Relationships between health status and socioeconomic and health services indicators during the financial crisis

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The literature has highlighted the association between social and economic determinants and physical and mental health. Several studies have stated that the positive correlation between socioeconomic status and health is different between countries and welfare states in Europe. On the other, the current financial crisis might have modified this relationship. Due to all the above, the aims of this research are to analyse the relationships between self-perceived health status and socioeconomic variables in Europe at NUTS 2 level (European regional statistical unit) focusing on the influence of the spatial factor during the financial crisis. Taking into account the focus on spatial effects, the analysis includes the continental regions and the closest ones, removing from the analysis the remote and far regions in order to assess the geographic influence. Moreover, in order to consider spatial relationships between regions, this research combines simple linear, spatial lag, spatial error and geographically weighted regressions. The analysis has related to the health status with macroeconomic indicators (income of households by inhabitant, GDP per capita in PPS and unemployment rate), social indicators (tertiary education rate and at-risk-of-poverty rate), and health indicators (crude death rate, hospital beds rate, life expectancy and medical doctor rate) during 2008-2014. Four models for each year have been designed using classical and spatial regression methods. The models show that self-perceived health is explained significantly by unemployment, risk of poverty, tertiary education and medical doctor rates for 2008, 2010 and 2014. In addition, life expectancy, hospital beds and death rates show collinearity worsening the models. Finally, the results support the objective of the research: the regression models improve when the geographical location and distance between analysis units are considered. Missing data and the lack of other interesting socioeconomic variables at regional level together with the ecological fallacy are the main limitations of this study. The results support the existence of contextual effects among European regions that varies the association between socioeconomic measures and health status throughout the time. The findings also points out the relevance of social context in explaining the differences in individuals’ states of health. Thus, the spatial analysis have stated that the macroeconomic indicators do not explain significantly the self-perceived health status in contrast to the social indicators during the financial crisis.
Book of proceedings: Annual AESOP Congress, Spaces of Dialog for Places of Dignity, Lisbon, 11-14th July, 2017
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