Effects of Housing Deprivation on Health: Empirical Evidence from Spain.

Severe housing deprivation rates in Spain have tripled in just four years, affecting 3.4% of the population in 2020, with a higher incidence among the low-income population (9.2%). Despite the social aspect of the problem, minimal research has been carried out in Spain on the effects that the various forms of housing deprivation have on health. This study analyzes the impact of housing deprivation on health outcomes, with the objective of achieving results that facilitate the creation of improved public policies. Microdata are used from the Living Conditions Survey carried out by the National Institute of Statistics for the period 2009-2019, and several multilevel logistic regression models are presented to control for possible regional differences. The results show that the elements with the greatest effect on objective health are noise, leaks and harmful temperatures in housing. In addition, environmental factors, such as pollution, neighborhood crime and the number of units in a given apartment building, can be added to the list. As a result, we conclude that there are certain structural and environmental elements in housing and the environment in which is located that have a more intense impact on objective health and on the subjective perception of a person's state of health.

[Approximation to the budgetary cost of universalizing oral health in Spain]. / Una aproximación al coste presupuestario de universalizar la salud bucodental en España.

OBJECTIVE: To make an approximation to an estimate of the impact that an increase in the portfolio of oral health benefits would have on public health spending, which would at least cover most of the therapeutic treatments that households currently pay for privately. METHOD: This estimate is based on the level of expenditure on dental services of the Health Accounts System for the year 2020. The data of increased demand is extracted from a RAND's study on universalization of services. Then we carry out various linear projections of increased spending by introducing several linear co-payment assumptions to explore the impact of different mixed financing mechanisms. RESULTS: The increase in the demand for treatment would be 47.54% with respect to the current level of spending and that, under the starting assumptions, the increase in public spending would reach some 5345 million euros. Various co-pay scenarios could reduce budget impact. CONCLUSIONS: Despite the improvement in the oral health of the Spanish population, there are still problems derived from the existence of a socioeconomic gradient that promotes the concentration of the presence and prevalence of diseases in the lowest socioeconomic levels. Extending the services of the oral-dental portfolio to attend to the entire population would increase public health spending by 0.48 points over GDP and, even so, Spanish public health spending would continue to be below the EU-27 average.

Una aproximación al coste presupuestario de universalizar la salud bucodental en España / Approximation to the budgetary cost of universalizing oral health in Spain

Objetivo: Realizar una aproximación a una estimación de la repercusión que tendría sobre el gasto público sanitario una ampliación de la cartera de prestaciones en salud bucodental que cubriera la mayor parte de los tratamientos terapéuticos que sufragan actualmente las personas de forma privada. Método: La estimación parte del nivel de gasto en servicios odontológicos del Sistema de Cuentas de Salud del año 2020 y se asume el dato de incremento de la demanda ante la universalización de los servicios extraído de un estudio de RAND para realizar, seguidamente, diversas proyecciones lineales de incremento del gasto introduciendo varios supuestos de copagos lineales para explorar el impacto de distintos mecanismos mixtos de financiación. Resultados: El incremento de la demanda sería de un 47,54% con respecto al gasto actual, y bajo los supuestos de partida el incremento en el gasto público alcanzaría unos 5345 millones de euros. Los diversos escenarios de copago minoran su impacto presupuestario. Conclusiones: A pesar de la mejora de la salud bucodental de la población española, persisten problemas derivados de la existencia de un gradiente socioeconómico que concentra la presencia y la prevalencia de enfermedades en los niveles socioeconómicos más bajos. Ampliar los servicios de la cartera bucodental para cubrir las necesidades de toda la población elevaría el gasto sanitario público en 0,48 puntos sobre el producto interior bruto, y aun así el gasto sanitario público español seguiría por debajo de la media de la Unión Europea. (AU)

Objective: To make an approximation to an estimate of the impact that an increase in the portfolio of oral health benefits would have on public health spending, which would at least cover most of the therapeutic treatments that households currently pay for privately. Method: This estimate is based on the level of expenditure on dental services of the Health Accounts System for the year 2020. The data of increased demand is extracted from a RAND's study on universalization of services. Then we carry out various linear projections of increased spending by introducing several linear co-payment assumptions to explore the impact of different mixed financing mechanisms. Results: The increase in the demand for treatment would be 47.54% with respect to the current level of spending and that, under the starting assumptions, the increase in public spending would reach some 5345 million euros. Various co-pay scenarios could reduce budget impact. Conclusions: Despite the improvement in the oral health of the Spanish population, there are still problems derived from the existence of a socioeconomic gradient that promotes the concentration of the presence and prevalence of diseases in the lowest socioeconomic levels. Extending the services of the oral-dental portfolio to attend to the entire population would increase public health spending by 0.48 points over GDP and, even so, Spanish public health spending would continue to be below the EU-27 average. (AU)