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Trends in health inequalities in 27 European countries
JP. Mackenbach, JR. Valverde, B. Artnik, M. Bopp, H. Brønnum-Hansen, P. Deboosere, R. Kalediene, K. Kovács, M. Leinsalu, P. Martikainen, G. Menvielle, E. Regidor, J. Rychtaříková, M. Rodriguez-Sanz, P. Vineis, C. White, B. Wojtyniak, Y. Hu, WJ. Nusselder,
Language English Country United States
Document type Journal Article, Research Support, Non-U.S. Gov't
NLK
Free Medical Journals
from 1915 to 6 months ago
Freely Accessible Science Journals
from 1915 to 6 months ago
PubMed Central
from 1915 to 6 months ago
Europe PubMed Central
from 1915 to 6 months ago
Open Access Digital Library
from 1915-01-01
Open Access Digital Library
from 1915-01-15
- MeSH
- Interrupted Time Series Analysis statistics & numerical data MeSH
- Healthcare Disparities economics statistics & numerical data MeSH
- Health Status Disparities MeSH
- Adult MeSH
- Economic Recession statistics & numerical data MeSH
- Middle Aged MeSH
- Humans MeSH
- Self-Assessment MeSH
- Aged MeSH
- Socioeconomic Factors MeSH
- Self Report MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Geographicals
- Europe MeSH
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.
Agència de Salut Pública de Barcelona 08023 Barcelona Spain
Demographic Research Institute 1525 Budapest Hungary
Department of Demography Charles University 128 43 Prague 2 Czech Republic
Department of Public Health Erasmus University Medical Center 3015 CE Rotterdam The Netherlands
Department of Public Health Faculty of Medicine 1000 Ljubljana Slovenia
Department of Sociology University of Helsinki 00100 Helsinki Finland
Department of Sociology Vrije Universiteit Brussel 1050 Ixelles Belgium
Epidemiology Biostatistics and Prevention Institute University of Zürich 8006 Zurich Switzerland
Institute of Public Health Copenhagen University 1165 Copenhagen Denmark
Lithuanian University of Health Sciences Kaunas 44307 Lithuania
Office of National Statistics Newport NP10 8XG United Kingdom
References provided by Crossref.org
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