Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 2.563
Filtrar
2.
Int J Equity Health ; 18(1): 144, 2019 09 14.
Artículo en Inglés | MEDLINE | ID: mdl-31521177

RESUMEN

BACKGROUND: The economic crisis posed various challenges to policy-makers who had to decide on which health policy measures to focus on and on which to refrain from. The aim of this research was to assess the relevance of ethics and to highlight ethical dimensions in decision-taking by policy-makers with regard to policy and priority-setting in health systems posed by the economic crisis. METHODS: Semi-structured qualitative interviews were conducted with eight European policy-makers from six countries. RESULTS: All interviewees recalled difficult and strenuous situations where they had to prioritise between distinct areas to focus on and invest in, for example around choices between prioritising medications, health professional staffing, care specific equipment, or urgent infrastructure issues. Values could be identified which they deemed as important within the policy-making process, such as trust and responsibility. They explicitly expressed the need for ethical tools and assistance in terms of policy advice for reaching morally sustainable decisions in health policy matters. CONCLUSIONS: The study showed that ethical concepts and values frequently come into play in health policy-making, and that ethics is highly relevant in policy-makers' daily decision-taking, yet that they lack ethical guidance on what to base their decisions. The study is of relevance since it can provide future decisions on austerity-related issues with an ethical underpinning and could identify areas of moral concern.


Asunto(s)
Personal Administrativo/psicología , Toma de Decisiones/ética , Recesión Económica , Política de Salud , Formulación de Políticas , Europa (Continente) , Humanos , Investigación Cualitativa
4.
BMC Public Health ; 19(1): 1202, 2019 Sep 02.
Artículo en Inglés | MEDLINE | ID: mdl-31477064

RESUMEN

BACKGROUND: In Italy, the number of individuals who have forgone medical examinations or treatments for economic reasons is one of the highest in Europe. During the global economic crisis of 2008, the restrictive policies concerning access to healthcare and the quality of these services, which differs widely throughout the country, may have accentuated the territorial differences in unmet needs, thereby penalizing the more disadvantaged segments of the population. The study aimed at evaluating the geographical and socioeconomic differences, in particular the risk of poverty, that influence forgoing healthcare services in Italy. METHODS: Cross-sectional Italian data from the 2004-2015 European Survey on Income and Living Conditions (EU-SILC) were used. Hierarchical logistic models were tested, using as the outcome unmet needs for medical examinations or treatment in the preceding 12 months, and as risk factor the condition of being at risk of poverty. Age, sex, citizenship, educational level, presence of chronic or severely limiting diseases and self-perceived health were used as adjustment factors. Analyses were stratified over three time periods: pre-crisis (2004-2007), initial phase of the crisis (2008-2012) and second phase of the crisis (2013-2015). RESULTS: In Central Italy and particularly in Southern Italy, a marked increase (9.9% in 2013-2015) was seen in the overall rate of unmet needs as well as in that of unmet needs due to economic reasons. The probability of unmet needs was higher, and increased over time, for those at risk of poverty (aOR = 1.54 in 2004-07, aOR = 1.70 in 2008-12, aOR = 2.21 in 2013-15). Individuals with a low educational level, who had a chronic or severely limiting disease, who perceived their health as not good and immigrants had a higher risk of forgoing healthcare. The regions in Southern Italy had a significantly higher probability of unmet needs. CONCLUSIONS: A strong association was found between the probability of forgoing medical examination or treatment and being at risk of poverty. Study results underline the need for healthcare policies aimed at facilitating access to healthcare services, particularly in the South, by developing a progressive mechanism of contribution to healthcare costs proportional to income and by guaranteeing free access to the poor.


Asunto(s)
Recesión Económica , Accesibilidad a los Servicios de Salud/economía , Examen Físico/estadística & datos numéricos , Terapéutica/estadística & datos numéricos , Adolescente , Adulto , Anciano , Estudios Transversales , Femenino , Geografía , Humanos , Italia , Masculino , Persona de Mediana Edad , Pobreza , Riesgo , Encuestas y Cuestionarios , Terapéutica/economía , Adulto Joven
5.
BMC Health Serv Res ; 19(1): 621, 2019 Sep 02.
Artículo en Inglés | MEDLINE | ID: mdl-31477104

RESUMEN

BACKGROUND: Equity in medical resource utilization is a crucial concern in countries with national health insurance systems. From the perspective of an active aging framework, public health insurance is one of the pillars of economic security, as suggested by the World Bank, to achieve the goal of social security for older adults. This study thus sought to quantify income-related inequality in national health insurance systems, especially during the global economic crisis of 2007-2008. METHODS: By employing the Taiwan National Health Interview Surveys (2005 and 2009) datasets, we analyzed the socioeconomic inequality of outpatient service utilization for older Taiwanese adults during the financial crisis of 2007-2008. We used corrected concentration indices (CCIs) to examine inequalities over time. Furthermore, we decomposed socioeconomic inequalities to reveal the contributions of determinant factors. The dependent variables related to whether participants had used outpatient services in the previous month, and the independent factors included individual's needs, enabling, predisposing, and environmental factors proposed by Andersen model. RESULTS: The sample consisted of 2415 observations in 2005 and 2554 observations in 2009. The income-related health care inequality was minor from pro-rich to pro-poor across the study duration, although the difference was insignificant (women: from a concentration index [CI] of 0.0256 in 2005 to a CI of - 0.0098 in 2009; men: from a CI of 0.0379 in 2005 to a CI of 0.0310 in 2009). We used a probit model to analyze the effect of explanatory factors on outpatient resource utilization by men and women. After other factors were controlled for, we found that that the income variable had a positive and significant effect on outpatient service utilization in 2009 and the absolute contribution of income to inequality notably increased from 0.0480 in 2005 to 0.3247 in 2009 for older women. CONCLUSIONS: In conclusion, Taiwan's National Health Insurance system guarantees the accessibility of health care services to older adults, but slight income-related inequality was maintained in the outpatient resource utilization of women during the 2007-2008 financial crisis. Close attention should be paid to the vulnerability of women during times of economic insecurity.


Asunto(s)
Atención Ambulatoria , Recesión Económica , Recursos en Salud , Accesibilidad a los Servicios de Salud , Anciano , Bases de Datos Factuales , Empleo/estadística & datos numéricos , Femenino , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Disparidades en Atención de Salud/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Programas Nacionales de Salud , Taiwán
6.
BMC Public Health ; 19(1): 1109, 2019 Aug 14.
Artículo en Inglés | MEDLINE | ID: mdl-31412835

RESUMEN

BACKGROUND: To estimate the relationship of the degree of urbanization to cardiovascular mortality and to risk behaviours before, during and after the 2008 economic crisis in Spain. METHODS: In three areas of residence - large urban areas, small urban areas and rural areas - we calculated the rate of premature mortality (0-74 years) from cardiovascular diseases before the crisis (2005-2007), during the crisis (2008-2010 and 2011-2013) and after the crisis (2014-2016), and the prevalence of risk behaviours in 2006, 2011 and 2016. In each period we estimated the mortality rate ratio (MRR) and the prevalence ratio, taking large urban areas as the reference. RESULTS: In men, no significant differences were observed in mortality between the two urban areas, while the MRR in rural areas went from 0.92 [95% confidence interval, 0.90-0.94) in 2005-2007 to 0.94 (0.92-0.96) in 2014-2016. In women, no significant differences were observed in mortality between the rural and large urban areas, whereas the MRR in small urban areas decreased from 1.11 (1.08-1.14) in 2005-2007 to 1.06 (1.02-1.09) in 2014-2016. The rural areas had the lowest prevalence of smoking, obesity and physical inactivity in men, and of obesity in women. No significant differences were observed in smoking or physical inactivity by area of residence in women. CONCLUSION: The pattern of cardiovascular mortality by degree of urbanization was similar before and after the crisis, although in women the excess mortality in small urban areas with respect to large urban areas was smaller after the crisis. The different pattern of risk behaviours in men and women, according to area of residence, could explain these findings.


Asunto(s)
Enfermedades Cardiovasculares/mortalidad , Recesión Económica/estadística & datos numéricos , Asunción de Riesgos , Urbanización , Adolescente , Adulto , Anciano , Niño , Preescolar , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Mortalidad Prematura/tendencias , Prevalencia , España/epidemiología , Adulto Joven
7.
Psychiatriki ; 30(2): 97-107, 2019.
Artículo en Griego moderno | MEDLINE | ID: mdl-31425138

RESUMEN

During previous financial crises as well as the recent global financial crisis, a strong impact of the crisis on the population mental health in many countries has been observed. Similarly, in Greece, a series of epidemiological studies pointed out the consequences of the economic crisis on the population mental health. However, there is limited data available, both in Greece and worldwide, regarding the impact of the economic crisis from the perspective of mental health services. The goal of the present study was to examine possible changes on the community mental health during the first years of the Greek financial crisis, as they are reflected on the operation of a community mental health unit with a specific catchment area within Athens (Byron and Kessariani). The demographic, social and clinical characteristics of adult users who were admitted for the first time at ByronKessariani Mental Health Community Center during the years 2008-2013 were analysed. The impact of the financial crisis on the workload of the center was also assessed during the same period. The sample of the study consisted of 1865 adult users and the data was collected with the use of an ad hoc structured questionnaire as well as from the users' case files. No significant differentiation on the number of clients admitted to the center per year after the beginning of the financial crisis was found. However, it is possible that an upper limit has been reached on the center's capacity to admit new clients, i.e. a ceiling effect, as it is shown from the increased number of provided sessions per year as well as from the increase in the mean waiting time for the intake of new patients during the same period. A constant increase in the number of women among the new clients of ByronKessariani Mental Health Community Center was found, but no significant differentiations were detected during the study period. Moreover, the study showed an upward trend in aggressive behavior as a reason for admission, a significant and continuous increase in the rate of unemployed individuals among the new clients, as well as a statistically significant increase in the number of referrals for psychotherapy during the study period. There was also an increase in the number of patients who had psychiatric history, even though they were admitted to Byron-Kessariani Mental Health Community Center for the first time. No significant differentiations were found in the remaining users' demographic and clinical characteristics assessed. Our study showed that during the crisis community mental health services are under pressure due to the increased needs of patients, especially the needs for psychotherapeutic intervention and psychological support. The increased unemployment rates affect the influx of new patients as well as the therapeutic management of many users. Reinforcement of the community mental health service network is an important strategy against the consequences of the crisis on the population mental health.


Asunto(s)
Centros Comunitarios de Salud Mental/estadística & datos numéricos , Recesión Económica/estadística & datos numéricos , Adulto , Agresión , Centros Comunitarios de Salud Mental/organización & administración , Servicios Comunitarios de Salud Mental , Femenino , Grecia/epidemiología , Humanos , Masculino , Trastornos Mentales/economía , Trastornos Mentales/psicología , Salud Mental , Persona de Mediana Edad , Psicoterapia/estadística & datos numéricos , Factores Socioeconómicos , Desempleo/psicología , Desempleo/estadística & datos numéricos
8.
Public Health ; 175: 28-35, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31377690

RESUMEN

OBJECTIVES: The objective of this study is to analyse how educational differentials in traffic mortality changed during economic fluctuations in four Argentinian provinces. STUDY DESIGN: Retrospective quantitative analysis of secondary data. METHODS: Data on fatalities due to traffic injuries (all traffic injuries, pedestrians/cyclists, motorcyclists, car users and unspecified road users) in four Argentinian provinces between 1999 and 2013 were linked to population data and information on the educational level of the deceased to compute mortality rates by educational level. Negative binomial models were estimated using age, sex, year, province of residence, year of economic expansion or recession and educational level as explanatory variables. RESULTS: Annual traffic mortality differentials by educational level were lower during the period of economic crisis. An absolute increase in traffic mortality was observed in individuals of low educational level during economic expansions, but here, there were no traffic mortality differences for individuals of medium to high educational level. The educational gap in motorcyclist mortality widened during the period of quick economic expansion between 2005 and 2013. CONCLUSIONS: We found less educational inequality in traffic mortality during an economic crisis in a developing country. However, the educational inequalities for different subtypes of traffic mortality show different patterns of evolution during the cycle of economic expansion and recession. Considering deaths due to traffic injuries, economic growth seems to be riskier for individuals of lower educational level compared with those of medium-high educational level.


Asunto(s)
Accidentes de Tránsito/mortalidad , Recesión Económica , Escolaridad , Disparidades en el Estado de Salud , Adulto , Anciano , Argentina/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos
9.
Artículo en Inglés | MEDLINE | ID: mdl-31344971

RESUMEN

Mental health is an intrinsic dimension of health influenced by individual and contextual factors. This cross-sectional study analyzes the association between the individual, neighborhood characteristics, and one's self-assessed mental health status in the Lisbon region after an economic crisis. Via the application of multilevel regression models, the study assesses the link between one's neighborhood environment-deprivation, low self-assessed social capital, and low self-assessed satisfaction with the area of residence-and mental health regardless of one's individual characteristics. Constraints related to the economic crisis play an important role in the explanation of poor mental health.


Asunto(s)
Recesión Económica , Salud Mental , Características de la Residencia , Adolescente , Adulto , Anciano , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Análisis Multinivel , Satisfacción Personal , Portugal , Capital Social , Adulto Joven
10.
Int J Equity Health ; 18(1): 108, 2019 07 16.
Artículo en Inglés | MEDLINE | ID: mdl-31311553

RESUMEN

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


Asunto(s)
Recesión Económica/estadística & datos numéricos , Disparidades en el Estado de Salud , Estado de Salud , Determinantes Sociales de la Salud/estadística & datos numéricos , Femenino , Humanos , Masculino , Salud Mental , Investigación Cualitativa , Clase Social , España/epidemiología
11.
Public Health ; 173: 126-129, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-31276890

RESUMEN

OBJECTIVES: Cuba is a tobacco-producing country that has been economically isolated as a consequence of an embargo imposed by the USA. It has also experienced a severe economic depression in the 1990s after the withdrawal of support by the former Soviet Union. These characteristics provide a unique opportunity to study the relation between large changes in economic activity, cigarette price and demand for cigarettes in a relatively isolated socialist economy. STUDY DESIGN: This is an observational epidemiological study. METHODS: Data were obtained on the annual price of a packet of cigarettes and the mean number of cigarettes consumed per adult living in Cuba from 1980 to 2014. Descriptive and regression analysis were used to explore the relationship between cigarette consumption and price in Cuba. RESULTS: In 1980, the mean price of a packet of cigarettes was 1.53 Cuban peso (CUP) in 1997 prices and the mean annual per capita consumption was 2237 cigarettes. In 2014, the mean price had increased to 5.57 CUP (1997 prices) per packet of cigarettes, and consumption had fallen to 1527 cigarettes per capita. There were significant negative associations between annual cigarette consumption and both price and living through an economic depression. The elasticity was approximately -0.31 with price, and living through an economic depression was also associated with lower consumption of cigarettes (a reduction of 9%, 95% confidence intervals -0.18 to -0.001). CONCLUSIONS: Higher cigarette pricing, along with other public health interventions, are required to protect the national population from the adverse effects of tobacco smoke exposure.


Asunto(s)
Fumar Cigarrillos/economía , Comercio/estadística & datos numéricos , Recesión Económica , Productos de Tabaco/economía , Adulto , Fumar Cigarrillos/epidemiología , Cuba/epidemiología , Humanos
12.
Adv Respir Med ; 87(3): 167-174, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31282558

RESUMEN

INTRODUCTION: In Greece, the last decade, the harsh austerity measures, that were enacted, had a huge impact on patients' suffering from chronic diseases. The aim of the current study was to assess the financial ability of the patients suffering from an acute or chronic respiratory disease hospitalized in an urban pulmonary university clinic in central Greece and to explore the correlation of their health status with their financial ability. MATERIAL AND METHODS: An anonymous and self completed questionnaire was administered in the Greek language. It included the SF-36 and the EQ-5D-3L scale that are validated in the Greek language and a new scale (Financial Ability Scale, FAS) that has been developed and validated. RESULTS: Half of the patients (55%) suffered from a chronic respiratory disease (64% COPD and 36% asthma) while 45% from an acute respiratory disease (pneumonia). Those suffering from COPD were mainly males (88.7%), over 65 years old (74.6%), with primary education or some primary (83.1%), covered by public health insurance (95.8%) and living with their families (91.5%). With the exception of anxiety/depression, the more the problems with mobility, self-care, usual activities and pain/discomfort, the worse the financial ability of the participants. Those > 65 years old, with fewer years of education, suffering from a chronic disease and those having a better experience from the current hospitalization, had a statistically significant lower VAS. Those aged > 65 years old reported a lower financial ability (26.00 ± 9.41 vs 29.24 ± 10.63) as well as those with a chronic respiratory disease (24.18 ± 7.90 vs 30.57 ± 11.98). The years lived with the disease correlated statistically and negatively (r = -0.232; p = 0.001) with the total financial ability score. CONCLUSION: Economic crisis in Greece, affected COPD burden in terms of financial ability, and quality of life.


Asunto(s)
Recesión Económica , Estado de Salud , Enfermedad Pulmonar Obstructiva Crónica/epidemiología , Enfermedad Pulmonar Obstructiva Crónica/psicología , Calidad de Vida/psicología , Adaptación Psicológica , Adulto , Anciano , Femenino , Grecia , Humanos , Masculino , Persona de Mediana Edad , Autoinforme
13.
Artículo en Inglés | MEDLINE | ID: mdl-31336776

RESUMEN

BACKGROUND: Our main objective was to evaluate the fundamental biases detected in studies assessing the effects the Great Recession had on health for the case of Spain. As secondary objectives we presented methods to control these biases and to discuss the results of the studies in question if they had controlled for them. METHODS: We carried out a systematic review of the literature published up to June 2018. We evaluated the biases that could have happened in all the eligible studies. RESULTS: From the review, we finally selected 53 studies. Of the studies we reviewed, 60.38% or 32 out of 53, were evaluated as having a high risk of bias. The main biases our review revealed were problems with evaluation, time bias, lack of control of unobserved confounding, and non-exogeneity when defining the onset of the Great Recession. CONCLUSIONS: The results from the studies that controlled the biases were quite consistent. Summing up, the studies reviewed found that the Great Recession increased the risk of declaring poor self-rated health and the deterioration of mental health. Both the mortality rate and the suicide rate may well have increased after the Great Recession, probably after a three- to four-year delay.


Asunto(s)
Sesgo , Recesión Económica/estadística & datos numéricos , Salud Mental/estadística & datos numéricos , Proyectos de Investigación , Humanos , España
14.
J Public Health Policy ; 40(3): 351-366, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31171846

RESUMEN

HIV/AIDS has disproportionately affected women worldwide. Several studies focus on economic sanctions and the health of populations, but little attention has been paid to the effects of sanctions on HIV rates. This study examines the influence of economic sanctions on HIV in women and finds that sanctions increase women's HIV rate by decreasing female labor participation. These findings are in line with previous findings that sanctions negatively affect public health in general as well as women in particular. All these findings suggest that policy makers need to consider more carefully the scourge of HIV/AIDS among women when formulating their policies toward target countries.


Asunto(s)
Infecciones por VIH/economía , Internacionalidad , Recesión Económica , Empleo/economía , Empleo/estadística & datos numéricos , Femenino , Infecciones por VIH/epidemiología , Humanos , Política , Derechos de la Mujer
15.
Artículo en Inglés | MEDLINE | ID: mdl-31195664

RESUMEN

We analyzed suicide mortality by occupation using administrative data from 1993 to 2016. Methods: National death records from 1993 to 2016 of the Korea National Statistical Office (KNSO) were used. Suicidal death was taken from Korean Classification of Disease codes as intentional self-harm (X60-X84) and sequelae of intentional self-harm (Y870). Occupational groups were categorized into "Manager," "Officer," "Service-Trade," "Agricultural-Fishery-Forestry" (AFF), "Skilled Manual," and "Unskilled Manual." Direct standardized mortality (DSM) and standardized mortality ratio (SMR) with 95% confidence interval (95% CI) were calculated. Overall, suicide rates increased during economic downturns, especially among lower socio-economic occupation classes. Both DSM and SMR were highest in AFF, followed by Unskilled Manual, Service-Trade, Officer, Skilled Manual, and Manager categories among men, whereas women showed the highest DSM and SMR in AFF, followed by Service-Trade, Officer, Unskilled Manual, Manager, and Skilled Manual categories. The age-stratified analysis showed that age groups with increasing trends in suicide differed according to occupation and gender. In certain occupational groups, the time-point prevalence fluctuated with socio-economic background in suicidal mortality and differed by age and gender.


Asunto(s)
Recesión Económica , Ocupaciones/estadística & datos numéricos , Suicidio/estadística & datos numéricos , Adulto , Factores de Edad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , República de Corea/epidemiología , Factores Sexuales , Adulto Joven
17.
J Gambl Stud ; 35(4): 1193-1210, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31165324

RESUMEN

In Greece no study has ever been conducted on the prevalence of problem gambling. Therefore, a cross-sectional survey was carried out amid the recession aiming to (1) estimate past year prevalence of problem gambling, (2) explore socio-economic and demographic differences among gamblers and non gamblers, (3) explore socio-economic and demographic differences among gamblers who started gambling prior and during the downturn and (4) identify its risk factors with a special interest in the influence of the recession. To this end, data emanating from a telephone and patron survey were combined. A random and representative sample of 3.404 people participated in the telephone survey and 2.400 in the patron survey. The interview schedule was the same in both studies. The presence of problem gambling was assessed with the Canadian Problem Gambling Index. Information on participants' socio-economic and demographic characteristics as well as their ways of dealing financially with the crisis were collected. Findings indicated that 2.4% of respondents met criteria for problem gambling. Male gender, minority status, living with family of origin, low educational level and low to zero income were found to constitute the risk factors of the disorder. Moreover, having started gambling during the recession increased the odds of suffering from problem gambling; however this finding was gender-specific. Thus, people end up in problem gambling through various pathways, with these trajectories being different for men and women. Any intervention should address the complexity of the issue and be tailored by gender.


Asunto(s)
Recesión Económica , Juego de Azar/epidemiología , Desempleo/estadística & datos numéricos , Adolescente , Adulto , Estudios Transversales , Empleo/psicología , Femenino , Juego de Azar/psicología , Grecia/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Factores de Riesgo , Encuestas y Cuestionarios , Desempleo/psicología , Adulto Joven
18.
BMC Public Health ; 19(1): 740, 2019 Jun 13.
Artículo en Inglés | MEDLINE | ID: mdl-31196081

RESUMEN

BACKGROUND: Although job loss has been associated with decline in health, the effect of long term unemployment is less clear and under-researched. Furthermore, the impact of an economic recession on this relationship is unclear. We investigated the associations of single transitions and persistence of unemployment with health. We subsequently examined whether these associations are affected by the latest recession, which began in 2008. METHODS: In total, 57,911 participants from the Dutch Health Interview Survey who belonged to the labour force between 2004 and 2014 were included. Based on longitudinal tax registration data, single employment transitions between time point 1 (t1) and time point 2 (t2) and persistent unemployment (i.e. number of years individuals were unemployed) between t1 and time point 5 (t5) were defined. General and mental health, smoking and obesity were assessed at respectively time point 3 (t3) and time point 6 (t6). Logistic regression models were performed and interactions with recession indicators (year, annual gross domestic product estimates and regional unemployment rates) were tested. RESULTS: Compared with individuals who stayed employed at t1 and t2, the likelihood of poor mental health at the subsequent year was significantly higher in those who became unemployed at t2. Persistent unemployment was associated with poor mental health, especially for those who were persistently unemployed for 5 years. Similar patterns, although less pronounced for smoking, were found for general health and obesity. Indicators of the economic recession did not modify these associations. CONCLUSIONS: Single transitions into unemployment and persistent unemployment are associated with poor mental and general health, obesity, and to a lesser extend smoking. Our study suggests that re-employment might be an important strategy to improve health of unemployed individuals. The relatively extensive Dutch social security system may explain that the economic recession did not modify these associations.


Asunto(s)
Estado de Salud , Desempleo/estadística & datos numéricos , Adulto , Estudios Transversales , Recesión Económica/estadística & datos numéricos , Femenino , Encuestas Epidemiológicas , Humanos , Masculino , Persona de Mediana Edad , Países Bajos
19.
Ir J Psychol Med ; 36(2): 99-104, 2019 06.
Artículo en Inglés | MEDLINE | ID: mdl-31187718

RESUMEN

OBJECTIVE: Subjective well-being in older people is strongly associated with emotional, physical and mental health. This study investigates subjective well-being in older adults in Ireland before and after the economic recession that commenced in 2008. METHODS: Cross-sectional data from the biennial European Social Survey (2002-2012) were analysed for two separate groups of older adults: one sampled before the recession and one after. Stratification and linear regression modelling were used to analyse the association between subjective well-being, the recession and multiple potential confounders and effect modifiers. RESULTS: Data were analysed on 2013 individuals. Overall, subjective well-being among older adults was 1.30 points lower after the recession compared with before the recession (s.e. 0.16; 95% confidence interval 1.00-1.61; p<0.001) [pre-recession: 16.1, out of a possible 20 (s.d. 3.24); post-recession:14.8 (s.d. 3.72)]. Among these older adults, the pre- and post-recession difference was especially marked in women, those with poor health and those living in urban areas. CONCLUSIONS: Subjective well-being was significantly lower in older adults after the recession compared with before the recession, especially in women with poor health in urban areas. Policy-makers need proactively to protect these vulnerable cohorts in future health and social policy. Future research could usefully focus on older people on fixed incomes whose diminished ability to alter their economic situation might make them more vulnerable to reduced subjective well-being during a recession.


Asunto(s)
Autoevaluación Diagnóstica , Recesión Económica/estadística & datos numéricos , Salud Mental , Anciano , Estudios Transversales , Empleo/estadística & datos numéricos , Femenino , Humanos , Irlanda , Masculino , Encuestas y Cuestionarios
20.
BMC Public Health ; 19(1): 836, 2019 Jun 27.
Artículo en Inglés | MEDLINE | ID: mdl-31248410

RESUMEN

BACKGROUND: It is known that occupational injury rates are higher for immigrant than for native workers, however the effects of the economic cycles on these differences has not been assessed to date. The aim of the paper is to test if the crisis has the same mechanism of selection in the two groups by comparing injury rates in 2005 (before the crisis) and in 2010 (after the crisis). METHODS: The Work History Italian Panel-Salute integrated database was interrogated to identify employment contracts in the metalworking and construction industries for the years 2005 and 2010 and the occupational injuries. A definition based on the type of injury, less likely to be biased by underreporting, was used to select serious events. Immigrants and natives were matched using the propensity score method and injury rates were calculated in the two years. Analyses were stratified by industry. RESULTS: In the metalworking industry injury rates slightly increased over time for both groups, and were higher among immigrant than native workers in both 2005 and 2010. In the construction industry the 2005 injury rate was the same in the two groups, and there was a negative trend over time in both groups. However the decline in the 2010 injury rate for Italian workers was much larger, which led to a considerable increase of the incidence rate ratio of immigrants with respect to native (IRR 3.83, 95% CI 2.52-5.75). CONCLUSIONS: The economic recession had an impact on the risk of workplace injury. Though the main observed factors (18 variables) usually reported in literature to explain the higher injury rates of the immigrant workers were controlled through the matching, there were still differences between immigrants and natives. The main reason is that immigrants continue to be assigned to the more dangerous jobs and the more dangerous tasks within these job. Furthermore, also differences in the perception of workplace injury risks, linguistic barriers, and cultural factors may have a role in explaining this gap.


Asunto(s)
Industria de la Construcción , Emigrantes e Inmigrantes/estadística & datos numéricos , Metalurgia , Traumatismos Ocupacionales/epidemiología , Adolescente , Adulto , Bases de Datos Factuales , Recesión Económica , Humanos , Italia/epidemiología , Masculino , Persona de Mediana Edad , Medición de Riesgo , Adulto Joven
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA