Depressed during the depression: has the economic crisis affected mental health inequalities in Europe? Findings from the European Social Survey (2014) special module on the determinants of health

Reibling, Nadine; Beckfield, Jason; Huijts, Tim; Schmidt-Catran, Alexander; Thomson, Katie; Wendt, Claus

doi:10.1093/eurpub/ckw225

Cited by 70 publications

(67 citation statements)

References 22 publications

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“…More recent evidence showed a more marked worsening of mental health for women in 2014 compared with 2007, but did not take into account intervening years 29. A large study of pan-European data including the UK found no systematic influence of the recession on socioeconomic inequalities in depression up to 2014,30 but did not differentiate between the immediate recessionary period and the period following any economic policy response. Work by Barr et al suggested that from 2009 to 2013 there may have been a widening of socioeconomic inequalities in mental health in the UK 31.…”

Section: Discussionmentioning

confidence: 99%

“…Ecological studies using pan-European data suggest that the direct effect of unemployment on suicide rates was greater in countries with lower social spending,35 and conversely, higher government spending on unemployment support may mitigate adverse impacts on self-rated health 36. On a relative scale the widening of socioeconomic inequalities postausterity is small in the context of long-term trends, particularly by highest qualification (figure 4), and the degree and timing of short-term trends around the recession and austerity period also differ between measures of SEP, possibly explaining the current lack of consensus in the literature 30 31…”

Section: Discussionmentioning

confidence: 99%

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Trends in gender and socioeconomic inequalities in mental health following the Great Recession and subsequent austerity policies: a repeat cross-sectional analysis of the Health Surveys for England

Thomson

Katikireddi

2018

BMJ Open

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ObjectiveIt is known that mental health deteriorated following the 2008 global financial crisis, and that subsequent UK austerity policies post-2010 disproportionately impacted women and those in deprived areas. We aimed to assess whether gender and socioeconomic inequalities in poor mental health have changed since the onset of austerity policies.DesignRepeat cross-sectional analysis of survey data.SettingEngland.ParticipantsNationally and regionally representative samples of the working-age population (25–64 years) from the Health Survey for England (1991–2014).Outcome measuresPopulation-level poor mental health was measured by General Health Questionnaire-12 (GHQ) caseness, stratified by gender and socioeconomic position (area-level deprivation and highest educational attainment).ResultsThe prevalence of age-adjusted male GHQ caseness increased by 5.9% (95% CI 3.2% to 8.5%, p<0.001) from 2008 to 2009 in the immediate postrecession period, but recovered to prerecession levels after 2010. In women, there was little change in 2009 or 2010, but an increase of 3.0% (95% CI 1.0% to 5.1%, p=0.004) in 2012 compared with 2008 following the onset of austerity. Estimates were largely unchanged after further adjustment for socioeconomic position, employment status and household income as potential mediators. Relative socioeconomic inequalities in GHQ caseness narrowed from 2008 to 2010 immediately following the recession, with Relative Index of Inequality falling from 2.28 (95% CI 1.89 to 2.76, p<0.001) to 1.85 (95% CI 1.43 to 2.38, p<0.001), but returned to prerecession levels during austerity.ConclusionsGender inequalities in poor mental health narrowed following the Great Recession but widened during austerity, creating the widest gender gap since 1994. Socioeconomic inequalities in poor mental health narrowed immediately postrecession, but this trend may now be reversing. Austerity policies could contribute to widening mental health inequalities.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Trends in gender and socioeconomic inequalities in mental health following the Great Recession and subsequent austerity policies: a repeat cross-sectional analysis of the Health Surveys for England

Thomson

Katikireddi

2018

BMJ Open

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“…73 Third, the findings for health inequalities according to income/wealth vary somewhat between the included studies: Some indicate increased inequalities, 60,63,69,78,87,91 whereas others show stability. 75,92,95 Two studies even show decreasing health inequalities between income groups during the crisis, although the decrease is of a negative kind. 81,86 This finding is probably explained, at least partly, by health-related social mobility patterns (see the discussion above).…”

Section: Socioeconomic Indicatorsmentioning

confidence: 99%

“…Twenty-three of the included studies investigate mental health. Despite some noticeable exceptions, 88,91,93,95,99 the main bulk of these studies find increasing socioeconomic inequalities during the Great Recession. From a theoretical perspective, it is reasonable to assume that mental health will be affected for people who lose their jobs and/or worry about how to make ends meet during a crisis.…”

Section: Health Outcomesmentioning

confidence: 99%

Socioeconomic inequalities in health during the Great Recession: A scoping review of the research literature

Heggebø

Tøge²,

Dahl

et al. 2018

Scand J Public Health

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Aims: The so-called ‘Great Recession’ in Europe triggered widespread concerns about population health, as reflected by an upsurge in empirical research on the health impacts of the economic crisis. A growing body of empirical studies has also been devoted to socioeconomic inequalities in health during the Great Recession. The aim of the current study is to summarise this health inequality literature by means of a scoping review. Methods: We have performed a scoping review of the research literature (English language) published in the years 2012–2017. Only empirical papers with (a) health status measured on the individual level, (b) information on socioeconomic position (i.e. employment status, educational level, income/wealth, and/or occupational class), and (c) data from European countries in both pre- and post-crisis years were considered relevant. In total, 49 empirical studies fulfilled these inclusion criteria. Results: The empirical findings in the 49 included studies predominantly show that socioeconomic inequalities in health either increased or remained stable from pre- to post-crisis years. Two-thirds (65%) of the studies found evidence of either increasing or partially increasing health inequalities. Thus, people in lower socioeconomic strata fared worse overall in terms of health during the Great Recession, compared to people with higher socioeconomic status. Conclusions: The Great Recession in Europe tends to be followed by increasing socioeconomic inequalities in health. Policymakers should take note of this finding. Widening socioeconomic inequalities in health is a major cause of concern, in particular if health deterioration among ‘vulnerable groups’ is caused by accelerating cumulative disadvantages.

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“…There is also a need for more research which examines risk and resilience factors at the individual level, as well as wider determinants affecting whole communities (Zivin et al, 2011). Research from an international literature review indicated relatively consistent evidence across Europe showing that suicides increased and mental health deteriorated during the 2008 recession (Parmar et al, 2016) -although not in countries with stronger social security systems (Copeland et al, 2015) -and research using data from the European Social Survey 2006-2014 showed that development of depressive feelings was worse among the precariously employed and economically inactive than for those with unlimited work contracts (Reibling et al, 2017). This is in keeping with a larger evidence base of the effects of previous recessions in the 1980s and 1990s.…”

Section: Background To the Researcha Review Of Existing Evidencementioning

confidence: 99%

Changing labour market conditions during the ‘great recession' and mental health in Scotland 2007-2011: an example using the Scottish Longitudinal Study and data for local areas in Scotland

Pearce

Curtis

Cherrie

et al. 2018

European Journal of Public Health

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This paper reports research exploring how trends in local labour market conditions during the period 2007-2011 (early stages of the 'great recession') relate to reported mental illness for individuals. It contributes to research on spatio-temporal variation in the wider determinants of health, exploring how the lifecourse of places relates to socio-geographical inequalities in health outcomes for individuals. This study also contributes to the renewed research focus on the links between labour market trends and population health, prompted by the recent global economic recession. We report research using the Scottish Longitudinal Study (SLS), a 5.3% representative sample of the Scottish population, derived from census data (https://sls.lscs.ac.uk/). In Scotland, (2011) census data include self-reported mental health. SLS data were combined with non-disclosive information from other sources, including spatio-temporal trends in labour market conditions (calculated using trajectory modelling) in the 32 local authority areas in Scotland. We show that, for groups of local authorities in Scotland over the period 2007-2011, trends in employment varied. These geographically variable trends in employment rates were associated with inequalities in self-reported mental health across the country, after controlling for a number of other individual and neighbourhood risk factors. For residents of regions that had experienced relatively high and stable levels of employment the odds ratio for reporting a mental illness was significantly lower than for the 'reference group', living in areas with persistently low employment rates. In areas where employment declined markedly from higher levels, the odds ratio was similar to the reference group. The findings emphasise how changes in local economic conditions may influence people's health and wellbeing independently of their own employment status. We conclude that, during the recent recession, the economic life course of places across Scotland has been associated with individual mental health outcomes.

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Depressed during the depression: has the economic crisis affected mental health inequalities in Europe? Findings from the European Social Survey (2014) special module on the determinants of health

Cited by 70 publications

References 22 publications

Trends in gender and socioeconomic inequalities in mental health following the Great Recession and subsequent austerity policies: a repeat cross-sectional analysis of the Health Surveys for England

Trends in gender and socioeconomic inequalities in mental health following the Great Recession and subsequent austerity policies: a repeat cross-sectional analysis of the Health Surveys for England

Socioeconomic inequalities in health during the Great Recession: A scoping review of the research literature

Changing labour market conditions during the ‘great recession' and mental health in Scotland 2007-2011: an example using the Scottish Longitudinal Study and data for local areas in Scotland

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