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BMC Public Health. 2015 Sep 7;15:865. doi: 10.1186/s12889-015-2204-5.

Health and health behaviours before and during the Great Recession, overall and by socioeconomic status, using data from four repeated cross-sectional health surveys in Spain (2001-2012).

Bartoll X1,2, Toffolutti V3, Malmusi D4,5,6, Palència L7,8,9, Borrell C10,11,12,13, Suhrcke M14,15.

Author information

1
Agència de Salut Pública de Barcelona, Barcelona, Spain. xbartoll@aspb.cat.
2
Institute of Biomedical Research (IIB-Sant Pau), Barcelona, Spain. xbartoll@aspb.cat.
3
Health Economics Group, Norwich Medical School, University of East Anglia, Norwich, United Kingdom. V.Toffolutti@uea.ac.uk.
4
Agència de Salut Pública de Barcelona, Barcelona, Spain. dmalmusi@aspb.cat.
5
CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain. dmalmusi@aspb.cat.
6
Institute of Biomedical Research (IIB-Sant Pau), Barcelona, Spain. dmalmusi@aspb.cat.
7
Agència de Salut Pública de Barcelona, Barcelona, Spain. lpalenci@aspb.cat.
8
CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain. lpalenci@aspb.cat.
9
Institute of Biomedical Research (IIB-Sant Pau), Barcelona, Spain. lpalenci@aspb.cat.
10
Agència de Salut Pública de Barcelona, Barcelona, Spain. cborrell@aspb.cat.
11
CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain. cborrell@aspb.cat.
12
Universitat Pompeu Fabra, Barcelona, Spain. cborrell@aspb.cat.
13
Institute of Biomedical Research (IIB-Sant Pau), Barcelona, Spain. cborrell@aspb.cat.
14
Centre for Health Economics, University of York, York, United Kingdom. marc.suhrcke@york.ac.uk.
15
Centre for Diet and Activity Research (CEDAR), Institute of Public Health, Cambridge, United Kingdom. marc.suhrcke@york.ac.uk.

Abstract

BACKGROUND:

The objective of this study was to estimate changes over time in health status and selected health behaviours during the Great Recession, in the period 2011/12, in Spain, both overall, and according to socioeconomic position and gender.

METHODS:

We applied a before-after estimation on data from four editions of the Spanish National Health Survey: 2001, 2003/04, 2006/07 and 2011/12. This involved applying linear probability regression models accounting for time-trends and with robust standard errors, using as outcomes self-reported health and health behaviours, and as the main explanatory variable a dummy "Great Recession" for the 2011/12 survey edition. All the computations were run separately by gender. The final sample consisted of 47,156 individuals aged between 25 and 64 years, economically active at the time of the interview. We also assessed the inequality of the effects across socio-economic groups.

RESULTS:

The probability of good self-reported health increased for women (men) by 9.6 % (7.6 %) in 2011/12, compared to the long term trend. The changes are significant for all educational levels, except for the least educated. Some healthy behaviours also improved but results were rather variable. Adverse dietary changes did, however, occur among men (though not women) who were unemployed (e.g., the probability of declaring eating fruit daily changed by -12.1 %), and among both men (-21.8 %) and women with the lowest educational level (-15.1 %).

CONCLUSIONS:

Socioeconomic inequalities in health and health behaviour have intensified, in the period 2011/12, in at least some respects, especially regarding diet. While average self-reported health status and some health behaviours improved during the economic recession, in 2011/12, this improvement was unequal across different socioeconomic groups.

PMID:
26346197
PMCID:
PMC4561448
DOI:
10.1186/s12889-015-2204-5
[Indexed for MEDLINE]
Free PMC Article

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