Trends in health inequalities in 27 European countries
File(s)
Author(s)
Type
Journal Article
Abstract
Unfavorable health trends among the lowly educated have recently been reported from the United States. We analyzed health trends by education in European countries, paying particular attention to the possibility of recent trend interruptions, including interruptions related to the impact of the 2008 financial crisis. We collected and harmonized data on mortality from ca. 1980 to ca. 2014 for 17 countries covering 9.8 million deaths and data on self-reported morbidity from ca. 2002 to ca. 2014 for 27 countries covering 350,000 survey respondents. We used interrupted time-series analyses to study changes over time and country-fixed effects analyses to study the impact of crisis-related economic conditions on health outcomes. Recent trends were more favorable than in previous decades, particularly in Eastern Europe, where mortality started to decline among lowly educated men and where the decline in less-than-good self-assessed health accelerated, resulting in some narrowing of health inequalities. In Western Europe, mortality has continued to decline among the lowly and highly educated, and although the decline of less-than-good self-assessed health slowed in countries severely hit by the financial crisis, this affected lowly and highly educated equally. Crisis-related economic conditions were not associated with widening health inequalities. Our results show that the unfavorable trends observed in the United States are not found in Europe. There has also been no discernible short-term impact of the crisis on health inequalities at the population level. Both findings suggest that European countries have been successful in avoiding an aggravation of health inequalities.
Date Issued
2018-06-19
Date Acceptance
2018-04-17
Citation
Proceedings of the National Academy of Sciences of the United States of America, 2018, 115 (25), pp.6440-6445
ISSN
0027-8424
Publisher
National Academy of Sciences
Start Page
6440
End Page
6445
Journal / Book Title
Proceedings of the National Academy of Sciences of the United States of America
Volume
115
Issue
25
Copyright Statement
© 2018 published under the PNAS license (http://www.pnas.org/page/authors/licenses).
Sponsor
Commission of the European Communities
Identifier
http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000435585200051&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
Grant Number
633666
Subjects
Science & Technology
Multidisciplinary Sciences
Science & Technology - Other Topics
mortality
morbidity
health inequalities
Europe
financial crisis
LIFE EXPECTANCY
SOCIOECONOMIC INEQUALITIES
ECONOMIC-CRISIS
EASTERN-EUROPE
MORTALITY
DIVERGENCE
RECESSION
EDUCATION
IMPACT
SPAIN
Publication Status
Published
Date Publish Online
2018-06-04