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Trends in health inequalities in 27 European countries
Erasmus University Medical Center, Rotterdam, The Netherlands.
Erasmus University Medical Center, Rotterdam, The Netherlands.
Faculty of Medicine, Ljubljana, Slovenia.
University of Zürich, Zurich, Switzerland.
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2018 (English)In: Proceedings of the National Academy of Sciences of the United States of America, ISSN 0027-8424, E-ISSN 1091-6490, Vol. 115, no 25, p. 6440-6445Article in journal (Refereed) Published
Abstract [en]

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 <i>ca</i> 1980 to <i>ca</i> 2014 for 17 countries covering 9.8 million deaths and data on self-reported morbidity from <i>ca</i> 2002 to <i>ca</i> 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.

Place, publisher, year, edition, pages
2018. Vol. 115, no 25, p. 6440-6445
Keywords [en]
Europe, financial crisis, health inequalities, morbidity, mortality
National Category
Sociology
Identifiers
URN: urn:nbn:se:sh:diva-35681DOI: 10.1073/pnas.1800028115ISI: 000435585200051PubMedID: 29866829Scopus ID: 2-s2.0-85048950034OAI: oai:DiVA.org:sh-35681DiVA, id: diva2:1223114
Available from: 2018-06-25 Created: 2018-06-25 Last updated: 2018-12-04Bibliographically approved

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Citation style
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