Impact of the great recession on self-perceived health in Spain: a longitudinal study with individual data
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Objectives Our objective in this study is to evaluate the
impact the Great Recession (2008–2014) had on selfperceived
health in Spain.
Design We use a longitudinal database (four waves of
the Bank of Spain’s Survey of Household Finances (2005,
2008, 2011 and 2014)) with repeated observations of the
same individuals before and after the Great Recession.
Interventions We consider the Great Recession in a
natural experiment and we introduce it as an explanatory
variable in a mixed logistic regression model in which we
explain the probability of a subject declaring poor health
(fair, bad and very bad). In the model we control for both
observed and unobserved confounders at both individual
and family level.
Results We find an average downward trend in selfperceived
health during the most severe period of the Great
Recession (2009–2011). However, the fact that the adjusted
measures are less volatile than the crude ones shows
that variation in health status can be captured by either
demographic or socioeconomic controls. In fact, there are
significant differences in the impact the economic crisis had
on health in terms of gender and age group. In particular, the
(adjusted) risk of declaring poor health increases after the
crisis began but only in those families in which the reference
person is a woman younger than 45 years of age or a man
aged 75 years or older.
Conclusions Given our results, we discuss the link
between financial wealth and self-rated health and how
policy-makers could address the health inequalities that
arise from adverse economic and financial shocks