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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 X, Toffolutti V, Malmusi D, Palència L, Borrell C, Suhrcke M - BMC Public Health (2015)

Bottom Line: 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.

View Article: PubMed Central - PubMed

Affiliation: Agència de Salut Pública de Barcelona, Barcelona, Spain. xbartoll@aspb.cat.

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.

No MeSH data available.


Related in: MedlinePlus

Average relative price aof selected food categories, 2001-2011 (Base year 2011=100). aAverage relative price corresponds to the specific price by class or subclass of food category relative to the general price index for that year. Source: price indices were obtained from the Spanish National Statistical Office
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Fig1: Average relative price aof selected food categories, 2001-2011 (Base year 2011=100). aAverage relative price corresponds to the specific price by class or subclass of food category relative to the general price index for that year. Source: price indices were obtained from the Spanish National Statistical Office

Mentions: Finally, we consider the contribution of prices and household incomes in shaping the associations between the Great Recession, in the period 2011/12, and health related behaviours, especially on food consumption, but also on smoking, alcohol and physical activity. Unfortunately, it was not feasible to add prices and incomes as independent variables to our baseline model, first because household incomes were missing for a large part of the sample across surveys (missing values ranging from 14.7 to 28.1 %): second, because there was a strong correlation among most prices and the trend variable; and third because our analysis of food consumption does not cover every single relevant food item or category but is based on a broad survey categorization that could hide substitution effects with other non included categories. However, we are in a position to develop some idea about the role of prices in changes in food consumption by looking at the evolution of relative prices from Fig. 1, and considering the price elasticity of food consumption previously estimated with household data1. Over the whole observation period the annual average relative price of fruits, vegetables and legumes increased by 12.4 % while prices for cold meat and sweet foods decreased by 7.9 %. From 2006 to 2011/12 the change in price level for fruits, vegetables and legumes was 0.0 %, −2.8 % for cold meat and sweet foods, −4.9 % for fish and −2.5 % for meat. Income and price elasticity for fish was lower than for meat, fruits and vegetables. With a drop in the prices of meat and fish and no variation in the prices of fruits, vegetables and legumes since 2006, the ‘income effect’ may have contributed significantly to the pattern of a reduction in consumption which we have found.Fig. 1


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 X, Toffolutti V, Malmusi D, Palència L, Borrell C, Suhrcke M - BMC Public Health (2015)

Average relative price aof selected food categories, 2001-2011 (Base year 2011=100). aAverage relative price corresponds to the specific price by class or subclass of food category relative to the general price index for that year. Source: price indices were obtained from the Spanish National Statistical Office
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4561448&req=5

Fig1: Average relative price aof selected food categories, 2001-2011 (Base year 2011=100). aAverage relative price corresponds to the specific price by class or subclass of food category relative to the general price index for that year. Source: price indices were obtained from the Spanish National Statistical Office
Mentions: Finally, we consider the contribution of prices and household incomes in shaping the associations between the Great Recession, in the period 2011/12, and health related behaviours, especially on food consumption, but also on smoking, alcohol and physical activity. Unfortunately, it was not feasible to add prices and incomes as independent variables to our baseline model, first because household incomes were missing for a large part of the sample across surveys (missing values ranging from 14.7 to 28.1 %): second, because there was a strong correlation among most prices and the trend variable; and third because our analysis of food consumption does not cover every single relevant food item or category but is based on a broad survey categorization that could hide substitution effects with other non included categories. However, we are in a position to develop some idea about the role of prices in changes in food consumption by looking at the evolution of relative prices from Fig. 1, and considering the price elasticity of food consumption previously estimated with household data1. Over the whole observation period the annual average relative price of fruits, vegetables and legumes increased by 12.4 % while prices for cold meat and sweet foods decreased by 7.9 %. From 2006 to 2011/12 the change in price level for fruits, vegetables and legumes was 0.0 %, −2.8 % for cold meat and sweet foods, −4.9 % for fish and −2.5 % for meat. Income and price elasticity for fish was lower than for meat, fruits and vegetables. With a drop in the prices of meat and fish and no variation in the prices of fruits, vegetables and legumes since 2006, the ‘income effect’ may have contributed significantly to the pattern of a reduction in consumption which we have found.Fig. 1

Bottom Line: 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.

View Article: PubMed Central - PubMed

Affiliation: Agència de Salut Pública de Barcelona, Barcelona, Spain. xbartoll@aspb.cat.

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.

No MeSH data available.


Related in: MedlinePlus