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Health protection in times of economic crisis: Challenges and opportunities for Europe

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Abstract

STOA, the European Parliament’s technology assessment body, and the European Observatory on Health Systems and Policies recently organised a workshop on the impacts of the economic crisis on European health systems. Evidence of the impact of the recent financial crisis on health outcomes is only just beginning to emerge. Data suggests that this latest recession has led to more frequent poor health status, rising incidence of some communicable diseases, and higher suicide rates. Further, available data are likely to underestimate the broader mental health crisis linked to increased rates of stress, anxiety, and depression among the economically vulnerable. Not only does recession affect factors that determine health, but it also affects the financial capacity to respond. Many European governments have reduced public expenditure on health services during the financial crisis, while introducing or increasing user charges. The recession has driven structural reforms, and has affected the priority given to public policies that could be used to help protect population health. The current economic climate, while challenging, presents an opportunity for reforming and restructuring health promotion actions and taking a long-term perspective.

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References

  • Karanikolos, M. et al. (2013) Financial crisis, austerity, and health in Europe. The Lancet 381 (9874): 1323–1331.

    Article  Google Scholar 

  • European Commission. (2012) Eurostat statistics database 2012. http://epp.eurostat.ec.europa.eu/portal/page/portal/statistics/search_database, accessed 5 August 2013.

  • Eurostat. (2013) Unemployment statistics. February, http://epp.eurostat.ec.europa.eu/statistics_explained/index.php/Unemployment_statistics, accessed 5 August 2013.

  • Padoan, P. (2013) What is the near-term global economic outlook? An interim assessment. OECD Interim Economic Outlook, OECD. http://www.slideshare.net/OECD/economic-outlook-17799404, accessed 5 August 2013.

  • Science and Technology Options Assessment. (STOA) http://www.europarl.europa.eu/stoa/cms/cache/offonce/home/about;jsessionid=0F484293E2C85B8987AE4C8D26C16CB2, accessed 5 August 2013.

  • European Observatory on Health Systems and Policies http://www.euro.who.int/en/who-we-are/partners/observatory, accessed 5 August 2013.

  • Science and Technology Options Assessment. (STOA). (2013) Strengthening health protection in times of economic crisis: Increasing the evidence-base. http://www.europarl.europa.eu/stoa/cms/home/events/workshops/2013_health, accessed 5 August 2013.

  • OECD Health Data. (2012) Eurostat statistics database. Frequently requested data. http://www.oecd.org/health/health-systems/oecdhealthdata2012-frequentlyrequesteddata.htm, accessed 5 August 2013.

  • Mladovsky, P. et al. (2012) Health policy in the financial crisis. Eurohealth 18 (1): 3–6.

    Google Scholar 

  • Kentikelenis, A., Karanikolos, M., Papanicolas, I., Basu, S., McKee, M. and Stuckler, D. (2012) Health and the financial crisis in Greece. The Lancet 379 (9820): 1001–1002.

    Article  Google Scholar 

  • Department of Health and Children. (2012) Health in Ireland: Key Trends 2012. Dublin, http://www.dohc.ie/publications/pdf/KeyTrends_2012.pdf?direct=1, accessed 5 August 2013.

  • OECD. (2011) Health at a Glance 2011: OECD Indicators. OECD Publishing. 75775 PARIS CEDEX 16, http://dx.doi.org/10.1787/health_glance-2011-en, accessed 5 August 2013.

  • Lusardi, A., Schneider, D. and Tufano, P. (2011) The economic crisis and medical care usage. http://www.dartmouth.edu/~alusardi/Papers/healthcare_031610.pdf, accessed 5 August 2013.

  • Barros, P.P. (2012) Health policy reform in tough times: The case of Portugal. Health Policy 106 (June): 17–22.

    Article  Google Scholar 

  • Ministry of Health. (2013) Statistics Yearbook 2010. Ministry of Health. Rome, Italy, http://www.salute.gov.it/imgs/C_17_pubblicazioni_1933_allegato.pdf, accessed 5 August 2013.

  • De Belvis, A.G., Ferrè, F., Specchia, M.L., Valerio, L., Fattore, G. and Ricciardi, W. (2012) The financial crisis in Italy: Implications for the healthcare sector. Health Policy 106 (1): 10–16.

    Article  Google Scholar 

  • Vogler, S., Zimmermann, N., Leopold, C. and De Joncheere, K. (2011) Pharmaceutical policies in European countries in response to the global financial crisis. Southern Med Review 4 (2): 69–79.

    Article  Google Scholar 

  • Paterlini, M. (2013) Italy’s health system reforms on hold. The Lancet 381 (9872): 1085–1086.

    Article  Google Scholar 

  • De Vogli, R., Marmot, M. and Stuckler, D. (2013) Excess suicides and attempted suicides in Italy attributable to the great recession. Journal of Epidemiology & Community Health 67 (4): 378–379.

    Google Scholar 

  • Costa, G., Marra, M. and Salmaso, S. (2012) Health indicators in the time of crisis in Italy (Gruppo AIE su crisi e salute). Epidemiologia E Prevenzione 36 (6): 337–366.

    Google Scholar 

  • Tapia Granados, J.A. (2008) Macroeconomic fluctuations and mortality in postwar Japan. Demography 45 (2): 323–343.

    Article  Google Scholar 

  • Ruhm, C. (2008) A healthy economy can break your heart. Demography 44 (4): 829–848.

    Article  Google Scholar 

  • Kentikelenis, A., Karanikolos, M., Papanikolas, I., Basu, S., McKee, M. and Stuckler, D. (2011) Health effects of financial crisis: Omens of a Greek tragedy. The Lancet 378 (9801): 1457–1458.

    Article  Google Scholar 

  • Astell-Burt, T. and Feng, X. (2013) Health and the 2008 Economic Recession: Evidence from the United Kingdom. Plos One 8 (2): e56674.

    Article  Google Scholar 

  • Minton, J.W., Pickett, K.E. and Dorling, D. (2012) Health, employment, and economic change, 1973–2009: Repeated cross sectional study. British Medical Journal 344 (e2316).

  • Gili, M., Roca, M., Basu, S., McKee, M. and Stuckler, D. (2013) The mental health risks of economic crisis in Spain: Evidence from primary care centres, 2006 and 2010. European Journal of Public Health 23 (1): 103–108.

    Article  Google Scholar 

  • Instituto Nacional de Estadística. (2013) Salud: Defunciones Según la Causa de Muerte. Madrid, Spain: INES.

  • Stuckler, D., Basu, S., Suhrcke, M., Coutts, A. and McKee, M. (2011) Effects of the 2008 recession on health: A first look at European data. The Lancet 378 (July): 124–125.

    Article  Google Scholar 

  • Barr, B., Taylor-Robinson, D., Scott-Samuel, A., McKee, M. and Stuckler., D. (2012) Suicides associated with the 2008–10 economic recession in England: Time trend analysis. British Medical Journal 345 (e5142), doi: http://dx.doi.org/10.1136/bmj.e5142.

  • Reeves, A., Stuckler, D., McKee, M., Gunnel, I. D., Chang, S.S. and Basu, S. (2013) Suicide, recession, and unemployment? Authors’ reply. The Lancet 381 (9868): 722.

    Article  Google Scholar 

  • Rihmer, Z., Kapitany, B., Gonda, X. and Dome, P. (2013) Suicide, recession, and unemployment. The Lancet 381 (9868): 722–723.

    Article  Google Scholar 

  • Zavras, D., Tsiantou, V., Pavi, E., Mylona, K. and Kyriopoulos, J. (2013) Impact of economic crisis and other demographic and socio-economic factors on self-rated health in Greece. European Journal of Public Health 23 (2): 206–210.

    Article  Google Scholar 

  • De Hert, M. et al. (2011) Physical illness in patients with severe mental disorders. I. Prevalence, impact of medications and disparities in health care. World Psychiatry 10 (1): 52–77.

    Article  Google Scholar 

  • Suhrcke, M. et al. (2011) The impact of economic crises on communicable disease transmission and control: A systematic review of the evidence. PLoS One 6 (6): e20724.

    Article  Google Scholar 

  • Nikolopoulos, G., Tsiodras, S. and Bonovas, S. (2012) Influenza vaccination: Cassandra’s prophecy. Public Health 126 (1): 82–83.

    Article  Google Scholar 

  • Anastasiadou, A., Kakoulidis, I., Butel, D., Kehagia, E. and Papa, A. (2013) Follow-up study of Greek patients with West Nile virus neuroinvasive disease. International Journal of Infectious Diseases 17 (7): e494–e497.

    Article  Google Scholar 

  • Danis, K., Lenglet, A., Tseroni, M., Baka, A., Tsiodras, S. and Bonovas, S. (2013) Malaria in Greece: Historical and current reflections on a re-emerging vector borne disease. Travel Medicine and Infectious Disease 11 (11): 8–14.

    Article  Google Scholar 

  • European Centre for Disease Prevention and Control. (2012) Risk assessment on HIV in Greece. http://ecdc.europa.eu/en/publications/Publications/20121130-Risk-Assessment-HIV-in-Greece.pdf, accessed 5 August 2013.

  • Kaitelidou, D. (2013) Informal payments for maternity health services in public hospitals in Greece. Health Policy 109 (1): 23–30.

    Article  Google Scholar 

  • Stuckler, D., Basu, S., Suhrcke, M., Coutts, A. and McKee, M. (2009) The public health effect of economic crises and alternative policy responses in Europe: An empirical analysis. The Lancet 374 (9686): 315–323.

    Article  Google Scholar 

  • Hong, J., Knapp, M. and McGuire, A. (2011) Income-related inequalities in the prevalence of depression and suicidal behaviour: A 10-year trend following economic crisis. World Psychiatry 10 (1): 40–44.

    Article  Google Scholar 

  • BBC News Europe. (2012) EU austerity drives country by country, http://www.bbc.co.uk/news/10162176, accessed 5 August 2013.

  • Wahlbeck, K. and McDaid, D. (2012) Actions to alleviate the mental health impact of the economic crisis. World Psychiatry 11 (3): 139–145.

    Article  Google Scholar 

  • Martin, J.P. and Grubb, D. (2001) What works and for whom: A review of OECD countries’ experiences with active labour market policies. Paris, France: OECD Publishing.

  • Knapp, M., McDaid, D. and Parsonage, M. (eds.) (2011) Mental Health Promotion and Mental Illness Prevention: The Economic Case. London: Department of Health.

    Google Scholar 

  • McDaid, D. and Park, A.L. (2011) Investing in mental health and well-being: Findings from the dataprev project. Health Promotion International 26 (Supplement 1): i108–i139.

    Article  Google Scholar 

  • Mihalopoulos, C., Vos, T., Pirkis, J. and Carter, R. (2011) The economic analysis of prevention in mental health programs. Annual Review of Clinical Psychology 7 (4): 169–201.

    Article  Google Scholar 

  • Meltzer, H., Bebbington, P., Brugha, T., Farrell, M. and Jenkins, R. (2013) The relationship between personal debt and specific common mental disorders. European Journal of Public Health 23 (1): 108–113.

    Article  Google Scholar 

  • Evans-Lacko, S., Fitch, C. and King, D. (2011) Mental health promotion and mental illness prevention: The economic case. In: M. Knapp, D. McDaid and M. Parsonage (eds.) Debt and Mental Health. London: Department of Health.

    Google Scholar 

  • Choi, B.C. et al. (2005) Can scientists and policy makers work together? Journal of Epidemiology & Community Health 59 (8): 632–637.

    Article  Google Scholar 

  • Suhrcke, M., McKee, M., Sauto Arce, R., Tsolava, S. and Mortnesen, J. (2005) European Commission, Directorate general Health and Consumer protection. The contribution of health to the economy in the European Union, http://ec.europa.eu/health/ph_overview/Documents/health_economy_en.pdf.

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Acknowledgements

We are grateful to Christian Felice, Laura Rolo Perez, and Elleke Arnold, from the STOA Secretariat, European Parliament, Brussels, Belgium, for assisting in the editing of this manuscript.

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Correction

One of the Author’s affiliations from this article originally published 29 August 2013, has now been corrected.

David McDaid and Gianluca Quaglio contributed equally to the paper.

The STOA Panel of the European Parliament and the European Observatory on Health Systems and Policies lay out very considerable health challenges for Europe posed by economic downturn.

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McDaid, D., Quaglio, G., Correia de Campos, A. et al. Health protection in times of economic crisis: Challenges and opportunities for Europe. J Public Health Pol 34, 489–501 (2013). https://doi.org/10.1057/jphp.2013.35

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