Mortality decrease according to socioeconomic groups during the economic crisis in Spain: a cohort study of 36 million people

Regidor, Enrique; Vallejo, Fernando; Granados, José A. Tapia; Viciana-Fernández, Francisco J; Fuente, Luís de la; Barrio, Gregorio

doi:10.1016/s0140-6736(16)30446-9

Cited by 91 publications

(60 citation statements)

References 48 publications

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“…There is, however, evidence against the unemployment story from Spain in Regidor et al (2016) who use individual level data for the complete population of Spain to study mortality in 2004–2007 compared with 2008–2011. In spite of the severity of the Great Recession in Spain, with unemployment rates rising from 8.2 percent in 2007 to 21.4 percent in 2011, mortality was lower in the later period.…”

Section: Mortality and Incomesmentioning

confidence: 99%

Mortality and Morbidity in the 21st Century

Case

Deaton

2017

Brookings Papers on Economic Activity

1,005

815

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SUMMARYWe build on and extend the findings in Case and Deaton (2015) on increases in mortality and morbidity among white non-Hispanic Americans in midlife since the turn of the century. Increases in all-cause mortality continued unabated to 2015, with additional increases in drug overdoses, suicides, and alcohol-related liver mortality, particularly among those with a high-school degree or less. The decline in mortality from heart disease has slowed and, most recently, stopped, and this combined with the three other causes is responsible for the increase in all-cause mortality. Not only are educational differences in mortality among whites increasing, but from 1998 to 2015 mortality rose for those without, and fell for those with, a college degree. This is true for nonHispanic white men and women in all five year age groups from 35-39 through 55-59. Mortality rates among blacks and Hispanics continued to fall; in 1999, the mortality rate of white nonHispanics aged 50-54 with only a high-school degree was 30 percent lower than the mortality rate of blacks in the same age group but irrespective of education; by 2015, it was 30 percent higher.There are similar crossovers in all age groups from 25-29 to 60-64.Mortality rates in comparable rich countries have continued their pre-millennial fall at the rates that used to characterize the US. In contrast to the US, mortality rates in Europe are falling for those with low levels of educational attainment, and have fallen further over this period than mortality rates for those with higher levels of education.Many commentators have suggested that poor mortality outcomes can be attributed to contemporaneous levels of resources, particularly to slowly growing, stagnant, and even declining incomes; we evaluate this possibility, but find that it cannot provide a comprehensive explanation. In particular, the income profiles for blacks and Hispanics, whose mortality rates have fallen, are no better than those for whites. Nor is there any evidence in the European data that mortality trends match income trends, in spite of sharply different patterns of median income across countries after the Great Recession.We propose a preliminary but plausible story in which cumulative disadvantage from one birth cohort to the next, in the labor market, in marriage and child outcomes, and in health, is triggered by progressively worsening labor market opportunities at the time of entry for whites with low levels of education. This account, which fits much of the data, has the profoundly negative A data appendix and a zipped archive of all programs used to create the figures and tables in this paper are is available at https:// www.brookings.edu/bpea-articles/mortality-and-morbidity-in-the-21st-century/ HHS Public Access Author Manuscript Author ManuscriptAuthor ManuscriptAuthor Manuscript implication that policies, even ones that successfully improve earnings and jobs, or redistribute income, will take many years to reverse the mortality and morbidity increase, and that those in midlife now a...

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Section: Mortality and Incomesmentioning

confidence: 99%

Mortality and Morbidity in the 21st Century

Case

Deaton

2017

Brookings Papers on Economic Activity

1,005

815

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“…Somewhat surprisingly, the health effects of the Great Recession in Europe have been controversial. Initial reports of harmful effects of the recession on health and health care in Europe in general or in specific European countries (Kentikelenis et al, ; Karanikolos et al, ; Simou & Koutsogeorgou, ) were questioned (Liaropoulos, ; Tapia Granados & Rodriguez, ), and several authors have found that apparently, the recession is having beneficial effects on health (de la Fuente et al, ), particularly on major indicators of population health, including general mortality (Regidor et al, ; Toffolutti & Suhrcke, ). After 2010, the available data for both e 0 and e 65 reveal continuous improvement—though Germany is an exception (Figures and ).…”

Section: Introductionmentioning

confidence: 99%

Population health and the economy: Mortality and the Great Recession in Europe

Granados

Ionides

2017

Health Economics

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We analyze the evolution of mortality-based health indicators in 27 European countries before and after the start of the Great Recession. We find that in the countries where the crisis has been particularly severe, mortality reductions in 2007-2010 were considerably bigger than in 2004-2007. Panel models adjusted for space-invariant and time-invariant factors show that an increase of 1 percentage point in the national unemployment rate is associated with a reduction of 0.5% (p < .001) in the rate of age-adjusted mortality. The pattern of mortality oscillating procyclically is found for total and sex-specific mortality, cause-specific mortality due to major causes of death, and mortality for ages 30-44 and 75 and over, but not for ages 0-14. Suicides appear increasing when the economy decelerates-countercyclically-but the evidence is weak. Results are robust to using different weights in the regression, applying nonlinear methods for detrending, expanding the sample, and using as business cycle indicator gross domestic product per capita or employment-to-population ratios rather than the unemployment rate. We conclude that in the European experience of the past 20 years, recessions, on average, have beneficial short-term effects on mortality of the adult population.

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“…Although the effect of macroeconomic fluctuations on overall and cause-specific mortality is generally procyclical (ie, favourable changes during crisis),7 countercyclical changes have often been observed for alcohol-related mortality,8–12 as well as for alcohol use disorders13 or heavy or binge drinking 3 4 14–17. Depending on differences in the predominant mediator mechanism, vulnerability of different sociodemographic groups, crisis features and context, the effects of recession on alcohol-related problems may be heterogeneous 2 6 10 16 18.…”

Section: Introductionmentioning

confidence: 99%