Crisis Económica

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A "Before and After" in the Use of Emergency Services in Spain? The Impact of the Economic Crisis

The objective of this study was to analyse whether variables associated with emergency services (ES) use in Spain have changed in the period 2006-2011 using a comparative analysis of the 2006 and 2011 Spanish National Health Surveys. The measure of association was the prevalence ratio with its 95% confidence interval, obtained by Poisson regression with robust variance. We studied interactions between the explanatory variables for ES use and year and subsequently performed a stratified analysis by year. ES use declined by 2.1% in 2011. Most emergency care (approximately 60% in both surveys) was provided in public hospitals. Between 2006 and 2011, ES use increased by 9% in women (p for interaction=0.008) [ref. men], 3% in persons with poor mental health (p for interaction=0.072) [ref. good mental health], and 8% in individuals with limitations on activities of daily living (p for interaction=0.006) [ref. no limitations]. The change in the effect of the variables sex, mental health, and limitations on activities of daily living on use of ES (2006 and 2011) is not explained by either demographic characteristics or individual socioeconomic indicators. These results could be associated with macroeconomic and structural changes occurring during the period 2006-2011.

TipoComunicaciones/Informes/Artículos (individual)
Publicado en ODS2016-04-14

Economic crisis and suicides in Spain. Socio-demographic and regional variability

Background: Evidence from previous recessions suggests that at times of economic deterioration, suicides increase. Spain has been one of the European countries hardest hit by the financial crisis that started in 2008. The aim of this paper is to examine the impact of the double-dip recession in Spain on the most recent trends in suicide.Methods: Suicide data from the years 2002-2012 were obtained from the "Death Statistic according to Cause of Death" of the National Statistics Institute (NSI). Population figures were obtained from the population estimates of the NSI.Results: While the suicide rate decreased between 2002 and 2012, the downward trend has reversed twice, in 2008-2009, and in 2012. This rise was particularly pronounced in males, with the rate ratio of 1.12 (95 % CI 1.05-1.20) in 2008 and 1.10 (95 % CI 1.03-1.18) in 2009. Following a decrease in 2010 and 2011, suicides among males have increased again in 2012-with RR of 1.10 (95 % CI 1.03-1.18) compared to 2007, however the difference between 2011 amounted to 14 % rise- the biggest interannual change in a decade. There was a similar but less pronounced pattern in females. Regional data showed variable results.Conclusions:These results suggest that the Spanish economic crisis has been associated with suicide rates in 2008, 2009, and 2012. These findings are consistent with the double-dip recession that Spain experienced.

TipoComunicaciones/Informes/Artículos (individual)
Publicado en ODS2016-03-31

Crisis, suicide and labour productivity losses in Spain

Crisis, suicide and labour productivity losses in Spain Objectives: Suicide became the first cause of death between the ages of 15 and 44 in Spain in the year 2013. Moreover, the suicide rate in Spain went up by more than 9 % with respect to the previous year. This increase could be related to the serious economic recession that Spain has been experiencing in recent years. In this sense, there is a lack of evidence to help assess to what extent these suicides have a social cost in terms of losses in human capital. Firstly, this article examines the relationship between the variables related to the economic cycle and the suicide rates in the 17 Spanish regions. Secondly, an estimate is made of the losses in labour productivity owing to these suicides.Methodology: In this article, panel data models are used to consider different variables related to the economic cycle. Demographic variables and the suicide rates for regions across Spain from 2002 to 2013 also come into play. The present and future production costs owing to premature death from suicide are calculated using a human capital model. These costs are valued from the gross salary that an individual no longer receives in the future at the very moment he or she leaves the labour market.Results: The results provide a strong indication that a decrease in economic growth and an increase in unemployment negatively affect suicide rates. Due to suicide, 38,038 potential years of working life were lost in 2013. This has an estimated cost of over 565 million euros.Conclusions:The eco ...

TipoComunicaciones/Informes/Artículos (individual)
Publicado en ODS2016-03-02

The impact of the Great Recession on mental health and its inequalities: the case of a Southern European region, 1997-2013

The impact of the Great Recession on mental health and its inequalities: the case of a Southern European region, 1997-2013 Background: Numerous studies have shown that macroeconomic changes have a great influence on health, prompting different concerns in recent literature about the effects of the current recession. The objetive of the study was to assess the changes in the mental health of the working-age population in the Basque Country (Spain) and its social inequalities following the onset of the 2008 recession, with special focus on the role of unemployment. Methods: Repeated cross-sectional study on the population aged 16-64, using four Basque Health Surveys (1997-2013). Age-adjusted prevalences of poor mental health and incremental prevalence ratios (working status and social class adjusted) between years were calculated. Absolute/relative measures of social inequalities were also calculated. Results: From 2008, there was a clear deterioration in the mental health, especially among men. Neither changes in employment status nor social class accounted for these changes. In men, the deterioration affected all working status categories, except the retired but significant changes occurred only among the employed. In women, poor mental health significantly increased among the unemployed. Students were also especially affected. Relative inequalities increased only in men. Conclusions: The Great Recession is being accompanied by adverse effects on mental health, which cannot be fully explained by the increase of unemployment. Public health professionals should closely monitor the medium and lon ...

TipoComunicaciones/Informes/Artículos (individual)
Publicado en ODS2016-02-05

Economic crisis and counter-reform of universal health care systems: Spanish case

The economic crisis that has been affecting Europe in the 21st century has modified social protection systems in the countries that adopted, in the 20th century, universal health care system models, such as Spain. This communication presents some recent transformations, which were caused by changes in Spanish law. Those changes relate to the access to health care services, mainly in regards to the provision of care to foreigners, to financial contribution from users for health care services, and to pharmaceutical assistance. In crisis situations, reforms are observed to follow a trend which restricts rights and deepens social inequalities.

TipoComunicaciones/Informes/Artículos (individual)
Publicado en ODS2015-07-17

Emergència habitacional a Catalunya. Impacte de la crisi hipotecària en el dret a la salut i els drets dels infants

L’objectiu d’aquest informe és analitzar la situació d’emergència habitacional que afecta Catalunya des d’una perspectiva de drets. Per a fer-ho, s’estudien, d’una banda, els compromisos jurídics assumits pel Govern de Catalunya en matèria de dret a l’habitatge, i de l’altra els impactes concrets que suposen les execucions hipotecàriesi els desnonaments per a les persones afectades. A partir dels resultats de l’estudi Emergencia habitacional en el Estado español. La crisis de las ejecuciones hipotecarias y los desalojos desde una perspectiva de derechoshumanos, publicat conjuntament entre l’Observatori DESC i la Plataforma d’Afectats per la Hipoteca, aquest informe respon a la necessitat d’abordar la problemàtica des d’una perspectiva integral.Això significa tenir cura dels impactes de la vulneració del dret a l’habitatge en el gaudiment d’altres drets per part de tots els membres de la llar. El present document,en particular, estudia els efectes de la crisi habitacional en la salut física i mental de les persones afectades, i fa especial atenció a la situació dels menors que integren la unitat familiar.

TipoComunicaciones/Informes/Artículos (individual)
Publicado en ODS2015-06-19

Emergència habitacional a Catalunya. Impacte de la crisi hipotecària en el dret a la salut i els drets dels infants

L’objectiu d’aquest informe és analitzar la situació d’emergència habitacional que afecta Catalunya des d’una perspectiva de drets. Per a fer-ho, s’estudien, d’una banda, els compromisos jurídics assumits pel Govern de Catalunya en matèria de dret a l’habitatge, i de l’altra els impactes concrets que suposen les execucions hipotecàriesi els desnonaments per a les persones afectades. A partir dels resultats de l’estudi Emergencia habitacional en el Estado español. La crisis de las ejecuciones hipotecarias y los desalojos desde una perspectiva de derechoshumanos, publicat conjuntament entre l’Observatori DESC i la Plataforma d’Afectats per la Hipoteca, aquest informe respon a la necessitat d’abordar la problemàtica des d’una perspectiva integral. Això significa tenir cura dels impactes de la vulneració del dret a l’habitatge en el gaudiment d’altres drets per part de tots els membres de la llar. El present document, en particular, estudia els efectes de la crisi habitacional en la salut física i mental de les persones afectades, i fa especial atenció a la situació dels menors que integren la unitat familiar.

TipoComunicaciones/Informes/Artículos (individual)
Publicado en ODS2015-06-19

Emergència habitacional a Catalunya. Impacte de la crisi hipotecària en el dret a la salut i els drets dels infants

Emergència habitacional a Catalunya. Impacte de la crisi hipotecària en el dret a la salut i els drets dels infants L’objectiu d’aquest informe és analitzar la situació d’emergència habitacional que afecta Catalunya des d’una perspectiva de drets. Per a fer-ho, s’estudien, d’una banda, els compromisos jurídics assumits pel Govern de Catalunya en matèria de dret a l’habitatge, i de l’altra els impactes concrets que suposen les execucions hipotecàriesi els desnonaments per a les persones afectades. A partir dels resultats de l’estudi Emergencia habitacional en el Estado español. La crisis de las ejecuciones hipotecarias y los desalojos desde una perspectiva de derechoshumanos, publicat conjuntament entre l’Observatori DESC i la Plataforma d’Afectats per la Hipoteca, aquest informe respon a la necessitat d’abordar la problemàtica des d’una perspectiva integral. Això significa tenir cura dels impactes de la vulneració del dret a l’habitatge en el gaudiment d’altres drets per part de tots els membres de la llar. El present document, en particular, estudia els efectes de la crisi habitacional en la salut física i mental de les persones afectades, i fa especial atenció a la situació dels menors que integren la unitat familiar.

TipoComunicaciones/Informes/Artículos (individual)
Publicado en ODS2015-06-19

Economic crisis, health systems and health in Europe: country experiences

Economic crisis, health systems and health in Europe: country experiences The financial and economic crisis has had a visible but varied impact on many health systems in Europe, eliciting a wide range of responses from governments faced with increased financial and other pressures. This book maps health system responses by country, providing a detailed analysis of policy changes in nine countries and shorter overviews of policy responses in 47 countries. It draws on a large study involving over one hundred health system experts and academic researchers across Europe. Focusing on policy responses in three areas – public funding of the health system, health coverage and health service planning, purchasing and delivery – this book gives policymakers, researchers and others valuable, systematic information about national contexts of particular interest to them, ranging from countries operating under the fiscal and structural conditions of international bailout agreements to those that, while less severely affected by the crisis, still have had to operate in a climate of diminished public sector spending since 2008. Along with a companion volume that analyses the impact of the crisis across countries, this book is part of a wider initiative to monitor the effects of the crisis on health systems and health, to identify those policies most likely to sustain the performance of health systems facing fiscal pressure and to gain insight into the political economy of implementing reforms in a crisis.

TipoComunicaciones/Informes/Artículos (individual)
Publicado en ODS2015-06-15

The impact of economic crises on social inequalities in health: what do we know so far?

Since 2008, Western countries are going through a deep economic crisis whose health impacts seem to be fundamentally counter-cyclical: when economic conditions worsen, so does health, and mortality tends to rise. While a growing number of studies have presented evidence on the effect of crises on the average population health, a largely neglected aspect of research is the impact of crises and the related political responses on social inequalities in health, even if the negative consequences of the crises are primarily borne by the most disadvantaged populations. This commentary will reflect on the results of the studies that have analyzed the effect of economic crises on social inequalities in health up to 2013. With some exceptions, the studies show an increase in health inequalities during crises, especially during the Southeast Asian and Japanese crises and the Soviet Union crisis, although it is not always evident for both sexes or all health or socioeconomic variables. In the Nordic countries during the nineties, a clear worsening of health equity did not occur. Results about the impacts of the current economic recession on health equity are still inconsistent. Some of the factors that could explain this variability in results are the role of welfare state policies, the diversity of time periods used in the analyses, the heterogeneity of socioeconomic and health variables considered, the changes in the socioeconomic profile of the groups under comparison in times of cris ...

TipoComunicaciones/Informes/Artículos (individual)
Publicado en ODS2014-09-16

Do Generous Unemployment Benefit Programs Reduce Suicide Rates? A State Fixed-Effect Analysis Covering 1968-2008

aje.oxfordjournals.org

Do Generous Unemployment Benefit Programs Reduce Suicide Rates? A State Fixed-Effect Analysis Covering 1968-2008 The recent economic recession has led to increases in suicide, but whether US state unemployment insurance programs ameliorate this association has not been examined. Exploiting US state variations in the generosity of benefit programs between 1968 and 2008, we tested the hypothesis that more generous unemployment benefit programs reduce the impact of economic downturns on suicide. Using state linear fixed-effect models, we found a negative additive interaction between unemployment rates and benefits among the US working-age (20-64 years) population (? = -0.57, 95% confidence interval: -0.86, -0.27; P < 0.001). The finding of a negative additive interaction was robust across multiple model specifications. Our results suggest that the impact of unemployment rates on suicide is offset by the presence of generous state unemployment benefit programs, though estimated effects are small in magnitude.

TipoComunicaciones/Informes/Artículos (individual)
Publicado en ODS2014-09-08

Impact of unemployment variations on suicide mortality in Western European countries (2000-2010)

jech.bmj.com

Impact of unemployment variations on suicide mortality in Western European countries (2000-2010) BACKGROUND:A scientific debate is currently taking place on whether the 2008 economic crisis caused an increase in suicide rates. Our main objective was to assess the impact of unemployment rate on suicide rate in Western European countries between 2000 and 2010. We then tried to estimate the excess number of suicides attributable to the increase of unemployment during the 2008-2010 economic crisis.METHODS:The yearly suicide rates were modelled using a quasi-Poisson model, controlling for sex, age, country and a linear time trend. For each country, the unemployment-suicide association was assessed, and the excess number of suicides attributable to the increase of unemployment was estimated. Sensitivity analyses were performed, notably in order to evaluate whether the unemployment-suicide association found was biased by a confounding context effect ('crisis effect').RESULTS:A significant 0.3% overall increase in suicide rate for a 10% increase in unemployment rate (95% CI 0.1% to 0.5%) was highlighted. This association was significant in three countries: 0.7% (95% CI 0.0% to 1.4%) in the Netherlands, 1.0% (95% CI 0.2% to 1.8%) in the UK and 1.9% (95% CI 0.8% to 2.9%) in France, with a significant excess number of suicides attributable to unemployment variations between 2008 and 2010 (respectively 57, 456 and 564). The association was modified inconsistently when adding a 'crisis effect' into the model.CONCLUSIONS:Unemployment and suicide rates are globally statistically associ ...

TipoComunicaciones/Informes/Artículos (individual)
Publicado en ODS2014-09-01

Secuelas a largo plazo de la crisis económica y desigualdades sociales en salud

Al margen de las definiciones oficiales de crisis económica, desde la perspectiva de la salud puede considerarse un fenómeno difuso que se resiste a cronologías precisas. Conceptualmente, ya al inicio de la crisis propusimos los mecanismos y procesos por los que puede acabar afectando a la salud, directa e indirectamente, a corto y a largo plazo. Cuantificar cada uno de ellos requiere métodos rigurosos, indicadores adecuados y tiempo (es decir, distancia temporalsuficiente para que los efectos a largo plazo se puedan apreciar). Porque las consecuencias de la crisis económica sobre la salud tardan más en empezar a percibirse que las que tienen lugar sobre la renta y el bienestar económico de las familias y que los efectos sobre la sanidad. Comparando los cuatro años de crisis (2008-2011) con los previos, los indicadores de mortalidad prematura no muestran empeoramiento y tampoco la salud percibida ni la incidencia de HIV/SIDA.

TipoEditores
Publicado en ODS2014-09-01

Quality of life in Europe: Families in the economic crisis

www.eurofound.europa.eu

The economic crisis has reshaped the lives of millions of European citizens. But how has it affected families with children? Children are more at risk of poverty or social exclusion than the overall population in a large majority of EU countries; hence, it is important to understand how the crisis has affected the households in which these children grow up. This report describes the changing quality of life across the EU for different types of families with children and compares their living standards and social situation. Grouping the EU Member States into four categories on the basis of the flexibility or otherwise of their family policies, it also examines potential patterns that may be related to different family policy approaches. Themes that emerge from the findings include the particular challenges facing lone parents, the greater difficulties facing jobless families since the onset of the crisis, and the increasing extent of conflict parents experience in seeking to balance their work and family lives

TipoComunicaciones/Informes/Artículos (individual)
Publicado en ODS2014-06-25

Informe SESPAS 2014: Crisis Económica y Salud

gacetasanitaria.org/es/

Cuando ya han pasado más de cinco años del inicio de la crisis económica el abordaje continúa siendo el de las causas, consecuencias y medidas económicas mientras que la salud y el bienestar no acaban de situarse en primera línea. Los objetivos del Informe SESPAS 2014 son: a) analizar el impacto de la crisis en la salud y los comportamientos relacionados con la salud, en las desigualdades y en los determinantes de la salud en España; b) describir los cambios en el sistema sanitario español a raíz de las medidas adoptadas para afrontar la crisis y valorar su posible impacto en la salud; c) revisar la evidencia sobre el impacto de otras crisis y de la actual en otros países, así como las respuestas políticas; y d) proponer intervenciones y políticas alternativas a las llevadas a cabo hasta el momento con una perspectiva de salud poblacional y evidencia científica, que ayuden a mitigar el impacto en la salud y en las desigualdades en salud. El Informe se organiza en cinco bloques: 1) crisis económico-financiera y salud, causas, consecuencias y contextos; 2) impacto sobre los determinantes estructurales de la salud y las desigualdades en salud; 3) impacto en salud y en comportamientos relacionados con la salud, e indicadores para la monitorización; 4) impacto sobre los sistemas de salud; y 5) impacto en grupos específicos de población: infancia, personas mayores y población inmigrante. Hay evidencia de la relación de la crisis con la salud de la población española, con las desigu ...

TipoComunicaciones/Informes/Artículos (individual)
Publicado en ODS2014-06-05

Impact of financial crisis on selected health outcomes in Europe

eurpub.oxfordjournals.org

Background: A number of health outcomes were affected by previous financial crises, e.g. suicides, homicides and transport accident mortality. Aim of this study was to analyse the effects of the current financial crisis on selected health outcomes at population level in Europe. Methods: A mixed approach of ecologic and time trend design was applied, including correlation analysis. For eight countries, data on the economic situation (unemployment rate and economic growth) and health indicators (overall mortality, suicide and transport accident mortality) was drawn from EUROSTAT database for 2000–10. Spearman's rank correlation was applied to analyse the influence of social protection on the association between exposure and outcome variables. Results: The financial crisis had no visible effect on overall mortality in any of the eight countries until 2010. Transport accident mortality decreased in all eight countries, in the range of 18% in Portugal to 52% in Slovenia. In contrast, suicide mortality increased in Germany (+5.3%), Portugal (+5.2%), Czech Republic (+7.6%), Slovakia (+22.7%) and Poland (+19.3%). The effect of unemployment on suicide is higher in countries with lower social spending (Spearman's r = ?0.83). Discussion: Clear cause–effect relations could not be established owing to the ecological study design and issues concerning data availability. However, there are clear changes in suicide and transport accident mortality after onset of the crisis, and findings are ...

TipoComunicaciones/Informes/Artículos (individual)
Publicado en ODS2014-05-28

Assesing the short term health impact of the Great Recession in the European Union: A cross-country panel analysis

www.sophie-project.eu/publications.htm

Background:There are great concerns and some initial country-specific, descriptive evidence about potential adverse health consequences of the recent Great Recession. Methods:Using data for 23 European Union countries we examine the short-term impact of macroeconomic decline during the Great Recession on a range of health and health behaviour indicators. We also examine whether the effect differed between countries according to the level of social protection provided. Results:Overall, during the recent recession, an increase of 1 percentage point in the standardised unemployment rate has been associated with a statistically significant decrease in the following mortality rates: all-cause-mortality (3.4%), cardiovascular diseases (3.7%), cirrhosis- and chronic liver disease-related mortality (9.2%), motor vehicle accident-related mortality (11.5%), parasitic infection-related mortality (4.1%), but an increase in the suicide rate (34.1%). In general, the effects were more marked in countries with lower levels of social protection, compared to those with higher levels. Conclusions:An increase in the unemployment rate during the Great Recession has had a beneficial health effect on average across EU countries, except for suicide mortality. Social protection expenditures appear to help countries “smooth” the health response to a recession, limiting health damage but also forgoing potential health gains that could otherwise result.

TipoComunicaciones/Informes/Artículos (individual)
Publicado en ODS2014-04-25

Have health trends worsened in Greece as a result of the financial crisis? A quasi-experimental approach

eurpub.oxfordjournals.org

Background: Health in Greece deteriorated after the recent financial crisis, but whether this decline was caused by the recent financial crisis has not been established. This article uses a quasi-experimental approach to examine the impact of the recent financial crisis on health in Greece. Methods: Data came from the European Union Statistics on Income and Living Conditions survey for the years 2006–09. We applied a difference-in-differences approach that compares health trends before and after the financial crisis in Greece with trends in a control population (Poland) that did not experience a recession and had health trends comparable with Greece before the crisis. We used logistic regression to model the impact of the financial crisis on poor self-rated health, controlling for demographic confounders. Results: Results provide strong evidence of a statistically significant negative effect of the financial crisis on health trends. Relative to the control population, Greece experienced a significantly larger increase in the odds of reporting poor health after the crisis (odds ratio, 1.16; 95% confidence interval, 1.04–1.29). There was no difference in health trends between Poland and Greece before the financial crisis, supporting a causal interpretation of health declines in Greece as a result of the financial crisis. Conclusion: Results provide evidence that trends in self-rated health in Greece worsened as a result of the recent financial crisis. Findings stress the need f ...

TipoComunicaciones/Informes/Artículos (individual)
Publicado en ODS2013-12-09

Impact of 2008 global economic crisis on suicide:time trend study in 54 countries

www.bmj.com

Objective To investigate the impact of the 2008 global economic crisis on international trends in suicide and to identify sex/age groups and countries most affected. Results There were an estimated 4884 (95% confidence interval 3907 to 5860) excess suicides in 2009 compared with the number expected based on previous trends (2000-07). The increases in suicide mainly occurred in men in the 27 European and 18 American countries; the suicide rates were 4.2% (3.4% to 5.1%) and 6.4% (5.4% to 7.5%) higher, respectively, in 2009 than expected if earlier trends had continued. For women, there was no change in European countries and the increase in the Americas was smaller than in men (2.3%). Rises in European men were highest in those aged 15-24 (11.7%), while in American countries men aged 45-64 showed the largest increase (5.2%). Rises in national suicide rates in men seemed to be associated with the magnitude of increases in unemployment, particularly in countries with low levels of unemployment before the crisis (Spearman’s rs=0.48).Conclusions After the 2008 economic crisis, rates of suicide increased in the European and American countries studied, particularly in men and in countries with higher levels of job loss.

TipoComunicaciones/Informes/Artículos (individual)
Publicado en ODS2013-11-07

The effect of the late 2000s financial crisis on suicides in Spain: an interrupted time-series anlysis

eurpub.oxfordjournals.org

Background: The current financial crisis is having a major impact on European economies, especially that of Spain. Past evidence suggests that adverse macro-economic conditions exacerbate mental illness, but evidence from the current crisis is limited. This study analyses the association between the financial crisis and suicide rates in Spain. Methods: An interrupted time-series analysis of national suicides data between 2005 and 2010 was used to establish whether there has been any deviation in the underlying trend in suicide rates associated with the financial crisis. Segmented regression with a seasonally adjusted quasi-Poisson model was used for the analysis.Stratified analyses were performed to establish whether the effect of the crisis on suicides varied by region, sex and age group. Results: The mean monthly suicide rate in Spain during the study period was 0.61 per 100 000 with an underlying trend of a 0.3% decrease per month. We found an 8.0% increase in the suicide rate above this underlying trend since the financial crisis (95% CI: 1.009–1.156; P = 0.03); this was robust to sensitivity analysis. A control analysis showed no change in deaths from accidental falls associated with the crisis. Stratified analyses suggested that the association between the crisis and suicide rates is greatest in the Mediterranean and Northern areas, in males and amongst those of working age. Conclusions: The financial crisis in Spain has been associated with a relative increase in ...

TipoComunicaciones/Informes/Artículos (individual)
Publicado en ODS2013-10-21