Longitudinal Trends in Self-Rated Health During Times of Economic Uncertainty in Italy
- 19 Downloads
Previous research examining self-rated health (SRH) outcomes following the 2008 financial crisis in the most affected European countries has reported mixed results: some indicated an improvement in SRH during the crisis while others showed a decline. This study analysed longitudinal SRH trends across age groups in Italy between 2004 and 2015 adopting a longer period for health data and adjusting for pre-existing trends. Data consisted of 97,250 Italian adult residents (aged 18 to 81) from nine cohorts collected with an accelerated longitudinal design between 2004 and 2015 by the Italian National Institute of Statistics using questionnaires from the European Union Statistics on Income and Living Conditions. Latent growth modeling analysed longitudinal SRH trends by different age groups in each cohort along 4-year assessments. Consistently across cohorts, SRH declined among participants aged 71 to 81 while it remained more stable for those aged 30 to 50. The worst SRH trends were observed in the 2010–2013 period where SRH declined in all age groups except for the those aged 31 to 40. Conversely, in the 2008–2011 period SRH remained stable. While at the aggregate level there seems to be a slight overall positive trend in SRH after the crisis, this long-term longitudinal stability in SRH may mask consistent within-country contrasted trends in health outcomes across different age groups. Periods of economic uncertainty and austerity measures coincided with a decline in SRH among the normal adult population in Italy.
KeywordsItaly Global financial crisis Self-rated health Latent growth modeling
This research has been conducted using the Istat resources under Application Number 02814/2018. The data reported in this article are available via application directly to Istat. The author wishes to thank Dr. Cecilia Morello for the support provided during the drafting of the article.
- Banca d’Italia. (2018). Indagine sui bilanci delle famiglie italiane. Retrieved September 20, 2018, from http://www.bancaditalia.it/pubblicazioni/indagine-famiglie/bil-fam2016/Statistiche_IBF_20180312.pdf.
- Bartoll, X., Toffolutti, V., Malmusi, D., Palència, L., Borrell, C., & Suhrcke, M. (2015). Health and health behaviours before and during the Great Recession, overall and by socioeconomic status, using data from four repeated cross-sectional health surveys in Spain (2001–2012). BMC Public Health, 15(1), 865.CrossRefGoogle Scholar
- Bollen, K. A., & Curran, P. J. (2006). Latent curve models: A structural equation perspective. New York: Wiley.Google Scholar
- Branas, C. C., Kastanaki, A. E., Michalodimitrakis, M., Tzougas, J., Kranioti, E. F., Theodorakis, P. N., et al. (2015). The impact of economic austerity and prosperity events on suicide in Greece: a 30-year interrupted time-series analysis. British Medical Journal Open, 5, e005619.Google Scholar
- Brand, H., Rosenkötter, N., Clemens, T., & Michelsen, K. (2013). Austerity policies in Europe—Bad for health: Health protection within the EU mandate is more relevant than ever. BMJ, 346(7941), 7.Google Scholar
- Cercle Santé Sociale and Europ Assistance. (2011). Healthcare in Europe and the United States. Results from the 2011 study and developments observed since 2006—Summary note. Retrieved July 18, 2018, from http://www.europ-assistance.com/sites/default/files/ea_cham2011_synthesis_en.pdf.
- Clause-Verdreau, A.-C., Audureau, É., Leplège, A., & Coste, J. (2018). Contrasted trends in health-related quality of life across gender, age categories and work status in France, 1995–2016: Repeated population-based cross-sectional surveys using the SF-36. Journal of Epidemiology and Community Health. https://doi.org/10.1136/jech-2018-210941.CrossRefGoogle Scholar
- Costa, G., Marra, M., & Salmaso, S. (2012). Health indicators in the time of crisis in Italy. Epidemiologia e Prevenzione, 36(6), 337–366.Google Scholar
- Dempster, A. P., Laird, N. M., & Rubin, D. B. (1977). Maximum likelihood from incomplete data via the EM algorithm. Journal of the Royal Statistical Society: Series B (Methodological), 39(1), 1–22.Google Scholar
- Eurostat. (2015). People in the EU: Who are we and how do we live?. Luxembourg: Publications Office of the European Union.Google Scholar
- Eurostat. (2018a). Income poverty statistics. Retrieved December 15, 2018, from https://ec.europa.eu/eurostat/statistics-explained/index.php?title=Income_poverty_statistics.
- Eurostat. (2018b). European Union statistics on income and living conditions (EU-SILC). Retrieved December 15, 2018, from https://ec.europa.eu/eurostat/web/microdata/european-union-statistics-on-income-and-living-conditions.
- Eurostat. (2019). Share of young adults aged 18–34 living with their parents by age and sex—EU-SILC survey. Retrieved April 15, 2019, from http://appsso.eurostat.ec.europa.eu/nui/submitViewTableAction.do.
- Feinglass, J., Lin, S., Thompson, J., Sudano, J., Dunlop, D., Song, J., et al. (2007). Baseline health, socioeconomic status, and 10-year mortality among older middle-aged Americans: Findings from the Health and Retirement Study, 1992–2002. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 62(4), S209–S217.CrossRefGoogle Scholar
- Freni Ricerche Sociali e di Marketing. (2011). Comportamenti in materia di spese sanitarie davanti alla crisi economica. Florence.Google Scholar
- Hancock, G. R., & Lawrence, F. R. (2006). Using latent growth models to evaluate longitudinal change. In G. R. Hancock & R. O. Mueller (Eds.), Structural equation modeling: A second course (pp. 171–196). Greenwood, CT: Information Age.Google Scholar
- Hurd, M., & Rohwedder, S. (2012). Effects of the economic crisis on the older population: How expectations, consumption, bequests, and retirement responded to market shocks. Reshaping Retirement Security: Lessons from the Global Financial Crisis (pp. 64–80).Google Scholar
- Istat. (2011). Household consumption. Retrieved August 12, 2018, from http://www.istat.it/en/archive/32560.
- Istat. (2017). Elderly people: Health conditions in Italy and in the European Union. Retrieved August 12, 2018, from https://www.istat.it/it/files//2017/09/Elderly_Health-conditions_2015.pdf.
- Istat. (2018a). Indagine sulle condizioni di vita (UDB IT - SILC) componente longitudinale. Retrieved March 25, 2019, from https://www.istat.it/it/archivio/5663.
- Istat. (2018b). Livelli di istruzione della popolazione e ritorni occupazionali: i principali indicatori. Retrieved March 25, 2019, from https://www.istat.it/it/archivio/219264.
- Istat. (2018c). Popolazione residente per stato civile. Retrieved March 25, 2019, https://www.istat.it/it/files//2018/09/Report_popolazione_residente_e_stato_civile.pdf.
- Jain, A. K., & Hausman, R. E. (2006). Stratified multistage sampling. In Encyclopedia of Statistical Sciences. Hoboken: Wiley.Google Scholar
- Kawachi, I., & Berkman, L. (2000). Social cohesion, social capital, and health. Social Epidemiology, 174(7), 190.Google Scholar
- Kline, R. B. (2015). Principles and practice of structural equation modeling. New York: Guilford Publications.Google Scholar
- Lohr, S. L. (2008). Coverage and sampling. In D. A. Dillman & J. J. Leeuw (Eds.), International handbook of survey methods (pp. 97–102). New York: Lawrence Erlbaum Associates.Google Scholar
- McArdle, J. J., & Nesselroade, J. R. (2003). Growth curve analysis in contemporary psychological research. In J. A. Schinka & W. F. Velicer (Eds.), Handbook of psychology: Research methods in psychology (pp. 447–480). New York, NY: Wiley.Google Scholar
- McKeeargue, M. (2010). Budget crises, health, and social welfare programmes. BMJ, 341, 77.Google Scholar
- Mladovsky, P., Srivastava, D., Cylus, J., Karanikolos, M., Evetovits, T., Thomson, S., et al. (2012). Health policy responses to the financial crisis in Europe edited by Philipa Mladovsky et al.. Copenhagen: WHO Regional Office for Europe.Google Scholar
- OECD. (2018a). Health speding. Retrieved February 12, 2019, from https://data.oecd.org/healthres/health-spending.htm.
- OECD. (2018b). Health statistics. Retrieved February 12, 2019, from http://www.oecd.org/els/health-systems/health-data.htm.
- Official Journal of the European Union. (2003). Regulation (EC) No 1982/2003 of 21 October 2003 implementing Regulation (EC) No 1177/2003 of the European parliament and of the Council of 16 June 2003 concerning Community statistics on income and living conditions (EUSILC) as regards the sampling and tracing rules.Google Scholar
- Paleari, F. G., Rosnati, R., & Lanz, M. (2002). The support in family relations and young-adults’ well-being: Differences of perspective. Ricerche di Psicologia, 25(4), 39–56.Google Scholar
- Reile, R., Helakorpi, S., Klumbiene, J., Tekkel, M., & Leinsalu, M. (2014). The recent economic recession and self-rated health in Estonia, Lithuania and Finland: A comparative cross-sectional study in 2004–2010. Journal of Epidemiology and Community Health. https://doi.org/10.1136/jech-2014-204196.CrossRefGoogle Scholar
- Saltkjel, T., Holm Ingelsrud, M., Dahl, E., & Halvorsen, K. (2017). A fuzzy set approach to economic crisis, austerity and public health. Part II: How are configurations of crisis and austerity related to changes in population health across Europe? Scandinavian Journal of Public Health, 45(18_suppl), 48–55.CrossRefGoogle Scholar
- Scarpetta, S., Sonnet, A., & Manfredi, T. (2010). Rising youth unemployment during the crisis: How to prevent negative long-term consequences on a generation? OECD Social, Employment and Migration Working Papers 106.Google Scholar
- Thomson, S., Figueras, J., Evetovits, T., Jowett, M., Mladovsky, P., Maresso, A., et al. (2014). Economic crisis, health systems and health in Europe: Impact and implications for policy. Copenhagen: WHO Regional Office for Europe.Google Scholar
- Tsekeris, C., Pinguli, M., & Georga, E. (2015). Young people’s perception of economic crisis in contemporary Greece: A social psychological pilot study. Crisis Observatory Research Paper, 19, 1–25.Google Scholar
- Verick, S. (2009). Who is hit hardest during a financial crisis? The vulnerability of young men and women to unemployment in an economic downturn. IZA Discussion Paper, no. 4359, Institute for the Study of Labor, Bonn.Google Scholar
- WHO. (2009a). Health in times of global economic crisis: Implications for the WHO European Region. Denmark: WHO, Regional Office for Europe.Google Scholar
- WHO. (2009). The finacial crisis and global health. Report of a high-level consultation. Geneva, Switzerland-19 January 2009: WHO.Google Scholar