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1
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Kamikawa Y. Impact of the active job openings-to-applicants ratio on the number of ambulance dispatches in Japan, 2003-2021: a longitudinal ecological study. BMJ Open 2024; 14:e083755. [PMID: 39581730 PMCID: PMC11590810 DOI: 10.1136/bmjopen-2023-083755] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 11/01/2024] [Indexed: 11/26/2024] Open
Abstract
OBJECTIVE To examine the contribution of the active job openings-to-applicants ratio, a macroeconomic indicator, to the number of ambulance dispatches. DESIGN Longitudinal ecological study. SETTING Japan, between January 2003 and December 2021. PARTICIPANTS All ambulance dispatches. PRIMARY AND SECONDARY OUTCOME MEASURES The contribution of the active job openings-to-applicants ratio in a month, adjusted by the number of older people, mean temperature and total population, to the number of ambulance dispatches in that specific month was examined and the primary model was compared to the conventional model considering only the older population, mean temperature, and total population. RESULTS There were 108 724 969 ambulance dispatches during this period. The active job openings-to-applicants ratio was significantly associated with the number of ambulance dispatches (the increase rate of monthly ambulance dispatches for 1% rise in the active job openings-to-applicants ratio, 1.00082; 95% CI 1.00052 to 1.00112). Additionally, the primary model effectively demonstrated better fitness to the actual trend than the conventional model (the quasi-likelihood under the independence model criteria were -2 626 817 720 and -2 626 775 185, respectively). CONCLUSIONS The number of ambulance dispatches was correlated with the active job openings-to-applicants ratio. Macroeconomic perspectives may be needed to address the issue of increasing ambulance dispatches.
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Affiliation(s)
- Yohei Kamikawa
- Department of Emergency Medicine, University of Fukui Hospital, Fukui, Japan
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2
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Brook A, Rendall G, Hearty W, Meier P, Thomson H, Macnamara A, Westborne R, Campbell M, McCartney G. What is the relationship between changes in the size of economies and mortality derived population health measures in high income countries: A causal systematic review. Soc Sci Med 2024; 357:117190. [PMID: 39178721 DOI: 10.1016/j.socscimed.2024.117190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 07/31/2024] [Accepted: 08/04/2024] [Indexed: 08/26/2024]
Abstract
CONTEXT The economy has been long recognised as an important determinant of population health and a healthy population is considered important for economic prosperity. AIM To systematically review the evidence for a causal bidirectional relationship between aggregate economic activity (AEA) at national level for High Income Countries, and 1) population health (using mortality and life expectancy rates as indicators) and 2) inequalities in population health. METHODS We undertook a systematic review of quantitative studies considering the relationship between AEA (GDP, GNI, GNP or recession) and population health (mortality or life expectancy) and inequalities for High Income Countries. We searched eight databases and grey literature. Study quality was assessed using an adapted version of the Effective Public Health Practice Project's Quality Assessment tool. We used Gordis' adaptation of the Bradford-Hill framework to assess causality. The studies were synthesised using Cochrane recommended alternative methods to meta-analysis and reported following the Synthesis without Meta-analysis (SWiM) guidelines. We assessed the certainty of the evidence base in line with GRADE principles. FINDINGS Of 21,099 records screened, 51 articles were included in our analysis. There was no evidence for a consistent causal relationship (either beneficial or harmful) of changes in AEA leading to changes in population health (as indicated by mortality or life expectancy). There was evidence suggesting that better population health is causally related to greater AEA, but with low certainty. There was insufficient evidence to consider the causal impact of AEA on health inequalities or vice versa. CONCLUSIONS Changes in AEA in High Income Countries did not have a consistently beneficial or harmful causal relationship with health, suggesting that impacts observed may be contextually contingent. We tentatively suggest that improving population health might be important for economic prosperity. Whether or not AEA and health inequalities are causally linked is yet to be established.
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Affiliation(s)
- Anna Brook
- Sheffield Centre for Health and Related Research, University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK.
| | - Georgia Rendall
- Public Health Scotland, Gyle Square, 1 South Gyle Crescent, Edinburgh, EH12 9EB, Scotland, UK.
| | - Wendy Hearty
- Public Health Scotland, Gyle Square, 1 South Gyle Crescent, Edinburgh, EH12 9EB, Scotland, UK.
| | - Petra Meier
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, Clarice Pears Building, 90 Byres Road, Glasgow, G12 8TB, Scotland, UK.
| | - Hilary Thomson
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, Clarice Pears Building, 90 Byres Road, Glasgow, G12 8TB, Scotland, UK.
| | - Alexandra Macnamara
- Leeds University Teaching Hospitals NHS Trust, St. James's University Hospital, Beckett Street, Leeds, West Yorkshire, LS9 7TF, UK.
| | - Rachel Westborne
- Sheffield Centre for Health and Related Research, University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK.
| | - Mhairi Campbell
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, Clarice Pears Building, 90 Byres Road, Glasgow, G12 8TB, Scotland, UK.
| | - Gerry McCartney
- School of Social and Political Sciences, University of Glasgow, 40 Bute Gardens, Glasgow, G12 8RT, Scotland, UK.
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Law TH, Ng CP, Poi AWH. The sources of the Kuznets relationship between the COVID-19 mortality rate and economic performance. INTERNATIONAL JOURNAL OF DISASTER RISK REDUCTION : IJDRR 2022; 81:103233. [PMID: 36093278 PMCID: PMC9444851 DOI: 10.1016/j.ijdrr.2022.103233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 07/11/2022] [Accepted: 08/05/2022] [Indexed: 06/15/2023]
Abstract
This paper discusses the findings of an empirical analysis of the Kuznets, or reverse U-shaped relationship, between the COVID-19 mortality rate and economic performance. In the early stages of economic development, the COVID-19 mortality rate is anticipated to rise with rising economic activity and urbanization. Eventually, the mortality rate decreases at higher economic development levels as people and the government are more capable of investing in disease abatement measures. The quality of political institutions, wealth distribution, urbanization, vaccination rate, and improvements in healthcare systems are hypothesized to affect the COVID-19 mortality rate. Examining this relationship can be effective in understanding the change in the COVID-19 mortality rate at different economic performance stages and in identifying appropriate preventive measures. This study employed the negative binomial regression to model a cross-sectional dataset of 137 countries. Results indicated that the relationship between the per-head gross domestic product (GDP) level and the COVID-19 mortality rate appeared to follow a pattern like the Kuznets curve, implying that changes in institutional quality, healthcare advancements, wealth distribution, urbanization, vaccination rate, and the percentage of the elderly population were significant in explaining the relationship. Improvement of the healthcare system has a notable effect on lowering the COVID-19 mortality rate under more effective government conditions. Additionally, the results suggested that a higher per-head GDP is required to reverse the rising trend of the mortality rate under higher income inequality. Based on these results, preventive measures, and policies to reduce COVID-19 mortalities were recommended in the conclusion section.
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Affiliation(s)
- Teik Hua Law
- Road Safety Research Center, Faculty of Engineering, Universiti Putra Malaysia, 43400 Selangor, Malaysia
| | - Choy Peng Ng
- Civil Engineering Department, Faculty of Engineering, Universiti Pertahanan Nasional Malaysia, 57000 Kuala Lumpur, Malaysia
| | - Alvin Wai Hoong Poi
- Road Safety Engineering and Environment Research Center, Malaysian Institute of Road Safety Research, 43000 Kajang, Selangor, Malaysia
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Dhungel B, Murakami T, Wada K, Ikeda S, Gilmour S. Difference in Mortality Rates by Occupation in Japanese Male Workers Aged 25 to 64 Years from 1980 to 2015. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11328. [PMID: 36141600 PMCID: PMC9517138 DOI: 10.3390/ijerph191811328] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 09/02/2022] [Accepted: 09/05/2022] [Indexed: 06/16/2023]
Abstract
This study examines the trends in mortality among Japanese working men, across various occupational categories, from 1980 to 2015. A Poisson model of trend, occupational category, and step variable was analysed for eight occupational categories separately, by cause, to explore the trends in mortality. This study found a sharp increase in mortality in the late 1990s, especially among professionals and managers. The overall trends in cancer, ischemic heart disease (IHD), cerebrovascular disease (CVD), and suicide mortality decreased across almost all occupational categories from 1980 to 2015, although there was an increasing trend in cancer of 0.5% among managers. Clerical workers had the greatest relative decrease in mortality rates from cancer (-82.9%), IHD (-81.7%), and CVD (-89.1%). Japan continues to make gains in lowering mortality and extending life expectancy, but its workplace culture must improve to ensure that those working at the heart of the Japanese corporate world can also benefit from Japan's progress in health. Mortality rates in working-aged Japanese men have been declining. However, similar declines are not evident among managers, for whom the mortality rate is remaining stable or slightly increasing. There is a need to address the needs of managers and improve workplace environments for these workers.
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Affiliation(s)
- Bibha Dhungel
- Graduate School of Public Health, St. Luke’s International University, Tsukiji, Tokyo 104-0044, Japan
- Department of Health Policy, National Centre for Child Health and Development, Setagaya, Tokyo 157-8535, Japan
| | - Tomoe Murakami
- Graduate School of Medicine, International University of Health and Welfare, Akasaka, Tokyo 107-8402, Japan
| | - Koji Wada
- Graduate School of Medicine, International University of Health and Welfare, Akasaka, Tokyo 107-8402, Japan
| | - Shunya Ikeda
- Graduate School of Medicine, International University of Health and Welfare, Akasaka, Tokyo 107-8402, Japan
| | - Stuart Gilmour
- Graduate School of Public Health, St. Luke’s International University, Tsukiji, Tokyo 104-0044, Japan
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5
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Salinari G, Benassi F. The long-term effect of the Great Recession on European mortality. JOURNAL OF POPULATION RESEARCH 2022; 39:417-439. [PMID: 35966415 PMCID: PMC9358630 DOI: 10.1007/s12546-022-09290-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2022] [Indexed: 12/03/2022]
Abstract
Some European countries, such as Greece and Spain, were severely hit by the 2008 economic crisis whereas others, such as Germany, were practically spared by it. This divergence allowed us to implement a difference in differences research design which offered the possibility to observe the long-lasting effects produced by the crisis on European life expectancy. Our analysis—based on Eurostat data from 2001 to 2019—shows that life expectancy increased faster, after the onset of the crisis, in those countries where the rise in unemployment was more intense. Furthermore, our results show that this gain in life expectancy persisted, and sometimes further increased, until 2019 when most macro-economic variables had returned to their pre-crisis values. Previous research has identified that mortality behaves procyclically in developed countries: when the economy slows down mortality decreases and vice versa. Our findings show, by contrast, that life expectancy behaves asymmetrically: it responded to an increase but not to a decrease in unemployment. This calls for a reconsideration of the causal mechanisms linking together the economic cycle and mortality in developed countries.
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Martinson ML, Lapham J, Ercin-Swearinger H, Teitler JO, Reichman NE. Generational Shifts in Young Adult Cardiovascular Health? Millennials and Generation X in the United States and England. J Gerontol B Psychol Sci Soc Sci 2022; 77:S177-S188. [PMID: 35195713 PMCID: PMC9154229 DOI: 10.1093/geronb/gbac036] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVES To compare cardiovascular (CV) risks/conditions of Millennials (born 1981-1996) to those of Generation X (Gen X; born 1965-1980) at ages 20-34 years, across 2 countries (United States, England), by gender. METHODS Using data from the National Health and Nutrition Examination Survey (United States) and Health Survey for England, we estimated weighted unadjusted and adjusted gender-specific proportions of CV risk factors/conditions, separately for Millennials and Generation X in each country. We also further calculated sex-specific generational differences in CV risk factor/conditions by income tercile and for individuals with normal body weight. RESULTS Millennials in the United States were more obese compared to their Gen X counterparts and more likely to have diabetes risk but less likely to smoke or have high cholesterol. Millennials in England had higher diabetes risk but similar or lower rates of other CV risk/conditions compared to their Gen X counterparts. Generational changes could not be fully attributed to increases in obesity or decreases in income. DISCUSSION We expected that Millennial CV risk factors/conditions would be worse than those of Gen X, particularly in the United States, because Millennials came of age during the Great Recession and a period of increasing population obesity. Millennials generally fared worse than their Gen X counterparts in terms of obesity and diabetes risk, especially in the United States, but had lower rates of smoking and high cholesterol in both countries. Secular trends of increasing obesity and decreased economic opportunities did not appear to lead to uniform generational differences in CV risk factors.
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Affiliation(s)
| | - Jessica Lapham
- School of Social Work, University of Washington, Seattle, Washington, USA
| | | | - Julien O Teitler
- School of Social Work, Columbia University, New York City, New York, USA
| | - Nancy E Reichman
- Department of Pediatrics and Child Health Institute of New Jersey, Rutgers University, New Brunswick, New Jersey, USA
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7
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Toffolutti V, Plach S, Maksimovic T, Piccitto G, Mascherini M, Mencarini L, Aassve A. The association between COVID-19 policy responses and mental well-being: Evidence from 28 European countries. Soc Sci Med 2022; 301:114906. [PMID: 35313221 PMCID: PMC8920116 DOI: 10.1016/j.socscimed.2022.114906] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 02/27/2022] [Accepted: 03/11/2022] [Indexed: 12/12/2022]
Abstract
This study assesses how the implementation and lifting of non-pharmaceutical policy interventions (NPIs), deployed by most governments, to curb the COVID-19 pandemic, were associated with individuals' mental well-being (MWB) across 28 European countries. This is done both for the general population and across key-groups. We analyze longitudinal data for 15,147 respondents from three waves of the Eurofound-"Living, Working and COVID-19" survey, covering the period April 2020-March 2021. MWB is measured by the WHO-5 index. Our evidence suggests that restriction on international travel, private gatherings, and contact tracing (workplace closures) were negatively (positively) associated with MWB by about, respectively, -0.63 [95% CI: -0.79 to -0.47], -0.24 [95% CI: -0.38 to -0.10], and -0.22 [95% CI: -0.36 to -0.08] (0.29 [95% CI: 0.11 to 0.48]) points. These results correspond to -3.9%, -1.5%, and -1.4% (+1.8%) changes compared to pre-pandemic levels. However, these findings mask important group-differences. Women compared to men fared worse under stay-at-home requirements, internal movement restrictions, private gatherings restrictions, public events cancellation, school closures, and workplace closures. Those residing with children below 12, compared to those who do not, fared worse under public events cancellation, school closures and workplace closures. Conversely, those living with children 12-17, compared to those who do not, fared better under internal movement restrictions and public events cancelling. Western-Europeans vis-à-vis Eastern-Europeans fared better under NPIs limiting their mobility and easing their debts, whereas they fared worse under health-related NPIs. This study provides timely evidence of the rise in inequalities during the COVID-19 pandemic and offers strategies for mitigating them.
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Affiliation(s)
- Veronica Toffolutti
- Centre for Health Economics & Policy Innovation, Department of Economics & Public Policy, Imperial College London - Business School, Exhibition Road, South Kensington, London, SW7 2AZ, United Kingdom; "Carlo F. Dondena" Centre for Research on Social Dynamics and Public Policies, Bocconi University, Via G. Roentgen, 1, 20136, Milano, Italy.
| | - Samuel Plach
- "Carlo F. Dondena" Centre for Research on Social Dynamics and Public Policies, Bocconi University, Via G. Roentgen, 1, 20136, Milano, Italy.
| | - Teodora Maksimovic
- "Carlo F. Dondena" Centre for Research on Social Dynamics and Public Policies, Bocconi University, Via G. Roentgen, 1, 20136, Milano, Italy.
| | - Giorgio Piccitto
- "Carlo F. Dondena" Centre for Research on Social Dynamics and Public Policies, Bocconi University, Via G. Roentgen, 1, 20136, Milano, Italy.
| | - Massimiliano Mascherini
- European Foundation for the Improvement of Living and Working Conditions, Wyattville Road, Loughlinstown, Co. Dublin, D18 KP65, Ireland.
| | - Letizia Mencarini
- "Carlo F. Dondena" Centre for Research on Social Dynamics and Public Policies, Bocconi University, Via G. Roentgen, 1, 20136, Milano, Italy; Department of Social and Political Science, Bocconi University, Via G. Roentgen, 1, 20136, Milano, Italy.
| | - Arnstein Aassve
- "Carlo F. Dondena" Centre for Research on Social Dynamics and Public Policies, Bocconi University, Via G. Roentgen, 1, 20136, Milano, Italy; Department of Social and Political Science, Bocconi University, Via G. Roentgen, 1, 20136, Milano, Italy.
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8
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Zafar A, Rehm J, Feng X, Jiang H, Kim KV, Manthey J, Radišauskas R, Štelemėkas M, Petkevičienė J, Tran A, Lange S. The Impact of Alcohol Control Policy on Pneumonia Mortality in Lithuania: An Interrupted Time-Series Analysis. Epidemiol Infect 2022; 150:1-25. [PMID: 35440352 PMCID: PMC9128348 DOI: 10.1017/s0950268822000711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 03/31/2022] [Accepted: 04/06/2022] [Indexed: 12/04/2022] Open
Abstract
Despite the growing body of evidence suggesting that alcohol consumption is associated with an increased risk of and poorer treatment outcomes from pneumonia, little is known about the association between alcohol control policy and pneumonia mortality. As such, this study aimed to assess the impact of three alcohol control policies legislated in 2008, 2017 and 2018 in Lithuania on sex-specific pneumonia mortality rates among individuals 15+ years of age. An interrupted time-series analysis using a generalised additive mixed model was performed for each policy. Of the three policies, only the 2008 policy resulted in a significant slope change (i.e. decline) in pneumonia mortality rates among males; no significant slope change was observed among females. The low R 2 values for all sex-specific models suggest that other external factors are likely also influencing the sex-specific pneumonia mortality rates in Lithuania. Overall, the findings from this study suggest alcohol control policy's targeting affordability may be an effective way to reduce pneumonia mortality rates, among males in particular. However, further research is needed to fully explore their impact.
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Affiliation(s)
- Anush Zafar
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto ON, Canada
- School of Public Health Sciences, University of Waterloo, Waterloo ON, Canada
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto ON, Canada
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
- Department of Psychiatry, University of Toronto, Toronto ON, Canada
- Institute of Medical Science, University of Toronto, Toronto ON, Canada
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
- Department of International Health Projects, Institute for Leadership and Health Management, L.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Xinyang Feng
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto ON, Canada
| | - Huan Jiang
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto ON, Canada
| | - Kawon Victoria Kim
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto ON, Canada
| | - Jakob Manthey
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
- Department of Psychiatry, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Ričardas Radišauskas
- Department of Environmental and Occupational Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
- Institute of Cardiology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Mindaugas Štelemėkas
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
- Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Janina Petkevičienė
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
- Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Alexander Tran
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto ON, Canada
| | - Shannon Lange
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto ON, Canada
- Department of Psychiatry, University of Toronto, Toronto ON, Canada
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9
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Fan Y, Fang M, Zhang X, Yu Y. Will the economic growth benefit public health? Health vulnerability, urbanization and COVID-19 in the USA. THE ANNALS OF REGIONAL SCIENCE 2022; 70:81-99. [PMID: 35095177 PMCID: PMC8782711 DOI: 10.1007/s00168-021-01103-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 12/07/2021] [Indexed: 06/14/2023]
Abstract
UNLABELLED Economic growth has a significant impact on health vulnerability primarily through the process of urbanization. This paper conducts a pioneer study by analyzing the impact of regional economic growth and urbanization on the public health vulnerability in the 51 states and territories of the USA from 2011 to 2018 with a fixed-effect panel data regression model. We construct an epidemiological vulnerability index (EVI) using regional smoking, diabetes, obesity, and hypertension, collect CDC social vulnerability index (SVI) as state-level public health vulnerability status, and use COVID-19 to test the actual effect of health vulnerability. The preliminary results show that higher regional economic growth is related to lower EVI and SVI, while urbanization is positively associated with regional health vulnerability and the severity of COVID-19 from case rate and death rate. Robustness check with unemployment shows the same result. We conclude that economic growth is related to lower public health vulnerability, and urbanization has negative public health benefits. Our finding indicates an urgent need to balance the externalities generated by economic development and urbanization trends on public health vulnerability by promoting reasonable medical resource distribution, health practices and safety, improving social and environmental justice, and other health management measures. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s00168-021-01103-9.
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Affiliation(s)
- Ye Fan
- School of Public Policy and Management, Tsinghua University, Beijing, China
| | - Ming Fang
- School of Economics and Management, China University of Petroleum (Beijing), Beijing, China
| | - Xin Zhang
- School of Public Health, University of Michigan, Ann Arbor, United States
| | - Yongda Yu
- School of Public Policy and Management, Tsinghua University, Beijing, China
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10
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Zhang X, Xu Y. Business Cycle and Public Health: The Moderating Role of Health Education and Digital Economy. Front Public Health 2022; 9:793404. [PMID: 35087786 PMCID: PMC8787688 DOI: 10.3389/fpubh.2021.793404] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 10/25/2021] [Indexed: 01/22/2023] Open
Abstract
The cyclicality of public health in the emerging market is underexplored in existing literature. In this study, we used a fixed effect model and provincial data to document how public health varies with the business cycle in China over the period of 2010-2019. The estimated results showed that the business cycle is negatively correlated with the mortality of infectious disease, a proxy variable of public health, thus indicating that public health exhibits a countercyclical pattern in China. Furthermore, we investigated the potential moderating role of public health education and digital economy development in the relationship between business cycle and public health. Our findings suggested that public health education and digital economy development can mitigate the damage of economic conditions on public health in China. Health education helps the public obtain more professional knowledge about diseases and then induces effective preventions. Compared with traditional economic growth, digital economy development can avoid environmental pollution which affects public health. Also, it ensures that state-of-the-art medical services are available for the public through e-health. In addition, digitalization assures that remote working is practicable and reduces close contact during epidemics such as COVID-19. The conclusions stand when subjected to several endogeneity and robustness checks. Therefore, the paper implies that these improvements in public health education and digitalization can help the government in promoting public health.
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Affiliation(s)
- Xing Zhang
- School of Finance, Renmin University of China, Beijing, China
| | - Yingying Xu
- School of Economics and Management, University of Science and Technology Beijing, Beijing, China
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11
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van Raalte AA. What have we learned about mortality patterns over the past 25 years? Population Studies 2021; 75:105-132. [PMID: 34902283 DOI: 10.1080/00324728.2021.1967430] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
In this paper, I examine progress in the field of mortality over the past 25 years. I argue that we have been most successful in taking advantage of an increasingly data-rich environment to improve aggregate mortality models and test pre-existing theories. Less progress has been made in relating our estimates of mortality risk at the individual level to broader mortality patterns at the population level while appropriately accounting for contextual differences and compositional change. Overall, I find that the field of mortality continues to be highly visible in demographic journals, including Population Studies. However much of what is published today in field journals could just as easily appear in neighbouring disciplinary journals, as disciplinary boundaries are shrinking.
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12
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Leveau CM, Tapia Granados JA, Dos Santos MI, Castillo-Riquelme M, Alazraqui M. Are Wealthier Times Healthier in Cities? Economic Fluctuations and Mortality in Urban Areas of Latin America. Int J Public Health 2021; 66:1604318. [PMID: 34955702 PMCID: PMC8696345 DOI: 10.3389/ijph.2021.1604318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 11/17/2021] [Indexed: 11/26/2022] Open
Abstract
Objective: To analyze the relationship between economic conditions and mortality in cities of Latin America. Methods: We analyzed data from 340 urban areas in ten countries: Argentina, Brazil, Chile, Colombia, Costa Rica, Guatemala, Mexico, Panama, Peru, and El Salvador. We used panel models adjusted for space-invariant and time-invariant factors to examine whether changes in area gross domestic product (GDP) per capita were associated with changes in mortality. Results: We find procyclical oscillations in mortality (i.e., higher mortality with higher GDP per capita) for total mortality, female population, populations of 0-9 and 45+ years, mortality due to cardiovascular diseases, malignant neoplasms, diabetes mellitus, respiratory infections and road traffic injuries. Homicides appear countercyclical, with higher levels at lower GDP per capita. Conclusions: Our results reveal large heterogeneity, but in our sample of cities, for specific population groups and causes of death, mortality oscillates procyclically, increasing when GDP per capita increases. In contrast we find few instances of countercyclical mortality.
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Affiliation(s)
- Carlos Marcelo Leveau
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
- Instituto de Producción, Economía y Trabajo (IPET), Universidad Nacional de Lanús, Remedios de Escalada, Argentina
| | | | - Maria Izabel Dos Santos
- Centro de Integração de Dados e Conhecimentos para a Saúde (CIDACS), Fundação Oswaldo Cruz, Salvador de Bahía, Brazil
| | | | - Marcio Alazraqui
- Instituto de Salud Colectiva, Universidad Nacional de Lanús, Remedios de Escalada, Argentina
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13
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Giri JK, Kumaresan T. The business cycle, health behavior, and chronic disease: A study over Three decades. ECONOMICS AND HUMAN BIOLOGY 2021; 43:101029. [PMID: 34174514 DOI: 10.1016/j.ehb.2021.101029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 05/19/2021] [Accepted: 06/14/2021] [Indexed: 06/13/2023]
Abstract
The effect of macroeconomic fluctuations on individual health remains highly debated. We estimate the effect of the business cycle on health and health behavior in the U.S. using the NLSY79 panel data for 11,406 respondents between 1979 and 2014. Most of our survey respondents have no chronic illness in 1979, and develop these conditions during the sample period. This allows us to estimate the true effect of economic fluctuation on the likelihood of developing chronic conditions. The results indicate a considerable difference in the cyclic variation of chronic diseases. After controlling for innate individual characteristics such as family health history, and unobserved regional characteristics, we find that obesity decreases during economic downturns, while diabetes, hypertension, and congestive heart failure increase. Sub-sample analyses show that Blacks are more likely to develop diabetes and hypertension and are less likely to develop obesity during economic downturns than other racial groups. The incidence of obesity declines during recessions for women, while males are more likely to develop diabetes. Income loss, particularly among Blacks, and lack of change in physical activity mediate these differential effects.
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Affiliation(s)
- Jeeten Krishna Giri
- Department of Economics, Union College, Lippman Hall 103, 807 Union St, Schenectady, NY, 12308, USA.
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14
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Nizalova O, Norton EC. Long-term effects of job loss on male health: BMI and health behaviors. ECONOMICS AND HUMAN BIOLOGY 2021; 43:101038. [PMID: 34304076 DOI: 10.1016/j.ehb.2021.101038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 06/20/2021] [Accepted: 06/26/2021] [Indexed: 06/13/2023]
Abstract
Employment is one of the most critical determinants of health and health behaviors for adults. This study focuses on Ukraine and measures how an involuntary job loss - defined as job loss due to business closures, reorganizations, bankruptcies, or privatization - affects BMI, being overweight or obese, smoking, alcohol consumption, and physical activity. There are three reasons to study Ukraine in the aftermath of an enormous economic transition that resulted in employment contraction as high as 40 % compared to 1990. First, nearly all published studies on the relationship between job loss and health and health behaviors have been on developed countries, meaning that our study fills the gap in the literature on transition economies. Second, the job losses that we study are plausibly exogenous and affected a significant share of the population. Third, the longitudinal survey follows individuals for up to 10 years starting from 2003, allowing us to capture the long-term effects of past job loss on outcomes at a specific point in time and their trajectories across the life cycle. Applying growth-curve models, we show that past involuntary job loss significantly alters the age trajectories of all considered outcomes at both extensive and intensive margins.
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Affiliation(s)
- Olena Nizalova
- University of Kent and GLO, CC.216 Cornwallis, Canterbury, Kent, CT2 7NF, UK.
| | - Edward C Norton
- University of Michigan and NBER, 1415 Washington Heights, Ann Arbor, MI, 48109, USA.
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15
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Stickley A, Baburin A, Jasilionis D, Krumins J, Martikainen P, Kondo N, Leinsalu M. Economic cycles and inequalities in alcohol-related mortality in the Baltic countries and Finland in 2000-2015: a register-based study. Addiction 2021; 116:3357-3368. [PMID: 33908662 DOI: 10.1111/add.15526] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 05/18/2020] [Accepted: 04/14/2021] [Indexed: 11/28/2022]
Abstract
AIM To estimate whether large macroeconomic fluctuations in the 2000s affected inequalities in alcohol-related mortality in the Baltic countries and Finland. DESIGN Longitudinal register-based follow-up study. SETTING Estonia, Latvia, Lithuania and Finland. PARTICIPANTS General population in the 35-74 age group. MEASUREMENTS Socioeconomic status was measured by the highest achieved educational level and was categorised using the International Standard Classification of Education 2011 as low (included categories 0-2), middle (3-4), and high (5-8). Educational inequalities in alcohol-related mortality in 2000-2003, 2004-2007, 2008-2011 and 2012-2015 were examined using census-linked longitudinal mortality data. We estimated age-standardised mortality rates and the relative and slope index of inequality. FINDINGS Alcohol-related mortality increased in all countries in 2004-2007 except among Estonian women and decreased/remained the same from 2008 onward except among Latvian men. By 2012-2015 alcohol-related mortality was still higher than in 2000-2003 in Finland, Latvia and Lithuania (women only). Relative inequalities increased across the study period in all countries (significantly in Lithuania and Latvia). The 2004-2007 increase in relative inequalities was mostly driven by a larger mortality increase among the low educated, whereas in 2008-2011 and in 2012-2015 inequalities often increased because of a larger relative mortality decline among the high educated. However, these period changes in relative inequalities and between educational groups were often not statistically significant. Absolute inequalities were larger in 2012-2015 versus 2000-2003 in all countries except Estonia (decrease). CONCLUSION In the Baltic countries and Finland, alcohol-related mortality tended to increase faster among the low educated during a period of economic expansion (2004-2007) and decrease more among the high educated during a period of economic recession (2008-2011).
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Affiliation(s)
- Andrew Stickley
- Stockholm Centre for Health and Social Change (SCOHOST), Södertörn University, Huddinge, Sweden.,Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan
| | - Aleksei Baburin
- Department of Epidemiology and Biostatistics, National Institute for Health Development, Tallinn, Estonia
| | - Domantas Jasilionis
- Max Planck Institute for Demographic Research, Rostock, Germany.,Demographic Research Centre, Vytautas Magnus University, Kaunas, Lithuania
| | - Juris Krumins
- Demography unit, Faculty of Business, Management and Economics, University of Latvia, Riga, Latvia
| | - Pekka Martikainen
- Max Planck Institute for Demographic Research, Rostock, Germany.,Population Research Unit, University of Helsinki, Helsinki, Finland.,Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
| | - Naoki Kondo
- Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan
| | - Mall Leinsalu
- Stockholm Centre for Health and Social Change (SCOHOST), Södertörn University, Huddinge, Sweden.,Department of Epidemiology and Biostatistics, National Institute for Health Development, Tallinn, Estonia
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16
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Cervini-Plá M, Vall-Castelló J. Business cycle and mortality in Spain. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2021; 22:1289-1299. [PMID: 34160727 PMCID: PMC8526462 DOI: 10.1007/s10198-021-01336-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 06/08/2021] [Indexed: 05/25/2023]
Abstract
In the last couple of decades, there has been a lot of interest on the impact of macroeconomic fluctuations on health and mortality rates. Many studies, for different countries, find that mortality is procyclical. However, studies examining the effects of more recent recessions are less conclusive, finding mortality to be less procyclical, or even countercyclical. In this paper, using data of Spanish provinces from 1999 to 2016, we investigate how this relationship works in the context of a country that is subject to extreme business cycle fluctuations. Furthermore, we analyze the impact of unemployment for different mortality causes and we explore differences by sex, age group and level of education. In general terms, we find mortality to be procyclical so that when the economy is in a recession, mortality falls. When exploring mortality causes, we show that deaths from cardiovascular disease, cancer, senility, transport accidents and homicides are procyclical. By sex, we find procyclicality for both men and women. By age, mortality is procyclical for all age groups; however, the causes of death that result in this procyclical behavior are specific to each age group. By educational level, suicide appears as a countercyclical cause for individuals with intermediate levels of education.
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Affiliation(s)
- María Cervini-Plá
- Universitat Autònoma de Barcelona, Edifici B. Campus UAB, Bellaterra (Cerdanyola del Vallès), 08193, Barcelona, Spain.
- EQUALITAS, Madrid, Spain.
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17
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Chai KC, Yang Y, Cui ZX, Ou YL, Chang KC. Threshold Effect of the Government Intervention in the Relationship Between Business Cycle and Population Health: Evidence From China. Front Public Health 2021; 9:689870. [PMID: 34164375 PMCID: PMC8216553 DOI: 10.3389/fpubh.2021.689870] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 05/06/2021] [Indexed: 11/13/2022] Open
Abstract
China is an emerging country, and government intervention is always considered as an important part of the solutions when people facing challenges in China. Under the impact of the coronavirus disease 2019 (COVID-19) epidemic and the global economic downturn, the Chinese government quickly brought the epidemic under control and restored the positive economic growth through strong intervention. Based on the panel data of provincial level in China and the government intervention as the threshold variable, this paper empirically analyzed the non-linear effect of business cycle on population health by using the panel threshold regression model. The empirical results show that the impact of the business cycle on population health is significantly negative, and government intervention has a single threshold effect on the relationship between business cycle and population health. When the government intervention is below the threshold value, the business cycle has a significant negative effect on the improvement of the population health level; when the level of government intervention exceeds the threshold value, the relationship between business cycle and population health becomes significantly positive. To some extent, the conclusions of this paper can guide the formulation and revision of government health policy and help to adjust the direction and intensity of government intervention. The Chinese government and other governments of emerging countries should do more to harness the power of state intervention in their response to the business cycle.
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Affiliation(s)
- Kuang-Cheng Chai
- Business School, Guilin University of Electronic Technology, Guilin, China
| | - Yang Yang
- Business School, Guilin University of Electronic Technology, Guilin, China
| | - Zhen-Xin Cui
- Business School, Guilin University of Electronic Technology, Guilin, China
| | - Yang-Lu Ou
- Business School, Guilin University of Electronic Technology, Guilin, China
| | - Ke-Chiun Chang
- School of Economics and Management, Wuhan University, Wuhan, China
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18
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Sun TT, Tao R, Su CW, Umar M. How Do Economic Fluctuations Affect the Mortality of Infectious Diseases? Front Public Health 2021; 9:678213. [PMID: 33968891 PMCID: PMC8100195 DOI: 10.3389/fpubh.2021.678213] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 03/25/2021] [Indexed: 11/24/2022] Open
Abstract
This paper uses the mixed frequency vector autoregression model to explore the impact of economic fluctuations on infectious diseases mortality (IDM) from China perspective. We find that quarterly gross domestic product (GDP) fluctuations have a negative impact on the annual IDM, indicating that the mortality of infectious diseases varies counter-cyclically with the business cycle in China. Specifically, IDM usually increases with deterioration in economic conditions, and vice versa. The empirical results are consistent with the hypothesis I derived from the theoretical analysis, which highlights that economic fluctuations can negatively affect the mortality of infectious diseases. The findings can offer revelations for the government to consider the role of economic conditions in controlling the epidemic of infectious diseases. Policymakers should adopt appropriate and effective strategies to mitigate the potential negative effects of macroeconomic downturns on the mortality of infectious diseases. In the context of the COVID-19 pandemic, these analyses further emphasize the importance of promoting economic growth, increasing public health expenditure, and preventing and controlling foreign infectious diseases.
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Affiliation(s)
- Ting-Ting Sun
- School of Economics, Qingdao University, Qingdao, China
| | - Ran Tao
- Qingdao Municipal Center for Disease Control and Preventation, Qingdao, China
| | - Chi-Wei Su
- School of Economics, Qingdao University, Qingdao, China
| | - Muhammad Umar
- School of Economics, Qingdao University, Qingdao, China
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19
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Lin FL, Wang MC. Longevity and Economic Growth in China and India Using a Newly Developed Bootstrap ARDL Model. Front Public Health 2020; 8:291. [PMID: 32850569 PMCID: PMC7427201 DOI: 10.3389/fpubh.2020.00291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 06/02/2020] [Indexed: 11/13/2022] Open
Abstract
In this study, we use a recently developed Bootstrap ARDL model to examine the influence of longevity (life expectancy after giving birth) and alcohol consumption on economic progression (GDP) in both China and India during the years between 1992 and 2015. Empirical results have shown an extended link across economic development, longevity, and alcohol use in both China and India. The Granger causality test, derived from the Bootstrap ARDL model, demonstrates a unidirectional relationship between economic growth and longevity in China. However, a bidirectional causality exists between longevity and alcohol use in India. Results have important implications for Indian and Chinese governments' public health policies, focused on alcohol consumption reduction specifically, and population health generally.
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Affiliation(s)
- Feng Li Lin
- Department of Accounting, Chaoyang University of Technology, Taichung, Taiwan
| | - Mei-Chih Wang
- Department of Finance, College of Management, Providence University, Taichung, Taiwan
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20
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Pinheiro PC, Queiroz BL, Teixeira RA, Ribeiro ALP, Malta DC. Female motorcycle mortality in Brazilian municipalities, 2005, 2010 and 2015. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2020; 23 Suppl 1:e200010.SUPL.1. [PMID: 32638989 DOI: 10.1590/1980-549720200010.supl.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 01/16/2020] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVE To analyze the spatial distribution of female mortality due to motorcycle accidents in Brazilian municipalities between 2005 and 2015, as well as the variation in rates in the same period. METHODS Female mortality rates for the years 2005, 2010 and 2015 were estimated considering a three-year moving average around the base year, standardized by the direct method. Rates were standardized using the same pattern (Brazilian females in 2010) for each year. Then, the empirical Bayes estimator was used to reduce the effect of the random fluctuation. The percentage variation of the standardized rates was also analyzed for different population sizes (less than ten thousand, less than 50 thousand, more than 100 thousand and more than one million inhabitants). RESULTS Bayesian rates showed a clear increase in female mortality due to motorcycle accidents, especially in the North, Northeast and Midwest regions. In the municipalities of the South and Southeast regions, mainly in the period between 2010 and 2015, there was an apparent decrease in mortality. The percentage variation showed a reduction in the indicator analyzed in the period between 2010 and 2015 for the largest municipalities in the South and Southeast regions. For almost all regions and population sizes, the period between 2010 and 2015 showed a deceleration in the growth of rates. CONCLUSION The analysis clearly shows concentrations of municipalities with higher mortality, while also showing that the phenomenon has spread to a greater number of municipalities. The studied period allows the identification of different dynamics in female mortality, in a period of significant variation in mortality due to motorcycle accidents.
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Affiliation(s)
| | - Bernardo Lanza Queiroz
- Departamento de Demografia e Centro de Desenvolvimento e Planejamento Regional, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
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21
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Thompson K, Wagemakers A, van Ophem J. Assessing health outcomes in the aftermath of the great recession: a comparison of Spain and the Netherlands. Int J Equity Health 2020; 19:84. [PMID: 32503561 PMCID: PMC7275523 DOI: 10.1186/s12939-020-01203-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 05/26/2020] [Indexed: 11/26/2022] Open
Abstract
Background Across time and space, financial security has been shown to impact health outcomes, with the acute loss of financial security being particularly detrimental. We compare financial security’s association with health in Spain and the Netherlands. These countries respectively exemplify low and high levels of financial security, general trends that have been exacerbated by the Great Recession of the 2010s. Methods We exploit the Spanish (n = 1001) and Dutch (n = 1010) editions of the European Social Survey 7, conducted in 2014, and condense relevant financial security- and health-related survey questions into latent variables using factor analyses. Using the component loadings as quasi-weightings, we generate one financial security variable and three health variables (mental, physical and social). Then, we run ordinary least squares regressions interacting financial security and nationality, for each of the three health outcomes. Results In unadjusted models, we find that financial security (p < 0.01) is positively associated with the three health outcomes, while being Spanish relative to being Dutch (p < 0.01) is associated with worse health outcomes. However, the results of the interaction term show that being Spanish relative to being Dutch weakens the relationship between physical health and social health, although not mental health. Conclusions We find evidence that financial security’s influence on health outcomes may vary in different contexts. This may be an important aspect of determining the Great Recession’s influence on health outcomes. Our study is a first step in understanding how the relationships between financial security and health may differ in countries with different experiences of the Great Recession.
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Affiliation(s)
- Kristina Thompson
- Department of Health Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Annemarie Wagemakers
- Health and Society Group, Wageningen University & Research, Wageningen, the Netherlands.
| | - Johan van Ophem
- Urban Economics Group, Wageningen University & Research, Wageningen, the Netherlands
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22
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Balbo N, Carapella P, Toffolutti V. Trends in the use of mind-altering drugs among European adolescents during the Great Recession. Health Policy 2020; 124:568-574. [PMID: 32223916 DOI: 10.1016/j.healthpol.2020.03.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 03/06/2020] [Accepted: 03/10/2020] [Indexed: 11/16/2022]
Abstract
Despite the growing evidence of health-responses to macroeconomic fluctuations, little research has been carried out on the economic reflexes of licit and illicit drug-consumption, especially among teenagers. This paper uses data on adolescents between 15 and 17 years old from 25 European countries to test, if and how, the substance-use pattern has changed during the Great Recession. The data come from two cross-sectional waves (2007 and 2011) of the European School Survey Project on Alcohol and Other Drugs (ESPAD) (n = 137,989 individuals). One percentage point increase in the unemployment rate is associated with an increase [decrease] in the probability of having tried inhalants and cocaine [ecstasy] at least once, by about 0.005 (95 % CI: 0.004, 0.006) and 0.001 (95 % CI: 0.0001, 0.001) [-0.001 (95 % CI: -0.001, -0.001)] respectively. Social protection expenditure reduces the use of inhalants, whereas ecstasy consumption rises. The pattern for cocaine is unclear.
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Affiliation(s)
- Nicoletta Balbo
- "Carlo F. Dondena" Centre for Research on Social Dynamics and Public Policies, Bocconi University, Via Roentgen, 1, 20136, Milan, Italy; Department of Social and Political Sciences, Bocconi University, Via Roentgen, 1, 20136, Milan, Italy
| | - Piergiorgio Carapella
- "Carlo F. Dondena" Centre for Research on Social Dynamics and Public Policies, Bocconi University, Via Roentgen, 1, 20136, Milan, Italy; Confindustria Economic Research Department, Viale dell'Astronomia, 30, 00144, Rome, Italy
| | - Veronica Toffolutti
- "Carlo F. Dondena" Centre for Research on Social Dynamics and Public Policies, Bocconi University, Via Roentgen, 1, 20136, Milan, Italy; Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, United Kingdom.
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23
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Cavicchioli M, Pistoresi B. Unfolding the relationship between mortality, economic fluctuations, and health in Italy. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2020; 21:351-362. [PMID: 31749025 DOI: 10.1007/s10198-019-01135-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 11/08/2019] [Indexed: 06/10/2023]
Abstract
Despite the long-run strong negative association between economic development and mortality, their short-run relationship remains controversial. In the present work, we study co-movement between mortality growth (overall, gender- and cause-specific) and economic fluctuations in Italy over the period 1862-2013. To this aim, we use Johansen (Econometrica 59:1551-1580, 1991) procedure to jointly estimate the short- and long-run dynamics of the two variables, avoiding omitted variable bias in the cyclical co-movement extraction or spurious association attributable to trends. We also take into account possible asymmetric responses of mortality growth to shocks in GDP. We find that an increase of 1% in real GDP per capita induces a reduction in mortality rate of 0.27% for total population. Moreover, we observe that business cycle fluctuations do not affect mortality in the pre-wars era, where only the long run decreases matters driven by reduction in infections and accidents mortality. On the contrary, in the post-wars period, expansive phases of business cycle are associated with reduction in mortality growth and periods of recession generate an ever-deeper decrease. However, in this period, mortality for cancer is procyclical and significantly increasing in expansion: this reinforces the debate for controlling environmental factors.
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Affiliation(s)
- Maddalena Cavicchioli
- Department of Economics "Marco Biagi", University of Modena and Reggio Emilia, Viale Berengario 51, 41121, Modena, Italy.
- RECent, Center for Economic Research, University of Modena and Reggio, Emilia, Modena, Italy.
| | - Barbara Pistoresi
- Department of Economics "Marco Biagi", University of Modena and Reggio Emilia, Viale Berengario 51, 41121, Modena, Italy
- RECent, Center for Economic Research, University of Modena and Reggio, Emilia, Modena, Italy
- Marco Biagi Foundation, University of Modena and Reggio Emilia, Modena, Italy
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Thompson K, Ophem JV, Wagemakers A. Studying the impact of the Eurozone's Great Recession on health: Methodological choices and challenges. ECONOMICS AND HUMAN BIOLOGY 2019; 35:162-184. [PMID: 31376735 DOI: 10.1016/j.ehb.2019.06.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 06/13/2019] [Accepted: 06/17/2019] [Indexed: 06/10/2023]
Abstract
Europe's Great Recession provides an opportunity to study the impact of increased financial insecurity on health. A number of studies explored the impact of the Recession on health, but they often reached different conclusions. To understand the root of this debate, we undertook a systematic literature review. Articles were analysed thematically based on: geography, data type, operationalisations of wealth and health, and study design. A critical appraisal was also undertaken. Forty-two studies, published from January 2010 to October 2018, were included in our review. Twenty-six of the forty-two studies found that the Great Recession worsened physical health indicators in the Eurozone. In terms of geography, a large concentration of studies focussed on Spain and Greece, indicating that there may be a gap in understanding the health consequences for EU countries with less severe experiences of the Recession. Regarding data type, nearly all studies used secondary datasets, possibly meaning that studies were constrained by the data available. In terms of operationalisations of wealth and health, a majority of studies used single/simple measures of both, so that these multi-faceted concepts were not fully reflected. Further, fewer than half included studies used panel data, with the remaining studies unable to undertake more causal analyses. The results of the critical appraisal showed that lower-quality studies tended to not find a negative impact of the Recession on health, whereas higher quality studies generally did. In future, we recommend conducting cross-country comparisons, using (inter)nationally-representative panel data conducted over a minimum of a ten-year time horizon, and employing multi-faceted operationalisations of wealth and health. This could provide more common ground across studies, and a clearer indication of whether the Recession impacted health.
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Affiliation(s)
- Kristina Thompson
- Department of Health Sciences, Vrije Universiteit Amsterdam, De Boelelaan 1085, 1081 HV Amsterdam, the Netherlands.
| | - Johan van Ophem
- Chair Group Urban Economics, Department of Social Sciences, Wageningen University and Research, Hollandseweg 1, 6706KN Wageningen, the Netherlands
| | - Annemarie Wagemakers
- Chair Group Health and Society, Department of Social Sciences, Wageningen University and Research, Hollandseweg 1, 6706KN Wageningen, the Netherlands
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Liang K, Fung IWH. The impact of macroeconomic and industrial fluctuation on fatalities of construction workers in China. JOURNAL OF SAFETY RESEARCH 2019; 70:149-158. [PMID: 31847990 DOI: 10.1016/j.jsr.2019.06.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 04/25/2019] [Accepted: 06/13/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE This study explores the relationship between fluctuation in economic and industrial development and work-related fatalities of Chinese construction workers. METHODS The data for work-related fatalities in housing and civil engineering in China from 1996 to 2016 were tested for fluctuation and trends of both general economic and industry-specific indicators using the Engle-Granger cointegration analysis and the augmented Granger Causality test the with modified Wald method. RESULTS Both the long-run equilibrium associations and short-run dynamic interactions between construction safety and macroeconomic development in China were determined. According to the estimates, fatalities in the construction industry appeared to be more significantly associated with changes in the gross output value of the industry, and the improvement in the workers' efficiency also contributed to the decline of fatalities. It initially revealed that the changes in growth rate, instead of growth itself, had a more significant influence on construction safety in China, while a marginal decreasing trend of positive effects exerted by the growth can be expected with the gradual maturity of the industry. SIGNIFICANCE The application of econometrical methods explored an untapped data source for gaining an insight into the underlying rules of occurrence of construction fatalities, thus strengthening the body of knowledge of construction safety by providing a new research perspective that some safety indicators can be treated as the macro-level socioeconomic index. Practical applications: The findings reminded policymakers and practitioners to be aware of potential challenges from the slowing or even declining trend facing the industry in the near future, and offered a reference to relevant authorities for establishing a more targeted and effective governance strategy.
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Affiliation(s)
- Kongzheng Liang
- Department of Civil & Architectural Engineering, City University of Hong Kong, Hong Kong, China.
| | - Ivan W H Fung
- Department of Civil & Architectural Engineering, City University of Hong Kong, Hong Kong, China
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26
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Brüning M, Thuilliez J. Mortality and Macroeconomic Conditions: What Can We Learn From France? Demography 2019; 56:1747-1764. [DOI: 10.1007/s13524-019-00811-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Abstract
This study uses aggregate panel data on French départements to investigate the relationship between macroeconomic conditions and mortality from 1982 to 2014. We find no consistent relationship between macroeconomic conditions and all-cause mortality in France. The results are robust across different specifications, over time, and across different geographic levels. However, we find that heterogeneity across age groups and mortality causes matters. Furthermore, in areas with a low average educational level, a large population, and a high share of migrants, mortality is significantly countercyclical. Similar to the case in the United States, the relationship between the unemployment rate and mortality seems to have moved from slightly procyclical to slightly countercyclical over the period of analysis.
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Affiliation(s)
- Max Brüning
- Department of Economics, School of Business and Economics, Maastricht University, 6200 MD Maastricht, The Netherlands
| | - Josselin Thuilliez
- CNRS – Centre d’économie de la Sorbonne, 106-112, Boulevard de l’Hôpital, 75013 Paris, France
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The medical assistance system and inpatient health care provision: Empirical evidence from short-term hospitalizations in Japan. PLoS One 2018; 13:e0204798. [PMID: 30286118 PMCID: PMC6171890 DOI: 10.1371/journal.pone.0204798] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 08/20/2018] [Indexed: 11/29/2022] Open
Abstract
This paper uses two nationally representative sets of medical claims data from medical assistance and universal public health insurance systems to examine how medical assistance system assignment affects short-term inpatient health care provision. In Japan, the medical assistance system, which is part of a public assistance system, provides medical care services for its beneficiaries without imposing any financial burdens, such as copayments or advance premium payments. These circumstances can lead to inpatient costs, as physicians may provide more treatments because there is a financial incentive. Because the assignment of public assistance in Japan is not random but is subject to means testing by the local government, I employ the instrumental variable model to control the potential correlation. I find that medical expenditure is significantly higher for medical assistance patients than for universal public health insurance patients, with an arc elasticity of approximately 0.20. This elasticity is slightly greater than that found for inpatient care in the randomized RAND Health Insurance Experiment and recent empirical studies on low-income populations. In addition, the elasticities for patients who receive medication, treatment and surgery are greater.
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28
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Habibov N, Auchynnikava A, Luo R, Fan L. Effects of the 2008 global financial crisis on population health. Int J Health Plann Manage 2018; 34:e327-e353. [PMID: 30265409 DOI: 10.1002/hpm.2652] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 08/13/2018] [Indexed: 12/26/2022] Open
Abstract
We compare the transmission channels through which the 2008 global financial crisis affected health. We find that postponing or skipping visits to the doctor after falling ill and stopping buying regular medication had the strongest negative effects on health, followed by a reduced consumption of staple foods, utilities being cut, being forced to move, and having to sell assets. In comparison, experiencing cuts in TV, phone, and internet services, as well as delaying payments for utilities had relatively weaker negative impacts. In contrast, having a household head or household member lose a job also had negative effects on health status, although this effect was relatively lower. Finally, a reduced flow of remittances had the weakest negative effect.
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Affiliation(s)
| | | | - Rong Luo
- University of Windsor, Ontario, Canada
| | - Lida Fan
- Lakehead University, Thunderbay, Ontario, Canada
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29
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Minagawa YS. Changing Life Expectancy and Health Expectancy Among Russian Adults: Results from the Past 20 Years. POPULATION RESEARCH AND POLICY REVIEW 2018. [DOI: 10.1007/s11113-018-9478-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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30
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Bilal U, Cooper R, Abreu F, Nau C, Franco M, Glass TA. Economic growth and mortality: do social protection policies matter? Int J Epidemiol 2018; 46:1147-1156. [PMID: 28338775 DOI: 10.1093/ije/dyx016] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/17/2017] [Indexed: 12/31/2022] Open
Abstract
Background In the 20th century, periods of macroeconomic growth have been associated with increases in population mortality. Factors that cause or mitigate this association are not well understood. Evidence suggests that social policy may buffer the deleterious impact of economic growth. We sought to explore associations between changing unemployment (as a proxy for economic change) and trends in mortality over 30 years in the context of varying social protection expenditures. Methods We model change in all-cause mortality in 21 OECD (Organization for Economic Cooperation and Development) countries from 1980 to 2010. Data from the Comparative Welfare States Data Set and the WHO Mortality Database were used. A decrease in the unemployment rate was used as a proxy for economic growth and age-adjusted mortality rates as the outcome. Social protection expenditure was measured as percentage of gross domestic product expended. Results A 1% decrease in unemployment (i.e. the proxy for economic growth) was associated with a 0.24% increase in the overall mortality rate (95% confidence interval: 0.07;0.42) in countries with no changes in social protection. Reductions in social protection expenditure strengthened this association between unemployment and mortality. The magnitude of the association was diminished over time. Conclusions Our results are consistent with the hypothesis that social protection policies that accompany economic growth can mitigate its potential deleterious effects on health. Further research should identify specific policies that are most effective.
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Affiliation(s)
- Usama Bilal
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Social and Cardiovascular Epidemiology Research Group, Universidad de Alcala, Madrid, Spain
| | - Richard Cooper
- Department of Public Health Sciences, Loyola University Stritch School of Medicine, Chicago, IL, USA
| | | | - Claudia Nau
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Manuel Franco
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Social and Cardiovascular Epidemiology Research Group, Universidad de Alcala, Madrid, Spain
| | - Thomas A Glass
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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31
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Colombo E, Rotondi V, Stanca L. Macroeconomic conditions and health: Inspecting the transmission mechanism. ECONOMICS AND HUMAN BIOLOGY 2018; 28:29-37. [PMID: 29197240 DOI: 10.1016/j.ehb.2017.11.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Revised: 10/12/2017] [Accepted: 11/17/2017] [Indexed: 06/07/2023]
Abstract
We study the relationship between macroeconomic conditions and self-reported health in a large sample of Italian individuals, focusing on the mediating role played by health behaviors (smoking, alcohol consumption, physical activity, eating habits) and economic stress. Our findings indicate that, overall, higher local unemployment is negatively related to individuals' health conditions. A one percentage point increase in the province-level unemployment rate is associated with a significant increase in the probability of experiencing diabetes (0.03 percentage points), infarction (0.01), ulcer (0.06), cirrhosis (0.01) and nervous disorders (0.07), with a time lag that differs across individual health conditions. Employment status and educational level play a significant role as moderators of these relationships. Eating habits, in addition to economic stress, play a key role as mediators, by enhancing the negative relationship between macroeconomic conditions and health outcomes, while physical exercise is found to play a dampening role.
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Affiliation(s)
- Emilio Colombo
- Università Cattolica del Sacro Cuore, DISEIS, Largo Gemelli 1, 20123 Milano, Italy.
| | - Valentina Rotondi
- Bocconi University, Dondena Centre for Research on Social Dynamics and Public Policy, Italy.
| | - Luca Stanca
- University of Milan Bicocca, Department of Economics Management and Statistics and Neuro-MI, Piazza dell'Ateneo Nuovo 1, 20126 Milan, Italy.
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van den Berg GJ, Gerdtham UG, von Hinke S, Lindeboom M, Lissdaniels J, Sundquist J, Sundquist K. Mortality and the business cycle: Evidence from individual and aggregated data. JOURNAL OF HEALTH ECONOMICS 2017; 56:61-70. [PMID: 28968530 PMCID: PMC6690392 DOI: 10.1016/j.jhealeco.2017.09.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Revised: 07/17/2017] [Accepted: 09/10/2017] [Indexed: 05/12/2023]
Abstract
There has been much interest recently in the relationship between economic conditions and mortality, with some studies showing that mortality is pro-cyclical, while others find the opposite. Some suggest that the aggregation level of analysis (e.g. individual vs. regional) matters. We use both individual and aggregated data on a sample of 20-64 year-old Swedish men from 1993 to 2007. Our results show that the association between the business cycle and mortality does not depend on the level of analysis: the sign and magnitude of the parameter estimates are similar at the individual level and the aggregate (county) level; both showing pro-cyclical mortality.
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Affiliation(s)
- Gerard J van den Berg
- School of Economics, Finance and Management, University of Bristol, Bristol, United Kingdom; The Institute for Evaluation of Labour Market and Education Policy (IFAU), Uppsala, Sweden
| | - Ulf-G Gerdtham
- Health Economics Unit, Department of Clinical Sciences, Malmö, Lund University, Sweden; Department of Economics, Lund University, Lund, Sweden; Centre for Economic Demography, Lund University, Lund, Sweden
| | - Stephanie von Hinke
- School of Economics, Finance and Management, University of Bristol, Bristol, United Kingdom
| | - Maarten Lindeboom
- School of Business and Economics, Vrije University Amsterdam, Amsterdam, Netherlands
| | - Johannes Lissdaniels
- Health Economics Unit, Department of Clinical Sciences, Malmö, Lund University, Sweden; The Swedish Agency for Health and Care Services Analysis, Stockholm, Sweden.
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Ásgeirsdóttir TL, Jóhannsdóttir HM. Income-related inequalities in diseases and health conditions over the business cycle. HEALTH ECONOMICS REVIEW 2017; 7:12. [PMID: 28275988 PMCID: PMC5342994 DOI: 10.1186/s13561-017-0150-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Accepted: 02/27/2017] [Indexed: 05/19/2023]
Abstract
How business cycles affect income-related distribution of diseases and health disorders is largely unknown. We examine how the prevalence of thirty diseases and health conditions is distributed across the income spectrum using survey data collected in Iceland in 2007, 2009 and 2012. Thus, we are able to take advantage of the unusually sharp changes in economic conditions in Iceland during the Great Recession initiated in 2008 and the partial recovery that had already taken place by 2012 to analyze how income-related health inequality changed across time periods that can be described as a boom, crisis and recovery. The concentration curve and the concentration index are calculated for each disease, both overall and by gender. In all cases, we find a considerable income-related health inequality favoring higher income individuals, with a slight increase over the study period. Between 2007 and 2009, our results indicate increased inequality for women but decreased inequality for men. Between 2009 and 2012 on the contrary, men's inequality increases but women's decreases. The overarching result is thus that the economic hardship of the crisis temporarily increased female income-related health inequality, but decreased that of men.
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Tapia Granados JA, Ionides EL. Population health and the economy: Mortality and the Great Recession in Europe. HEALTH ECONOMICS 2017; 26:e219-e235. [PMID: 28345272 DOI: 10.1002/hec.3495] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Revised: 12/22/2016] [Accepted: 01/19/2017] [Indexed: 06/06/2023]
Abstract
We analyze the evolution of mortality-based health indicators in 27 European countries before and after the start of the Great Recession. We find that in the countries where the crisis has been particularly severe, mortality reductions in 2007-2010 were considerably bigger than in 2004-2007. Panel models adjusted for space-invariant and time-invariant factors show that an increase of 1 percentage point in the national unemployment rate is associated with a reduction of 0.5% (p < .001) in the rate of age-adjusted mortality. The pattern of mortality oscillating procyclically is found for total and sex-specific mortality, cause-specific mortality due to major causes of death, and mortality for ages 30-44 and 75 and over, but not for ages 0-14. Suicides appear increasing when the economy decelerates-countercyclically-but the evidence is weak. Results are robust to using different weights in the regression, applying nonlinear methods for detrending, expanding the sample, and using as business cycle indicator gross domestic product per capita or employment-to-population ratios rather than the unemployment rate. We conclude that in the European experience of the past 20 years, recessions, on average, have beneficial short-term effects on mortality of the adult population.
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Lin CL, Liu TC, Chen CS. The association between attempted suicide and stock price movements: Evidence from Taiwan. Psychiatry Res 2017; 254:323-331. [PMID: 28505601 DOI: 10.1016/j.psychres.2017.05.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 04/29/2017] [Accepted: 05/04/2017] [Indexed: 12/18/2022]
Abstract
This study is the first comprehensive analysis to investigate the potential association between stock market fluctuations and attempted suicide events as measured by self-inflicted injuries treated in hospitalization. Using nationwide, 15-year population-based data from 1998 through 2012, we observe that the occurrences for the hospitalizations of attempted suicides are apparently predicted by stock price movements. A low stock price index, a daily fall in the stock index, and consecutive daily falls in the stock index have been shown to be associated with increased risk of hospitalization in patients with attempted suicide. More specifically, stock price index is found to be significant impact on attempted suicide in the 45-54 age groups of both genders, whilst daily change is significant for both genders in the 25-34 and 55-64 age groups and accumulated change is only significant in female aged 25-44 and above 65. On the basis of the results, relevant organizations should consider the suicidal factors that relate prime-working-age and near-retirement-age people to better carry out specific suicide prevention measures, and, meanwhile, encourage those people to pay less attention towards daily stock price movements.
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Affiliation(s)
- Chung-Liang Lin
- Department of Economics, National Dong Hwa University, 1, Section 2, Da-Hsueh Rd., Shou-Feng, Hualien 97401, Taiwan.
| | - Tsai-Ching Liu
- Department of Public Finance, Public Finance and Finance Research Center, National Taipei University, 151, University Rd., San Shia, New Taipei City 23741, Taiwan.
| | - Chin-Shyan Chen
- Department of Economics, Public Finance and Finance Research Center, National Taipei University, 151, University Rd., San Shia, New Taipei City 23741, Taiwan.
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Regidor E, Vallejo F, Granados JAT, Viciana-Fernández FJ, de la Fuente L, Barrio G. Mortality decrease according to socioeconomic groups during the economic crisis in Spain: a cohort study of 36 million people. Lancet 2016; 388:2642-2652. [PMID: 27745879 DOI: 10.1016/s0140-6736(16)30446-9] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Studies of the effect of macroeconomic fluctuations on mortality in different socioeconomic groups are scarce and have yielded mixed findings. We analyse mortality trends in Spain before and during the Great Recession in different socioeconomic groups, quantifying the change within each group. METHODS We did a nationwide prospective study, in which we took data from the 2001 Census. All people living in Spain on Nov 1, 2001, were followed up until Dec 31, 2011. We included 35 951 354 people alive in 2001 who were aged between 10 and 74 years in each one of the four calendar years before the economic crisis (from 2004 to 2007) and in each one of the first four calendar years of the crisis (from 2008 to 2011), and analysed all-cause and cause-specific mortality in those people. We classified individuals by socioeconomic status (low, medium, or high) using two indicators of household wealth: household floor space (<72 m2, 72-104 m2, and >104 m2) and number of cars owned by the residents of the household (none, one, and two or more). We used Poisson regression to calculate the annual percentage reduction (APR) in mortality rates during 2004-07 (pre-crisis) and 2008-11 (crisis) in each socioeconomic group, as well as the effect size, measured by the APR difference between the pre-crisis and crisis period. FINDINGS The annual decline in all-cause mortality in the three socioeconomic groups was 1·7% (95% CI 1·2 to 2·1) for the low group, 1·7% (1·3 to 2·1) for the medium group, and 2·0% (1·4 to 2·5) for the high group in 2004-07, and 3·0% (2·5 to 3·5) for the low group, 2·8% (2·5 to 3·2) for the medium group, and 2·1% (1·6 to 2·7) for the high group in 2008-11 when individuals were classified by household floor space. The annual decline in all-cause mortality when people were classified by number of cars owned by the household was 0·3% (-0·1 to 0·8) for the low group, 1·6% (1·2 to 2·0) for the medium group, and 2·2% (1·6 to 2·8) for the high group in 2004-07, and 2·3% (1·8 to 2·8) for the low group, 2·4% (2·0 to 2·7) for the medium group and 2·5% (1·9 to 3·0) for the high group in 2008-11. The low socioeconomic group showed the largest effect size for both wealth indicators. INTERPRETATION In Spain, probably due to the decrease in exposure to risk factors, all-cause mortality decreased more during the economic crisis than before the economic crisis, especially in low socioeconomic groups. FUNDING None.
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Affiliation(s)
- Enrique Regidor
- Department of Preventive Medicine and Public Health, Universidad Complutense de Madrid, Madrid, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain.
| | - Fernando Vallejo
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; National Epidemiology Centre, Instituto de Salud Carlos III, Madrid, Spain
| | | | | | - Luis de la Fuente
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; National Epidemiology Centre, Instituto de Salud Carlos III, Madrid, Spain
| | - Gregorio Barrio
- National School of Public Health, Instituto de Salud Carlos III, Madrid, Spain
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Angrisani M, Lee J. Health Effects of Short-Term Fluctuations in Macroeconomic Conditions: The Case of Hypertension for Older Americans. HEALTH ECONOMICS 2016; 25 Suppl 2:113-125. [PMID: 27870298 DOI: 10.1002/hec.3374] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2015] [Revised: 04/16/2016] [Accepted: 05/18/2016] [Indexed: 06/06/2023]
Abstract
We investigate the health effects of short-term macroeconomic fluctuations as described by changes in unemployment rate, house, and stock market price indexes. The 'Great Recession' provides the opportunity to conduct this analysis as it involved contemporaneous shocks to the labor, housing, and stock markets. Using panel data from the Health and Retirement Study over the period 2004-2010, we relate changes in hypertension status to changes in state-level unemployment rate and house prices and to changes in stock market prices. We consider hypertension, a disease related to stress and of high prevalence among older adults, that has received little attention in the literature linking macroeconomic conditions to individual health. Our analysis exploits self-reports of hypertension diagnosis as well as directly measured blood pressure readings. Using both measures, we find that the likelihood of developing hypertension is negatively related to changes in house prices. Also, decreasing house prices lower the probability of stopping hypertension medication treatment for individuals previously diagnosed with the condition. We do not observe significant associations between hypertension and either changes in unemployment rate or stock market prices. We document heterogeneity in the estimated health effects of the recession by gender, education, asset ownership, and work status. Copyright © 2016 John Wiley & Sons, Ltd.
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Tapia Granados JA, Ionides EL. Statistical evidence shows that mortality tends to fall during recessions: a rebuttal to Catalano and Bruckner. Int J Epidemiol 2016; 45:1683-1686. [PMID: 27634887 DOI: 10.1093/ije/dyw206] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- José A Tapia Granados
- Department of Politics, Drexel University, 3021-E MacAlister Hall, 3250-60 Chestnut Street, Philadelphia, PA 19104
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40
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Bartoll X, Marí-Dell'Olmo M. Patterns of life expectancy before and during economic recession, 2003-12: a European regions panel approach. Eur J Public Health 2016; 26:783-788. [PMID: 27371666 DOI: 10.1093/eurpub/ckw075] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Previous research has reported a decrease in all-cause mortality during times of economic recession. Our objective was to identify the short-term effects of the current Great Recession on life expectancy at birth in Europe, and the role of social protection typology, income and gender. METHODS We used a pooled time series cross-sectional design, with 232 European regions (level 2 of the Nomenclature of Territorial Units for Statistics) as the unit of analysis over 10 years (2003-12). The dependent variable was life expectancy at birth, and the independent variable was unemployment rate. We fit a model in first differences for the periods before and during the Great Recession (2003-07 and 2008-12, respectively), and stratified by sex, social protection typology (Eastern, Mediterranean and Northern) and regional income per capita RESULTS: We observed a negative association during the Great Recession between life expectancy (in years) and in unit change in unemployment among men and women in low-income Mediterranean regions [-0.048(95%CI: -0.081,-0.014) and -0.050(95%CI:-0.091,-0.007), respectively] but no change in trend, and a change in trend to a non-significant negative association among men in high-income Mediterranean and Northern regions (P = 0.005 and P = 0.002, respectively). We also observed a positive association among men in middle-income Mediterranean regions [0.044 (95%CI:0.004,0.084)], with change in trend (P = 0.047), and Eastern regions [0.042 (95%CI:0.001,0.072)] without change in trend. CONCLUSION Overall, our data do not support the notion that increased life expectancy is associated with unemployment during the Great Recession.
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Affiliation(s)
- Xavier Bartoll
- Agència de Salut Pública de Barcelona, Barcelona, Barcelona, Spain .,Institut d'Investigació Biomèdica (IIB Sant Pau), Barcelona, Spain
| | - Marc Marí-Dell'Olmo
- Agència de Salut Pública de Barcelona, Barcelona, Barcelona, Spain.,Institut d'Investigació Biomèdica (IIB Sant Pau), Barcelona, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Spain
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He MM. Driving through the Great Recession: Why does motor vehicle fatality decrease when the economy slows down? Soc Sci Med 2016; 155:1-11. [PMID: 26967529 DOI: 10.1016/j.socscimed.2016.02.016] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Revised: 02/06/2016] [Accepted: 02/09/2016] [Indexed: 11/26/2022]
Abstract
The relationship between short-term macroeconomic growth and temporary mortality increases remains strongest for motor vehicle (MV) crashes. In this paper, I investigate the mechanisms that explain falling MV fatality rates during the recent Great Recession. Using U.S. state-level panel data from 2003 to 2013, I first estimate the relationship between unemployment and MV fatality rate and then decompose it into risk and exposure factors for different types of MV crashes. Results reveal a significant 2.9 percent decrease in MV fatality rate for each percentage point increase in unemployment rate. This relationship is almost entirely explained by changes in the risk of driving rather than exposure to the amount of driving and is particularly robust for crashes involving large commercial trucks, multiple vehicles, and speeding cars. These findings provide evidence suggesting traffic patterns directly related to economic activity lead to higher risk of MV fatality rates when the economy improves.
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Affiliation(s)
- Monica M He
- University of Pennsylvania, Population Studies Center, 3718 Locust Walk, McNeil Building, Philadelphia, PA 19104, USA.
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Boen C, Yang YC. The physiological impacts of wealth shocks in late life: Evidence from the Great Recession. Soc Sci Med 2016; 150:221-30. [PMID: 26773705 PMCID: PMC4764349 DOI: 10.1016/j.socscimed.2015.12.029] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Revised: 12/16/2015] [Accepted: 12/18/2015] [Indexed: 01/05/2023]
Abstract
Given documented links between individual socioeconomic status (SES) and health, it is likely that-in addition to its impacts on individuals' wallets and bank accounts-the Great Recession also took a toll on individuals' disease and mortality risk. Exploiting a quasi-natural experiment design, this study utilizes nationally representative, longitudinal data from the National Social Life, Health, and Aging Project (NSHAP) (2005-2011) (N = 930) and individual fixed effects models to examine how household-level wealth shocks experienced during the Great Recession relate to changes in biophysiological functioning in older adults. Results indicate that wealth shocks significantly predicted changes in physiological functioning, such that losses in net worth from the pre-to the post-Recession period were associated with increases in systolic blood pressure and C-reactive protein over the six year period. Further, while the association between wealth shocks and changes in blood pressure was unattenuated with the inclusion of other indicators of SES, psychosocial well-being, and health behaviors in analytic models, we document some evidence of mediation in the association between changes in wealth and changes in C-reactive protein, which suggests specificity in the social and biophysiological mechanisms relating wealth shocks and health at older ages. Linking macro-level conditions, meso-level household environments, and micro-level biological processes, this study provides new insights into the mechanisms through which economic inequality contributes to disease and mortality risk in late life.
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Affiliation(s)
- Courtney Boen
- Department of Sociology and Carolina Population Center, University of North Carolina at Chapel Hill, USA.
| | - Y Claire Yang
- Department of Sociology, Lineberger Comprehensive Cancer Center, and Carolina Population Center, University of North Carolina at Chapel Hill, USA
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More than just numbers: Suicide rates and the economic cycle in Portugal (1910-2013). SSM Popul Health 2016; 2:14-23. [PMID: 29349124 PMCID: PMC5757999 DOI: 10.1016/j.ssmph.2015.11.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Revised: 11/24/2015] [Accepted: 11/25/2015] [Indexed: 12/13/2022] Open
Abstract
Suicides are a major concern for public health first and foremost because they are an avoidable cause of death. Moreover, they can be an indicator of self-reported emotional satisfaction and a good marker of overall well-being. In this study we examine how different economic and social aspects affected Portuguese suicide rates for more than one hundred years (1910–2013). We place this exercise in the specific historical context of the XX and early XXI century in Portugal, emphasizing the role of economic recessions and expansions. Controlling for aspects like wars, health care availability, political instability, and demographic changes, we find a strong association between a decline in the growth rate of real output and an increase in suicide rates for the whole population. In this regard, while male suicide rates are non-negligibly influenced by economic downturns, female suicide rates are in general more responsive to a more open political and economic environment. Our results are robust if we consider the mid-term cyclical relationship. Our findings advocate that, during recessions, public health responses should be seen as a crucial component of suicide prevention.
We study the relation between suicide rates and Portuguese output. Our dataset has more than a century where we analyze several economic, social and political events. Suicide rates tend to severely increase during times of recessions. In general, males are more sensitive to GDP fluctuations than females. Males react more, on average, to war events; while women are more affected by events related to social stability.
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Tapia Granados JA. Commentary: William Ogburn, Dorothy Thomas and the influence of recessions and expansions on mortality. Int J Epidemiol 2015; 44:1484-90. [PMID: 26613711 DOI: 10.1093/ije/dyv288] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- José A Tapia Granados
- Department of Politics, Drexel University, 3141 Chestnut St., 3021E MacAlister Hall, Philadelphia, PA 19104, USA. E-mail:
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The health effects of the global financial crisis: can we reconcile the differing views? A network analysis of literature across disciplines. HEALTH ECONOMICS POLICY AND LAW 2015; 10:83-99. [PMID: 25662198 DOI: 10.1017/s1744133114000255] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Why are researchers studying the health effects of economic change reaching markedly varying conclusions? To understand these differences, we first systematically searched Web of Science for the literature on recessions and health yielding 461 articles and 14,401 cited documents. We then undertook a network analysis of co-citation pattern by disciplines, journals and backgrounds of the authors, followed by a chronological review of the literature, to trace the evolution of ideas. We then examined the extent to which earlier literature predicted what has happened in the 2007-2012 crisis. Our analysis finds the literature is dominated by disciplinary silos, with economics studies predominantly citing each other and relative isolation of psychiatry and substance abuse journals. Different philosophical approaches to assessing causality appear to contribute to varying interpretations, a tendency that is unlikely to be resolved without a shift in research norms. We conclude by calling for more inter-disciplinary research that combines empirical findings with a search for plausible mechanisms. This approach would evaluate not only the effects of economic shocks but also the mechanisms that offer protection against them.
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Oyesanya M, Lopez-Morinigo J, Dutta R. Systematic review of suicide in economic recession. World J Psychiatry 2015; 5:243-254. [PMID: 26110126 PMCID: PMC4473496 DOI: 10.5498/wjp.v5.i2.243] [Citation(s) in RCA: 123] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Revised: 12/04/2014] [Accepted: 04/07/2015] [Indexed: 02/05/2023] Open
Abstract
AIM: To provide a systematic update of the evidence concerning the relationship between economic recession and suicide.
METHODS: A keyword search of Ovid Medline, Embase, Embase Classic, PsycINFO and PsycARTICLES was performed to identify studies that had investigated the association between economic recession and suicide.
RESULTS: Thirty-eight studies met predetermined selection criteria and 31 of them found a positive association between economic recession and increased suicide rates. Two studies reported a negative association, two articles failed to find such an association, and three studies were inconclusive.
CONCLUSION: Economic recession periods appear to increase overall suicide rates, although further research is warranted in this area, particularly in low income countries.
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Tapia Granados JA, Rodriguez JM. Health, economic crisis, and austerity: A comparison of Greece, Finland and Iceland. Health Policy 2015; 119:941-53. [PMID: 25979416 DOI: 10.1016/j.healthpol.2015.04.009] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Revised: 03/23/2015] [Accepted: 04/15/2015] [Indexed: 10/23/2022]
Abstract
Reports have attributed a public health tragedy in Greece to the Great Recession and the subsequent application of austerity programs. It is also claimed that the comparison of Greece with Iceland and Finland-where austerity policies were not applied-reveals the harmful effect of austerity on health and that by protecting spending in health and social budgets, governments can offset the harmful effects of economic crises on health. We use data on life expectancy, mortality rates, incidence of infectious diseases, rates of vaccination, self-reported health and other measures to examine the evolution of population health and health services performance in Greece, Finland and Iceland since 1990-2011 or 2012-the most recent years for which data are available. We find that in the three countries most indicators of population health continued improving after the Great Recession started. In terms of population health and performance of the health care system, in the period after 2007 for which data are available, Greece did as good as Iceland and Finland. The evidence does not support the claim that there is a health crisis in Greece. On the basis of the extant evidence, claims of a public health tragedy in Greece seem overly exaggerated.
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Affiliation(s)
- José A Tapia Granados
- Department of History and Political Science, Drexel University, Philadelphia, PA, United States.
| | - Javier M Rodriguez
- Mathematica Policy Research and Population Studies Center, Institute for Social Research, University of Michigan,, Ann Arbor, MI, USA
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A reappraisal of the unemployment–mortality relationship: Transitory and permanent effects. J Public Health Policy 2014; 36:81-94. [DOI: 10.1057/jphp.2014.40] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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De Vogli R, Owusu JT. The causes and health effects of the Great Recession: from neoliberalism to ‘healthy de-growth’. CRITICAL PUBLIC HEALTH 2014. [DOI: 10.1080/09581596.2014.957164] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Kondo N, Rostila M, Yngwe MÅ. Rising inequality in mortality among working-age men and women in Sweden: a national registry-based repeated cohort study, 1990-2007. J Epidemiol Community Health 2014; 68:1145-50. [PMID: 25143429 PMCID: PMC4255670 DOI: 10.1136/jech-2013-203619] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Background In the past two decades, health inequality has persisted or increased in states with comprehensive welfare. Methods We conducted a national registry-based repeated cohort study with a 3-year follow-up between 1990 and 2007 in Sweden. Information on all-cause mortality in all working-age Swedish men and women aged between 30 and 64 years was collected. Data were subjected to temporal trend analysis using joinpoint regression to statistically confirm the trajectories observed. Results Among men, age-standardised mortality rate decreased by 38.3% from 234.9 to 145 (per 100 000 population) over the whole period in the highest income quintile, whereas the reduction was only 18.3% (from 774.5 to 632.5) in the lowest quintile. Among women, mortality decreased by 40% (from 187.4 to 112.5) in the highest income group, but increased by 12.1% (from 280.2 to 314.2) in the poorest income group. Joinpoint regression identified that the differences in age-standardised mortality between the highest and the lowest income quintiles decreased among men by 18.85 annually between 1990 and 1994 (p trend=0.02), whereas it increased later, with a 2.88 point increase per year (p trend <0.0001). Among women, it continuously increased by 9.26/year (p trend <0.0001). In relative terms, age-adjusted mortality rate ratios showed a continuous increase in both genders. Conclusions Income-based inequalities among working-age male and female Swedes have increased since the late 1990s, whereas in absolute terms the increase was less remarkable among men. Structural and behavioural factors explaining this trend, such as the economic recession in the early 1990s, should be studied further.
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Affiliation(s)
- Naoki Kondo
- School of Public Health, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Mikael Rostila
- Department of Sociology, Stockholm University, Stockholm, Sweden Centre for Health Equity Studies, Stockholm University/Karolinska Institutet, Stockholm, Sweden
| | - Monica Åberg Yngwe
- Centre for Health Equity Studies, Stockholm University/Karolinska Institutet, Stockholm, Sweden
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