirmed in sensitivity analyses through three-way cross-level interaction terms in multilevel models. Behaviours related to dental care produced similar, consistent attenuations in the Scandinavian and Eastern regimes for both socioeconomic indicators. SII findings showed a similar picture. The role of particular behaviours in explaining oral health inequalities could be heterogeneous across European welfare regimes, indicating that their importance might be influenced by the general approach to social policies.

Welfare states, the Great Recession and health: Trends in educational inequalities in self-reported health in 26 European countries.

BackgroundAlthough socioeconomic inequalities in health have long been observed in Europe, few studies have analysed their recent patterning. In this paper, we examined how educational inequalities in self-reported health have evolved in different European countries and welfare state regimes over the last decade, which was troubled by the Great Recession.MethodsWe used cross-sectional data from the EU-SILC survey for adults from 26 European countries, from 2005 to 2014 (n = 3,030,595). We first calculated education-related absolute (SII) and relative (RII) inequalities in poor self-reported health by country-year, adjusting for age, sex, and EU-SILC survey weights. We then regressed the year- and country-specific RII and SII on a yearly time trend, globally and by welfare regime, adjusting for country fixed effects. We further adjusted the analysis for the economic cycle using GDP growth, unemployment, and income inequality.ResultsOverall, absolute inequalities persisted and relative inequalities slightly widened (betaRII = 0.0313, p<0.05). There were substantial differences by welfare regime: Anglo-Saxon countries experienced the largest increase in absolute inequalities (betaSII = 0.0032, p<0.05), followed by Bismarkian countries (betaSII = 0.0024, p<0.001), while they reduced in Post-Communist countries (betaSII = -0.0022, p<0.001). Post-Communist countries also experienced a widening in relative inequalities (betaRII = 0.1112, p<0.001), which were found to be stable elsewhere. Adjustment for income inequality only explained such trend in Anglo-Saxon countries.ConclusionsEducational inequalities in health have overall persisted across European countries over the last decade. However, there is considerable variation across welfare regimes, possibly related to underpinning social safety nets and to austerity measures implemented during this 10-year period.

Changes in European Welfare State Regimes as a Response to Fertility Trends: Family Policy Perspective

Following 1945, that is the Second World War, Europe faced a huge demographic increase in the number of births, known as baby-boom. Encouraged by the improvement of the living conditions after the devastating war, the return of the optimism, opening of the employment opportunities and the renewal of the idea about the family, this demographic trend entailed the so-called familism tide. In the mid 1960-ies however, demographic indicators in almost all European countries began to change suddenly. Massive development of contraception, increased birth control and family planning, as well as higher employment of women and their integration in the labour market, took place. As a result of these trends, in the 1970-ties European countries faced a considerable drop in fertility rates. This trend reached its peak during 1970-1980-ties when a dramatic drop in fertility rates took place, known as baby-bust. As a consequence, almost everywhere in Europe, the fertility rate dropped below the level needed for simple population reproduction or below 2.1 children per woman. Several related trends also contributed to the change in the demographic picture of Europe, such as: dropping birthrates, shrinking of the population, delay in births (increase in the age of birth of the first child), increase in the number of one-child families, as well as growth in the number of couples without children (universality of births is no longer present – at least 1 child per family). Similar trends are evidenced in the countries of Central and Eastern Europe (CIE), with one considerable difference – they took place around a decade later compared to the developed European countries. One common characteristic which shaped the demographic changes in CIE countries was the fact that they occurred simultaneously with the radical changes of the societal system from socialism towards democracy in the 1990-ties. Due to this, demographic changes in CIE countries gain in weight, are furthermore under the influence of the transitional processes and thus differ considerably compared to those in the developed countries. The differences are heavily attributable to two sets of factors: a) different institutional settings, especially in the family policies related to employment of women and child raising; and b) different effects of these family policies upon fertility rates and participation of women in the labour market. Given the above demographic trends, welfare states in Europe, adjust accordingly, predominantly through the policies and measures of family policy as one of the social policy domains. Following a detailed statistical analysis of demographic indicators in Europe, this paper will produce an analysis of the family policy responses to demographic trends based on the Esping-Andersens’ classification of welfare states: universal welfare states (Nordic countries); conservative welfare states (Continental European countries); liberal social states (Anglo-Saxon countries) and South-European social states (Mediterranean countries). A specific focus in the paper will be also given to the demographic trends and corresponding family policy developments in the Republic of Macedonia, as a country of South Europe. Cross-cutting issues in the analysis of the family policy models will be: the extent to which family policies are gender-neutral or gender-specific (are they women-friendly and do they promote active fatherhood?), measures for harmonization of work and family life (are women appropriately supported in performing their roles of mothers and active participants in the labour market at the same time) and the scope in which family policy is being designed to serve the purposes of population policy (how the concern and the interest of the state to increase fertility rates shapes family policy?).

The influence of poor health on competing exit routes from paid employment among older workers in 11 European countries.

Objectives The study aimed to (i) determine the influence of poor health on competing exit routes from paid employment among older workers in Europe, (ii) assess whether these risks are different among welfare state regimes in Europe, and (iii) evaluate differences in estimates between two different competing risk approaches. Methods The study population consisted of 5273 respondents (6-years follow-up) from the Survey of Health, Ageing, and Retirement in Europe (SHARE). The effect of poor health on exit routes from paid employment was assessed with a cause-specific Cox model and a Fine & Gray (F&G) model. These two competing risk analyses were used to calculate absolute risks of labor force exit among welfare state regimes in Europe. Results In both models, poor health was a risk factor for disability benefit [hazard ratio (HR) 3.36; subdistribution hazard ratio (SHR) 3.22], and unemployment (HR 1.43, SHR 1.32). Both models produced similar absolute risks. In countries with a Bismarckian welfare state regime, low-educated older workers living alone and in poor health had an 11% risk of disability benefit, 7% of unemployment, 46% of early retirement, and 7% of becoming economically inactive. In countries with a Scandinavian welfare state regime, the risks were 10%, 7%, 29%, and 3%, respectively, and in Southern European welfare state regimes 4%, 5%, 35%, and 7%. Conclusions Workers with poor health are more likely to leave the labor force than workers with good health. The absolute risks of early retirement and becoming economically inactive were lowest in countries with a Scandinavian welfare state regime. For disability benefit and unemployment, absolute risks were lowest in Southern European welfare state regimes. The direct estimation of absolute risks of leaving the labor force in the presence of competing exit routes is an appealing feature of the F&G model.

Discovering complex interrelationships between socioeconomic status and health in Europe: A case study applying Bayesian Networks

Studies assume that socioeconomic status determines individuals’ states of health, but how does health determine socioeconomic status? And how does this association vary depending on contextual differences? To answer this question, our study uses an additive Bayesian Networks model to explain the interrelationships between health and socioeconomic determinants using complex and messy data. This model has been used to find the most probable structure in a network to describe the interdependence of these factors in five European welfare state regimes. The advantage of this study is that it offers a specific picture to describe the complex interrelationship between socioeconomic determinants and health, producing a network that is controlled by socio-demographic factors such as gender and age. The present work provides a general framework to describe and understand the complex association between socioeconomic determinants and health.

Intergenerational private transfers: Portugal in the European context.

Intergenerational private transfers should be made important as a common occurrence in familialistic societies when establishing the identity of Southern European welfare state regimes. They function as a safety net and as a way of reinforcing the bonds amongst elements in a family. Although Portugal is undoubtedly a Southern European country, it is frequently ignored in comparative studies, and is assumed to share the characteristics of Spain and Italy. But do these countries really belong to a common, distinctive model? Portugal was included in the fourth wave of the survey of health, ageing and retirement in Europe, which provides a large sample for the study of intergenerational private transfers in this country. It also enables comparison with what happens elsewhere in Europe. We examine the upward and downward flows between generations and identify several important determinants of each type of transfers. Additionally, we show that the different types and directions of transfers are positively correlated, pointing to a self-reinforcement of transfer behaviour in families. We find that Portugal has an especially low probability of private transfers of time and money. After taking into consideration the household-level characteristics, none of the countries included in this study has a significantly lower probability of occurrence of any type of transfer than that of Portugal. A Southern European specific pattern of family transfers is only partially confirmed, yet Portugal and Spain do share the same model.

Changes in socioeconomic determinants of health: comparing the effect of social and economic indicators through European welfare state regimes

Aim This study is aimed at comparing the effect of different measures of socioeconomic status on self-rated health throughout European welfare state regimes during the period 2002–2008, in order to study how diverse socioeconomic inequalities can vary our health over time. Subjects and methods This study uses the European Social Survey to compare the impact of three specific socioeconomic measures (income, education and occupational status) on selfrated health. Results The main finding to be highlighted is that the importance of education-related inequalities surpasses differences in income and occupational status, especially in southern and eastern countries. The relationship between income and selfrated health is stronger in liberal and social-democratic regimes, where labour market regulation is characterized by its flexibility and high liberalization. The impact of occupational status is moderate among liberal, social democratic and conservative regimes, but lower in southern and eastern ones. Conclusion These findings support the existence of a contextual effect among welfare states that varies the impact of social and economic indicators in self-rated health over time.

Socioeconomic inequalities in oral health in different European welfare state regimes

BackgroundThere is very little information about the relationship between welfare regimes and oral health inequalities. We compared socioeconomic inequalities in adults’ oral health in five European welfare-state regimes: Scandinavian, Anglo-Saxon,...

Taking welfare state regime research globally: An application of the Wood and Gough typology to individual health

Seldom do studies on welfare regimes and health take a global perspective. Usually most research on this genre concentrates on high-income countries only, few studies include low- and middle-income countries, and even fewer examinations combine a large number of countries to obtain a worldwide view. For this, we need global welfare regime typologies that would allow for such examinations. Given this, we investigated the usefulness of the Wood and Gough welfare regime typology on 49 countries by examining the association between welfare regimes and self-reported individual disability worldwide. The World Health Survey data were examined on 207 818 people from 49 countries using the welfare regime classification developed by Wood and Gough. Multilevel logistic regression was used to investigate links between disability and welfare regimes while also accounting for individual-level socioeconomic factors. Variations in individual disability prevalence were found within the different welfare regimes. For example, odds of poor health prevalence for citizens within the insecurity Sub-Saharan African regime as compared with the European-conservative regime were OR=1.83 95 per cent CI: 0.85–3.95. Living in a state-organized regime was associated with lower odds of disability prevalence, as higher odds of disability prevalence were observed in all non-state regimes (with the exception of the productivist regime). For instance, the people in the productivist regime of East Asia reported similar prevalence of poor health odds as compared with the European-conservative regime (OR=0.94 95 per cent CI: 0.45–1.99). This short report found that the Wood and Gough typology enables the study of welfare regimes and health globally, and appears to be a useful tool in welfare regime type research. The productivist regime seems to have health protective features that are on par with European welfare state regimes. We recommend that this finding is investigated further in future empirical analyses.

Welfare State Regime Life Courses: The Development of Western European Welfare State Regimes and Age-Related Patterns of Educational Inequalities in Self-Reported Health

This article uses data from three waves of the European Social Survey (2002, 2004, 2006) to compare educational inequalities in self-reported health (good vs. bad) and limiting longstanding illness in six age groups based on decade of birth (1930s-1980s) in 17 countries, categorized into four welfare state regimes (Anglo-Saxon, Bismarckian, Scandinavian, Southern). The authors hypothesized that health inequalities in these age groups would vary because of their different welfare state experiences-welfare state regime life courses-both temporally, in terms of different phases of welfare state development (inequalities smaller among older people), and spatially, in terms of welfare state regime type (inequalities smaller among older Scandinavians). The findings are that inequalities in health tended to increase, not decrease, with age. Similarly, inequalities in health were not smallest in the Scandinavian regime or among the older Scandinavian cohorts. In keeping with the rest of the literature, the Bismarckian and Southern regimes had smaller educational inequalities in health. Longitudinal analysis that integrates wider public health factors or makes smaller comparisons may be a more productive way of analyzing cross-national variations in health inequalities and their relationship to welfare state life courses.

Gender, health inequalities and welfare state regimes: a cross-national study of 13 European countries

This study is the first to examine the relationship between gender and self-assessed health (SAH), and the extent to which this varies by socioeconomic position in different European welfare state regimes (Liberal, Corporatist, Social Democratic, Southern). The EUROTHINE harmonised data set (based on representative cross-sectional national health surveys conducted between 1998 and 2004) was used to analyse SAH differences by gender and socioeconomic position (educational rank) in different welfare states. The sample sizes ranged from 7124 (Germany) to 118 245 (Italy) and concerned the adult population (aged >or=16 years). Logistic regression analysis (adjusting for age) identified significant gender differences in SAH in nine European welfare states. In the UK (OR 0.88; 95% CI 0.78 to 0.99) and Finland (OR 0.85; 95% CI 0.77 to 0.95), men were significantly more likely to report "bad" or "very bad" health. In Denmark, Sweden, Norway, Holland, Italy, Spain and Portugal, a significantly higher proportion of women than men reported that their health was "bad" or "very bad". The increased risk of poor SAH experienced by women from these countries ranged from a 23% increase in Denmark (OR 1.23; 95% CI 1.08 to 1.39) to more than a twofold increase in Portugal (OR 2.01; 95% CI 1.87 to 2.15). For some countries (Italy, Portugal, Sweden), women's relatively worse SAH tended to be most prominent in the group with the highest level of education. Women in the Social Democratic and Southern welfare states were more likely to report worse SAH than men. In the Corporatist countries, there were no gender differences in SAH. There was no consistent welfare state regime patterning for gender differences in SAH by socioeconomic position. These findings constitute a challenge to regime theory and comparative social epidemiology to engage more with issues of gender.

European Welfare State Regimes and Their Generosity Toward the Elderly

European Welfare State Regimes and Their Generosity Toward the Elderly

Popular support for institutionalised solidarity: a comparison between European welfare states

In this article, we study the determinants of supportiveness for the welfare state as a system of institutionalised solidarity. We distinguish between two types of support; namely, 1) whether people hold the state responsible for achieving social‐economic security and distributive justice, and 2) people's preference for the range of these goals that should be realised if the state is indeed held responsible. Using data from the Eurobarometer survey series, we investigate how, and to what extent, both kinds of support for the welfare state are related to position in the stratification structure, demographic characteristics, and social‐political beliefs, as well as to features of European welfare state regimes. The results of a two‐level hierarchical model suggest that moral commitment to the welfare state dominates at the individual level, whereas self‐interest enters the picture mainly if a person is highly dependent on the provisions of the welfare state. Further, the findings give no support to the claim of a systematic variation between levels of popular support for the welfare state and its institutional set‐up.