Measuring social deprivation and social exclusion ▸ While material deprivation decreases with age, social deprivation affects those aged 65+ much more often compared to those aged 50-64 ▸ Estonia, Israel and Italy are countries with highest proportion of the 50+ suffering high levels of both material and social deprivation ▸ A two-dimensional measure of social exclusion shows strong correlation with poor health and with hearing and eyesight impairments. It is lower among the employed and those with income from retirement pensions
Objective: We use the panel structure of the Survey of Health, Ageing and Retirement in Europe (SHARE) data for 14 countries to examine the implications of material and social deprivation for health deterioration in old age and mortality. Method: To minimize the potential endogeneity bias, we examine the relationship between deprivation and changes in health rather than levels of health. We include a substantial set of fixed “initial conditions,” and extend the controls with health measures, as observed at the initial period. Results: The results of the probit regression suggest a strong and statistically significant relationship between measures of material and social deprivation and changes in physical and mental health. Mortality is only affected by the social dimension of deprivation. Discussion: Treating material and social deprivation separately rather than as a single social exclusion indicator allows for more specific identification of the role of the two dimensions, which might be important for policy decisions.
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Background Given the nature of the spread of SARS-CoV-2, strong regional patterns in the fatal consequences of the COVID-19 pandemic related to local characteristics such as population and health care infrastructures were to be expected. In this paper we conduct a detailed examination of the spatial correlation of deaths in the first year of the pandemic in two neighbouring countries – Germany and Poland, which, among high income countries, seem particularly different in terms of the death toll associated with the COVID-19 pandemic. The analysis aims to yield evidence that spatial patterns of mortality can provide important clues as to the reasons behind significant differences in the consequences of the COVID-19 pandemic in these two countries. Methods Based on official health and population statistics on the level of counties, we explore the spatial nature of mortality in 2020 in the two countries – which, as we show, reflects important contextual differences. We investigate three different measures of deaths: the officially recorded COVID-19 deaths, the total values of excessive deaths and the difference between the two. We link them to important pre-pandemic regional characteristics such as population, health care and economic conditions in multivariate spatial autoregressive models. From the point of view of pandemic related fatalities we stress the distinction between direct and indirect consequences of COVID-19, separating the latter further into two types, the spatial nature of which is likely to differ. Results The COVID-19 pandemic led to much more excess deaths in Poland than in Germany. Detailed spatial analysis of deaths at the regional level shows a consistent pattern of deaths officially registered as related to COVID-19. For excess deaths, however, we find strong spatial correlation in Germany but little such evidence in Poland. Conclusions In contrast to Germany, for Poland we do not observe the expected spatial pattern of total excess deaths and the excess deaths over and above the official COVID-19 deaths. This difference cannot be explained by pre-pandemic regional factors such as economic and population structures or by healthcare infrastructure. The findings point to the need for alternative explanations related to the Polish policy reaction to the pandemic and failures in the areas of healthcare and public health, which resulted in a massive loss of life.
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