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1.
Am J Epidemiol ; 191(11): 1847-1855, 2022 10 20.
Artigo em Inglês | MEDLINE | ID: mdl-35767881

RESUMO

Substantial evidence suggests that economic hardship causes violence. However, a large majority of this research relies on observational studies that use traditional violence surveillance systems that suffer from selection bias and over-represent vulnerable populations, such as people of color. To overcome limitations of prior work, we employed a quasi-experimental design to assess the impact of the Great Recession on explicit violence diagnoses (injuries identified to be caused by a violent event) and proxy violence diagnoses (injuries highly correlated with violence) for child maltreatment, intimate partner violence, elder abuse, and their combination. We used Minnesota hospital data (2004-2014), conducting a difference-in-differences analysis at the county level (n = 86) using linear regression to compare changes in violence rates from before the recession (2004-2007) to after the recession (2008-2014) in counties most affected by the recession, versus changes over the same time period in counties less affected by the recession. The findings suggested that the Great Recession had little or no impact on explicitly identified violence; however, it affected proxy-identified violence. Counties that were more highly affected by the Great Recession saw a greater increase in the average rate of proxy-identified child abuse, elder abuse, intimate partner violence, and combined violence when compared with less-affected counties.


Assuntos
Recessão Econômica , Violência , Idoso , Criança , Humanos , Maus-Tratos Infantis/estatística & dados numéricos , Abuso de Idosos/estatística & dados numéricos , Violência por Parceiro Íntimo/estatística & dados numéricos , Violência/estatística & dados numéricos , Populações Vulneráveis , Recessão Econômica/estatística & dados numéricos , Minnesota/epidemiologia , Hospitais , Modelos Lineares , Masculino , Feminino
2.
PLoS One ; 16(11): e0259623, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34793519

RESUMO

In this paper we assess the impact of the recent European recession on stillbirth indices over the course of the 2000s and 2010s; the analysis focuses on four Southern European countries (Greece, Italy, Spain, Portugal), which were seriously affected by the sovereign debt crisis from around 2008 to 2017. We use national vital statistics and established economic indicators for the period 2000-2017; stillbirth ratios (stillbirths per 1000 livebirths) are the chosen response variable. For the purpose of the study, we employ correlation analysis and fit regression models. The overall impact of economic indicators on the stillbirth indices is sizeable and statistically robust. We find that a healthy economy is associated with low and declining levels of stillbirth measures. In contrast, economic recession appears to have an adverse effect (Greece, Italy and Spain), or an unclear impact (Portugal), on the stillbirth outcome. This study provides evidence of the adverse effect of the European sovereign debt crisis and ensuing period of austerity on a scarcely explored aspect of health.


Assuntos
Recessão Econômica/estatística & dados numéricos , Natimorto/epidemiologia , Europa (Continente) , Feminino , Grécia , Humanos , Itália , Portugal , Gravidez , Espanha
3.
Nutrients ; 13(9)2021 Aug 27.
Artigo em Inglês | MEDLINE | ID: mdl-34578854

RESUMO

The coronavirus (COVID-19) pandemic has had serious repercussions on the global economy, work force, and food systems. In Lebanon, the pandemic overlapped with an economic crisis, which threatened to exacerbate food insecurity (FI). The present study aims to evaluate the trends and projections of FI in Lebanon due to overlapping health and economic crises. Data from Gallup World Poll (GWP) 2015-2017 surveys conducted in Lebanon on nationally representative adults (n = 3000) were used to assess FI trends and explore its sociodemographic correlates. Predictive models were performed to forecast trends in FI (2018-2022), using GWP data along with income reduction scenarios to estimate the impact of the pandemic and economic crises. Pre crises, trend analyses showed that FI could reach 27% considering wave year and income. Post crises, FI was estimated to reach on average 36% to 39%, considering 50-70% income reduction scenarios among Lebanese population. FI projections are expected to be higher among females compared to males and among older adults compared to younger ones (p < 0.05). These alarming findings call for emergency food security policies and evidence-based programs to mitigate the burden of multiple crises on the FI of Lebanese households and promote resilience for future shocks.


Assuntos
COVID-19/epidemiologia , Recessão Econômica/tendências , Insegurança Alimentar/economia , Abastecimento de Alimentos/estatística & dados numéricos , Pandemias/economia , Adolescente , Adulto , COVID-19/economia , COVID-19/psicologia , COVID-19/virologia , Estudos Transversais , Recessão Econômica/estatística & dados numéricos , Feminino , Abastecimento de Alimentos/economia , Humanos , Líbano/epidemiologia , Masculino , Pessoa de Meia-Idade , Pandemias/prevenção & controle , Pandemias/estatística & dados numéricos , Prevalência , Resiliência Psicológica , Fatores Socioeconômicos , Inquéritos e Questionários/estatística & dados numéricos , Adulto Jovem
4.
Can Rev Sociol ; 58(3): 352-371, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34324270

RESUMO

While some scholars suggest that critical attitudes towards inequality follow the class gradient during recessions, others find that classes are largely unresponsive. In this article, I consider how party affiliation interacts with class to shape perceptions of inequality during a recession. I argue that it is important to look at the interplay between class and partisanship to better understand individual views towards inequality during times of economic crises. Leveraging data from the International Social Survey Programme before and after The Great Recession, I find that the recession did not raise awareness of inequality across classes. This is because party affiliation moderates the relationship differently according to class. Specifically, party affiliation is more important in shaping the inequality views for the upper class and less so for the working class. Future research needs to consider the interplay between class and politics when exploring how inequality attitudes respond to economic crises.


Si certains chercheurs suggèrent que les attitudes critiques à l'égard de l'inégalité suivent le gradient de classe pendant les récessions, d'autres constatent que les classes ne réagissent guère. Dans cet article, j'examine comment l'affiliation à un parti interagit avec la classe sociale pour façonner les perceptions de l'inégalité pendant une récession. Je soutiens qu'il est important d'examiner l'interaction entre la classe et l'appartenance partisane pour mieux comprendre les opinions individuelles sur l'inégalité en période de crise économique. En m'appuyant sur les données de l'International Social Survey Programme avant et après la Grande Récession, je constate que la récession n'a pas augmenté la conscience de l'inégalité entre les classes. Cela est dû au fait que l'affiliation à un parti modère la relation différemment selon la classe. Plus précisément, l'affiliation à un parti joue un rôle plus important dans la formation des opinions sur l'inégalité pour la classe supérieure et moins pour la classe ouvrière. Les recherches futures doivent tenir compte de l'interaction entre la classe sociale et la politique lorsqu'elles étudient la manière dont les attitudes en matière d'inégalité réagissent aux crises économiques.


Assuntos
Atitude , Recessão Econômica/estatística & dados numéricos , Renda/estatística & dados numéricos , Política , Classe Social , Fatores Socioeconômicos , Canadá , Opinião Pública
5.
Eur J Epidemiol ; 36(6): 641-647, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34114185

RESUMO

Previous studies have found an association between recessions and increased rates of suicide. In the present study we widened the focus to examine the association between economic uncertainty and suicides. We used monthly suicide data from the US at the State level from 2000 to 2017 and combined them with the monthly economic uncertainty index. We followed a panel data econometric approach to study the association between economic uncertainty and suicide, controlling for unemployment and other indicators. Economic uncertainty is positively associated with suicide when controlling for unemployment [coeff: 8.026; 95% CI: 3.692-12.360] or for a wider range of economic and demographic characteristics [coeff: 7.478; 95% CI: 3.333-11.623]. An increase in the uncertainty index by one percent is associated with an additional 11-24.4 additional monthly suicides in the US. Economic uncertainty is likely to act as a trigger, which underlines the impulsive nature of some suicides. This highlights the importance of providing access to suicide prevention interventions (e.g. hotlines) during periods of economic uncertainty.


Assuntos
Recessão Econômica/estatística & dados numéricos , Suicídio/economia , Suicídio/estatística & dados numéricos , Incerteza , Desemprego/estatística & dados numéricos , Adulto , Feminino , Humanos , Masculino , Modelos Econométricos , Suicídio/psicologia , Desemprego/psicologia , Estados Unidos/epidemiologia
6.
Hosp Pract (1995) ; 49(4): 232-239, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33866912

RESUMO

The COVID-19 pandemic caused the United States to hit record numbers of COVID-19 cases: peak unemployment of 14.7%, an increase in $4 trillion in national debt, and an estimated 3.4% GDP decline. The current socio-economic environment the pandemic created is just an earthquake that can create a tsunami that is bound to hit the healthcare system and can be felt around the globe. This tsunami is composed of a post-pandemic increase in healthcare facilities admission of indigent patients, decrease in medical reimbursement, and high operating costs to maintain healthcare workers, which can cause a synergistic effect that can lead to healthcare facilities experiencing significant negative total revenue. Time is of the essence, and it is imperative to make a collective effort from all healthcare professionals and legislatures to shift the nation's attention to the issue at hand that can threaten the closure of many healthcare facilities post-pandemic.


Assuntos
COVID-19/economia , COVID-19/epidemiologia , Setor de Assistência à Saúde/organização & administração , COVID-19/prevenção & controle , Vacinas contra COVID-19/provisão & distribuição , Controle de Doenças Transmissíveis/economia , Recessão Econômica/estatística & dados numéricos , Setor de Assistência à Saúde/economia , Gastos em Saúde/estatística & dados numéricos , Humanos , Pandemias , Pobreza , SARS-CoV-2 , Fatores Socioeconômicos , Estados Unidos/epidemiologia
7.
Int J Behav Nutr Phys Act ; 18(1): 57, 2021 04 29.
Artigo em Inglês | MEDLINE | ID: mdl-33926455

RESUMO

BACKGROUND: The 2008 Great Recession significantly impacted economies and individuals globally, with potential impacts on food systems and dietary intake. We systematically reviewed evidence on the impact of the Great Recession on individuals' dietary intake globally and whether disadvantaged individuals were disproportionately affected. METHODS: We searched seven databases and relevant grey literature through June 2020. Longitudinal quantitative studies with the 2008 recession as the exposure and any measure of dietary intake (energy intake, dietary quality, and food/macronutrient consumption) as the outcome were eligible for inclusion. Eligibility was independently assessed by two reviewers. The Newcastle Ottawa Scale was used for quality and risk of bias assessment. We undertook a random effects meta-analysis for changes in energy intake. Harvest plots were used to display and summarise study results for other outcomes. The study was registered with PROSPERO (CRD42019135864). RESULTS: Forty-one studies including 2.6 million people met our inclusion criteria and were heterogenous in both methods and results. Ten studies reported energy intake, 11 dietary quality, 34 food intake, and 13 macronutrient consumption. The Great Recession was associated with a mean reduction of 103.0 cal per adult equivalent per day (95% Confidence Interval: - 132.1, - 73.9) in high-income countries (5 studies) and an increase of 105.5 cal per adult per day (95% Confidence Interval: 72.8, 138.2) in middle-income countries (2 studies) following random effects meta-analysis. We found reductions in fruit and vegetable intake. We also found reductions in intake of fast food, sugary products, and soft drinks. Impacts on macronutrients and dietary quality were inconclusive, though suggestive of a decrease in dietary quality. The Great Recession had greater impacts on dietary intake for disadvantaged individuals. CONCLUSIONS: The 2008 recession was associated with diverse impacts on diets. Calorie intake decreased in high income countries but increased in middle income countries. Fruit and vegetable consumption reduced, especially for more disadvantaged individuals, which may negatively affect health. Fast food, sugary products, and soft drink consumption also decreased which may confer health benefits. Implementing effective policies to mitigate adverse nutritional changes and encourage positive changes during the COVID-19 pandemic and other major economic shocks should be prioritised.


Assuntos
Dieta/estatística & dados numéricos , Recessão Econômica , COVID-19 , Bebidas Gaseificadas/estatística & dados numéricos , Ingestão de Alimentos , Recessão Econômica/história , Recessão Econômica/estatística & dados numéricos , Frutas , História do Século XXI , Humanos , Pandemias , Verduras
8.
Health Serv Res ; 56(4): 655-667, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-33660277

RESUMO

OBJECTIVE: We examine whether broadened access to Medicaid helped insulate households from declines in health coverage and health care access linked to the 2007-2009 Great Recession. DATA SOURCE: 2004-2010 Behavioral Risk Factor Surveillance System (BRFSS). STUDY DESIGN: Flexible difference-in-difference regressions were used to compare the impact of county-level unemployment on health care access in states with generous Medicaid eligibility guidelines versus states with restrictive guidelines. DATA COLLECTION/EXTRACTION METHODS: Nonelderly adults (aged 19-64) in the BRFSS were linked to county unemployment rates from the Bureau of Labor Statistics' Local Area Unemployment Statistics Program. We created a Medicaid generosity index by simulating the share of a nationally representative sample of adults that would be eligible for Medicaid under each state's 2007 Medicaid guidelines using data from the 2007 Current Population Survey's Annual Social and Economic Supplement. PRINCIPAL FINDINGS: A percentage point (PPT) increase in the county unemployment rate was associated with a 1.3 PPT (95% CI: 0.9-1.6, P < .01) increase in the likelihood of being uninsured and a 0.86 PPT (95% CI: 0.6-1.1, P < .01) increase in unmet medical needs due to cost in states with restrictive Medicaid eligibility guidelines. Conversely, a one PPT increase in unemployment was associated with only a 0.64 PPT (P < .01) increase in uninsurance among states with the most generous eligibility guidelines. Among states in the fourth quartile of generosity (ie, most generous), rises in county-level unemployment were associated with a 0.68 PPT (P < .10) increase in unmet medical needs due to cost-a 21% smaller decrease relative to states with the most restrictive Medicaid eligibility guidelines. CONCLUSIONS: Increased access to Medicaid during the Great Recession mitigated the effects of increased unemployment on the rate of unmet medical need, particularly for adults with limited income.


Assuntos
Recessão Econômica/estatística & dados numéricos , Acesso aos Serviços de Saúde/estatística & dados numéricos , Medicaid/estatística & dados numéricos , Adulto , Sistema de Vigilância de Fator de Risco Comportamental , Feminino , Humanos , Cobertura do Seguro/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Desemprego/estatística & dados numéricos , Estados Unidos , Adulto Jovem
9.
Int J Equity Health ; 20(1): 79, 2021 03 16.
Artigo em Inglês | MEDLINE | ID: mdl-33726753

RESUMO

BACKGROUND: The Great Recession, starting in 2008, was characterized by an overall reduction in living standards. This pushed several governments across Europe to restrict expenditures, also in the area of healthcare. These austerity measures are known to have affected access to healthcare, probably unevenly among social groups. This study examines the unequal effects of retrenchment in healthcare expenditures on access to medical care for different income groups across European countries. METHOD: Using data of two waves (2008 and 2014) of the European Union Statistics of Income and Living Conditions survey (EU-SILC), a difference-in-differences (DD) approach was used to analyse the overall change in unmet medical needs over time within and between countries. By adding another interaction, the differences in the effects between income quintiles (difference-in-difference-in-differences: DDD) were estimated. To do so, comparisons between two pairs of a treatment and a control case were made: Iceland versus Sweden, and Ireland versus the United Kingdom. These comparisons are made between countries with recessions equal in magnitude, but with different levels of healthcare cuts. This strategy allows isolating the effect of cuts, net of the severity of the recession. RESULTS: The DD-estimates show a higher increase of unmet medical needs during the Great Recession in the treatment cases (Iceland vs. Sweden: + 3.24 pp.; Ireland vs. the United Kingdom: + 1.15 pp). The DDD-estimates show different results over the two models. In Iceland, the lowest income groups had a higher increase in unmet medical needs. This was not the case in Ireland, where middle-class groups saw their access to healthcare deteriorate more. CONCLUSION: Restrictions on health expenditures during the Great Recession caused an increase in self-reported unmet medical needs. The burden of these effects is not equally distributed; in some cases, the lower-income groups suffer most. The case of Ireland, nevertheless, shows that certain policy measures may relatively spare lower-income groups while affecting middle-class income groups more. These results bring in evidence that policies can reduce and even overshoot the general effect of income inequalities on access to healthcare.


Assuntos
Recessão Econômica/estatística & dados numéricos , Gastos em Saúde , Acesso aos Serviços de Saúde/estatística & dados numéricos , Necessidades e Demandas de Serviços de Saúde , Disparidades nos Níveis de Saúde , Disparidades em Assistência à Saúde/economia , Disparidades em Assistência à Saúde/estatística & dados numéricos , Humanos , Renda , Pobreza , Classe Social , Fatores Socioeconômicos
10.
Eur Addict Res ; 27(4): 239-241, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33477135

RESUMO

The ongoing COVID-19 pandemic is likely to have a profound impact on the lives of high-risk drug users and on the services responding to their needs in at least two important ways: first, through the restrictive measures introduced to mitigate the spread of the virus and, second, as a result of extensive economic downturn. Currently there is great uncertainty as to the future intensity and duration of the pandemic. In addition, the lessons we have been able to learn from previous economic downturns may be of limited applicability to the current situation, which differs in a number of significant respects. Experience nevertheless suggests that the potential consequences for drug users' health and well-being may be severe. The ongoing uncertainty serves to underline the importance of close monitoring of the drug situation and preparing flexible and innovative solutions to be able to meet new challenges which may arise.


Assuntos
COVID-19/economia , COVID-19/prevenção & controle , Usuários de Drogas/estatística & dados numéricos , Recessão Econômica/estatística & dados numéricos , Distanciamento Físico , Transtornos Relacionados ao Uso de Substâncias/reabilitação , Intervenção na Crise , Usuários de Drogas/psicologia , Saúde , Humanos , Pandemias , Transtornos Relacionados ao Uso de Substâncias/economia , Incerteza
11.
J Gerontol B Psychol Sci Soc Sci ; 76(5): 1005-1014, 2021 04 23.
Artigo em Inglês | MEDLINE | ID: mdl-32227082

RESUMO

OBJECTIVES: This research compares three cohorts of individuals in their fifth decade of life and examines whether sleep problems are greater in cohorts following the Great Recession. We argue that these differences will occur because postrecession cohorts are exposed to more economic burdens that harm sleep. We also suggest that postrecession exposure to economic burdens will be amplified among women, leading to greater cross-cohort differences in sleep problems. METHOD: Data were derived from the Health and Retirement Study, focusing on cohort surveys starting in 2004, 2010, and 2016 (N = 12,129). Structural equation models compared cohorts in latent levels of sleep problems and also examined whether economic burdens mediated cohort differences. Interactions tested whether cohort differences varied between men and women. RESULTS: The 2010 and 2016 cohorts had higher mean levels of sleep problems than the 2004 cohort. Greater postrecession exposure to economic burdens largely explained inter-cohort change in sleep problems, with this pattern stronger among women. DISCUSSION: Americans are approaching their senior years increasingly burdened by economic stressors that incur sleep problems. Practitioners and aging researchers should be prepared to address deleterious health consequences created by heightened sleep impairments.


Assuntos
Envelhecimento/psicologia , Recessão Econômica/estatística & dados numéricos , Aposentadoria/psicologia , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Transtornos do Sono-Vigília/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Distúrbios do Início e da Manutenção do Sono/psicologia , Transtornos do Sono-Vigília/psicologia
12.
J Gerontol B Psychol Sci Soc Sci ; 76(5): 956-967, 2021 04 23.
Artigo em Inglês | MEDLINE | ID: mdl-32303760

RESUMO

OBJECTIVES: While home foreclosures are often thought of as a household-level event, the consequences may be far-reaching, and spill over to the broader community. Older adults, in particular, could be affected by the spiral of community changes that result from foreclosures, but we know very little about how the foreclosure crisis is related to older adult health, in particular cognition. METHOD: This article uses growth curve models and data from the Health and Retirement Study matched to Census and county-level foreclosure data to examine whether community foreclosures are related to older adults' cognitive health and the mechanisms responsible. RESULTS: We find that higher rates of county-level foreclosures are associated with a faster decline in individual cognition at older ages. Although we examined an extensive number of individual and community mechanisms, including individual housing wealth and depressive symptoms, community structural factors, social factors, and perceptions of physical disorder and cohesion, none of the mechanisms examined here explained this relationship. DISCUSSION: This study shows that the adverse consequences of home foreclosures spill over to the local community, with implications for the cognitive health of older adults.


Assuntos
Recessão Econômica/estatística & dados numéricos , Habitação/economia , Saúde Mental/estatística & dados numéricos , Características de Residência/estatística & dados numéricos , Idoso , Cognição , Disfunção Cognitiva/epidemiologia , Feminino , Disparidades nos Níveis de Saúde , Humanos , Masculino , Fatores Socioeconômicos
13.
Psychiatr Rehabil J ; 44(2): 132-141, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33030932

RESUMO

Objective: To examine variation in employment and economic outcomes before, during, and after the great recession by disability and mental health status. Methods: Using a sample of adults in the 1999 to 2016 National Health Interview Survey (N = 419,336), we examined changes in labor force and economic outcomes by mental health and physical disability status. We employed difference-in-differences analyses to determine whether the changes in these outcomes during and after the recession for each comparison group (those with moderate mental illness, serious psychiatric disability, or physical disability) were significantly different from the changes for persons with neither a mental illness nor a disability. Findings: While the recession impacted all groups, those with mental illnesses or physical disabilities were hardest hit. Persons with disabilities were disadvantaged on all outcomes at each period, but persons with mental illnesses were the most disadvantaged. Unemployment, poverty, and use of food stamps increased for all groups, but the increase was greatest for persons with mental health problems who also saw a more substantial decline in wage income. Conclusions and Implications for Practice: The effects of the recession persist well after the recovery period. Practitioners should be aware that although most persons with mental illnesses want to work, they face significant barriers to employment. Following economic shocks such as those brought on by the current coronavirus pandemic, interventions should focus on people who are the most vulnerable, especially those with mental health problems. Renewed focus on employment for people with mental disorders is important. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Assuntos
COVID-19 , Pessoas com Deficiência , Recessão Econômica/estatística & dados numéricos , Transtornos Mentais , Desemprego/estatística & dados numéricos , Adulto , COVID-19/economia , COVID-19/epidemiologia , COVID-19/psicologia , Pessoas com Deficiência/reabilitação , Pessoas com Deficiência/estatística & dados numéricos , Status Econômico/estatística & dados numéricos , Emprego/estatística & dados numéricos , Feminino , Disparidades nos Níveis de Saúde , Humanos , Masculino , Transtornos Mentais/economia , Transtornos Mentais/epidemiologia , Transtornos Mentais/reabilitação , Saúde Mental/economia , Pessoa de Meia-Idade , SARS-CoV-2 , Estados Unidos/epidemiologia , Populações Vulneráveis
14.
Dis Esophagus ; 34(2)2021 Feb 10.
Artigo em Inglês | MEDLINE | ID: mdl-32766686

RESUMO

The aim of this study is to describe outcomes of esophageal cancer surgery in a quaternary upper gastrointestinal (GI) center in Athens during the era of the Greek financial crisis. We performed a retrospective analysis of patients that underwent esophagectomy for esophageal or gastroesophageal junction (GEJ) cancer at an upper GI unit of the University of Athens, during the period January 2004-June 2019. Time-to-event analyses were performed to explore trends in survival and recurrence. A total of 146 patients were identified. Nearly half of the patients (49.3%) underwent surgery during the last 4 years of the financial crisis (2015-2018). Mean age at the time of surgery was 62.3 ± 10.3 years, and patients did not present at older ages during the recession (P = 0.50). Most patients were stage III at the time of surgery both prior to the recession (35%) and during the financial crisis (39.8%, P = 0.17). Ivor-Lewis was the most commonly performed procedure (67.1%) across all eras (P = 0.06). Gastric conduit was the most common form of GI reconstruction (95.9%) following all types of surgery (P < 0.001). Pre-recession anastomoses were usually performed using a circular stapler (65%). Both during (88.1%) and following the recession (100%), the vast majority of anastomoses were hand-sewn. R0 resection was achieved in 142 (97.9%) patients. Anastomosis technique did not affect postoperative leak (P = 0.3) or morbidity rates (P = 0.1). Morbidity rates were not significantly different prior to (25%), during (46.9%), and after (62.5%) the financial crisis, P = 0.16. Utilization of neoadjuvant chemotherapy (26.9%, P = 0.90) or radiation (8.4%, P = 0.44) as well as adjuvant chemotherapy (54.8%, P = 0.85) and irradiation (13.7%, P = 0.49) was the same across all eras. Disease-free survival (DFS) and all-cause mortality rates were 41.2 and 47.3%, respectively. Median DFS and observed survival (OS) were 11.3 and 22.7 months, respectively. The financial crisis did not influence relapse (P = 0.17) and survival rates (P = 0.91). The establishment of capital controls also had no impact on recurrence (P = 0.18) and survival (P = 0.94). Austerity measures during the Greek financial crisis did not influence long-term esophageal cancer outcomes. Therefore, achieving international standards in esophagectomy may be possible in resource-limited countries when centralizing care.


Assuntos
Recessão Econômica , Neoplasias Esofágicas , Esofagectomia , Idoso , Terapia Combinada/economia , Terapia Combinada/métodos , Terapia Combinada/estatística & dados numéricos , Recessão Econômica/estatística & dados numéricos , Neoplasias Esofágicas/economia , Neoplasias Esofágicas/cirurgia , Esofagectomia/efeitos adversos , Esofagectomia/economia , Esofagectomia/métodos , Esofagectomia/estatística & dados numéricos , Feminino , Estresse Financeiro/epidemiologia , Grécia/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
15.
PLoS One ; 15(12): e0244130, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33326495

RESUMO

The coronavirus pandemic led to a severe economic shock in the United States. This paper uses a unique survey data collected early on in the pandemic to measure economic deprivation among individuals. The Federal Reserve Board fielded a Survey of Household Economics and Decision-making (SHED) in April 2020. This survey is used to compile data on four indicators of economic deprivation, namely: i) Overall financial condition, ii) Loss of employment, iii) Reduction in income and iv) Inability to pay bills in full. Data on these indicators is compiled for each individual and is used in a novel way to construct a set of multidimensional deprivation indices. These indices measure the overlap of deprivations experienced by an individual. Results show that almost 25 percent of the respondents faced hardships in at least two of the four indicators. More than 13 percent of adults reported their inability to pay monthly bills and struggled to make ends meet financially. One in four respondents had lower income compared to income from previous month. The economic shock affected Hispanics in a more profound way. More than 37 percent Hispanics reported hardship in two or more indicators and 8 percent reported hardship in all four indicators. Higher proportion of young adults and those without a college degree suffered multiple hardships. The paper highlights the plight of Americans during the early months of the economic crisis set in motion amid the coronavirus pandemic and sheds light on how economic disparities deepened along racial/ethnic lines.


Assuntos
COVID-19/patologia , Recessão Econômica/estatística & dados numéricos , Adolescente , Adulto , COVID-19/epidemiologia , COVID-19/virologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pobreza/etnologia , Análise de Regressão , SARS-CoV-2/isolamento & purificação , Estados Unidos/epidemiologia , Adulto Jovem
16.
Global Health ; 16(1): 118, 2020 12 17.
Artigo em Inglês | MEDLINE | ID: mdl-33334370

RESUMO

BACKGROUND: Since 2016 Venezuela has seen a collapse in its economy and public health infrastructure resulting in a humanitarian crisis and massive outward migration. With the emergence of the novel coronavirus SARS-CoV-2 at the end of 2019, the public health emergency within its borders and in neighboring countries has become more severe and as increasing numbers of Venezuelans migrants return home or get stuck along migratory routes, new risks are emerging in the region. RESULTS: Despite clear state obligations to respect, protect and fulfil the rights to health and related economic, social, civil and political rights of its population, in Venezuela, co-occurring malaria and COVID-19 epidemics are propelled by a lack of public investment in health, weak governance, and violations of human rights, especially for certain underserved populations like indigenous groups. COVID-19 has put increased pressure on Venezuelan and regional actors and healthcare systems, as well as international public health agencies, to deal with a domestic and regional public health emergency. CONCLUSIONS: International aid and cooperation for Venezuela to deal with the re-emergence of malaria and the COVID-19 spread, including lifting US-enforced economic sanctions that limit Venezuela's capacity to deal with this crisis, is critical to protecting rights and health in the country and region.


Assuntos
COVID-19/prevenção & controle , Emigração e Imigração/estatística & dados numéricos , Direitos Humanos/normas , Malária/transmissão , COVID-19/epidemiologia , Recessão Econômica/estatística & dados numéricos , Direitos Humanos/tendências , Humanos , Malária/epidemiologia , Refugiados/estatística & dados numéricos , Venezuela/epidemiologia
17.
Int J Health Econ Manag ; 20(4): 391-421, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33025350

RESUMO

Many theoretical and empirical studies have analyzed the relationship between the economic cycle and tobacco consumption using the GDP and unemployment rates as the key variables for measuring economic phases. However, few studies focus on the pathways that cause tobacco consumption to be linked with the economic cycle, and there are no studies analyzing the heterogeneous effects underlying this relationship across nations and regions. This article explores the relationship and its pathways in 16 Spanish regions for the period 1989-2018. To this end, we apply a Granger causality analysis based on the augmented vector autoregressive (VAR) model in levels and extra lags. This method provides more efficient and robust results than the standard VAR model, which can lead to biased results with limited samples, especially in a region-by-region analysis. The empirical results suggest that the impact of the business cycle on tobacco consumption is heterogeneous and specific to each region. In addition, although recession phases cause a decline in tobacco consumption in Spain, in line with the literature, this procyclical relationship does not occur for expansion phases in all regions. One of the main findings of this article is that in expansion phases, tobacco consumption is sensitive to GDP, while in recession phases, tobacco consumption is affected by unemployment. National and regional governments should consider these results when they develop smoking control policies because homogeneous strategies can lead to heterogeneous results. Thus, the results can be useful for policymakers dealing with tobacco control strategies.


Assuntos
Economia/estatística & dados numéricos , Uso de Tabaco/economia , Uso de Tabaco/epidemiologia , Desemprego/estatística & dados numéricos , Interpretação Estatística de Dados , Desenvolvimento Econômico/estatística & dados numéricos , Recessão Econômica/estatística & dados numéricos , Humanos , Espanha/epidemiologia
18.
Demography ; 57(6): 2199-2220, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33051832

RESUMO

Analyses of the Health and Retirement Study (HRS) between 1992 and 2014 compare the relationship between different levels and forms of debt and heart attack risk trajectories across four cohorts. Although all cohorts experienced growing household debt, including the increase of both secured and unsecured debt, they nevertheless encountered different economic opportunity structures and crises at sensitive times in their life courses, with implications for heart attack risk trajectories. Results from frailty hazards models reveal that unsecured debt is associated with increased risk of heart attack across all cohorts. Higher levels of housing debt, however, predict higher rates of heart attack among only the earlier cohorts. Heart attack risk trajectories for Baby Boomers with high levels of housing debt are lower than those of same-aged peers with no housing debt. Thus, the relationship between debt and heart attack varies by level and form of debt across cohorts but distinguishes Baby Boomer cohorts based on their diverse exposures to volatile housing market conditions over the sensitive household formation period of the life course.


Assuntos
Renda/estatística & dados numéricos , Infarto do Miocárdio/epidemiologia , Fatores Etários , Estudos de Coortes , Recessão Econômica/estatística & dados numéricos , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Grupos Raciais , Fatores de Risco , Fatores Sexuais , Fatores Socioeconômicos
19.
Ann Glob Health ; 86(1): 112, 2020 09 03.
Artigo em Inglês | MEDLINE | ID: mdl-32944509

RESUMO

Background: Although "social isolation" protects the life and health of Vietnamese citizens from the adverse effects of the COVID-19 pandemic, it also triggers massive reductions in the economic activities of the country. Objective: our study aimed to identify negative impacts of COVID-19 on occupations of Vietnamese people during the first national lockdown, including the quality and quantity of jobs as well as adverse problems at work due to COVID-19. Methods: A cross-sectional study using web-based platforms was conducted during the first time of social isolation in Vietnam at the beginning of April 2020. We utilized a respondent-driven sampling technique to select 1423 respondents from 63 cities and provinces over Vietnam. Exploratory factor analysis (EFA) was used to define sub-domains of perceived impacts of COVID-19 on occupations. Findings: Approximately two-thirds of respondents reported decreases in their income (61.6%), and 28.2% reported that their income deficit was 40% and above. The percentage of female individuals having decreased revenue due to COVID-19 was higher than that of male respondents (65.2% and 54.7%, respectively). "Worry that colleagues exposed to COVID-19 patients" and "Being alienated because employment-related to COVID-19" accounted for the highest score in each factor. Compared to healthcare workers, being self-employed/unemployed/retired were less likely to suffer from "Increased workload and conflicts due to COVID-19" and "Disclosure and discrimination related to COVID-19 work exposure." Conclusion: Our study revealed a drastic reduction in both the quality and quantity of working, as well as the increased fear and stigmatization of exposure to COVID-19 at workplaces. Health protection and economic support are immediate targets that should be focused on when implementing policies and regulations.


Assuntos
Controle de Doenças Transmissíveis , Infecções por Coronavirus , Recessão Econômica/estatística & dados numéricos , Emprego/estatística & dados numéricos , Pandemias , Pneumonia Viral , Adulto , Betacoronavirus , COVID-19 , Controle de Doenças Transmissíveis/métodos , Controle de Doenças Transmissíveis/organização & administração , Infecções por Coronavirus/economia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Estudos Transversais , Feminino , Humanos , Renda/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Determinação de Necessidades de Cuidados de Saúde , Pandemias/economia , Pandemias/prevenção & controle , Pneumonia Viral/economia , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , SARS-CoV-2 , Controle Social Formal/métodos , Vietnã/epidemiologia , Desempenho Profissional , Carga de Trabalho/estatística & dados numéricos
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