Effects of the economic crisis and social support on health-related quality of life: first wave of a longitudinal study in Spain (original) (raw)
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Contribution of the Economic Crisis to the Risk Increase of Poor Mental Health in a Region of Spain
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Mental health impact of the economic crisis in Spain
2013
According to preliminary data, by 2010 the economic crisis in Spain had already led to an increase in the prevalence of anxiety, mood disorders and alcohol misuse, identified in primary care settings, but there had not been an impact on suicide rates. Since then, several indicators suggest that the full impact of the economic crisis on mental health was delayed, until at least the second half of 2011 and even later, to 2012. There is increasing evidence that budget cuts had a particular impact on mental healthcare during this latter period.
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Background: We explored the impact of 2008 recession on the prevalence of mental health problems in Spain. Methods: Repeated cross-sectional survey design. Datasets from 2006 and 2011 were used, and temporal change was examined. The study was conducted on the economically active population (16-64 years old). The two surveys included 29,478 and 21,007 people, obtaining a 96 and 89.6% response rate, respectively. Multiple logistic regression models were adjusted to identify poor mental health risk factors. A standardisation analysis was performed to estimate the prevalence of people at risk of poor mental health (GHQ+). Results: The prevalence of GHQ+ following the crisis increased in men and decreased in women. Two logistic regression analyses identified GHQ+ risk factors. From 2006 to 2011, unemployment rose and income fell for both men and women, and there was a decline in the prevalence of somatic illness and limitations, factors associated with a higher prevalence of GHQ+. After controlling for age, the change in employment and income among men prompted an increase in the prevalence of GHQ+, while the change in somatic illness and limitations tended to mitigate this effect. After the recession, unemployed men showed a better level of somatic health. The same effects were not detected in women. Conclusions: The economic recession exerted a complex effect on mental health problems in men. The reduction of prevalence in women was not associated with changes in socioeconomic factors related to the economic crisis nor with changes in somatic health.
The evolution of mental health during the Spanish economic crisis
We analyse how mental health and socioeconomic inequalities have changed in the Spanish population, aged 16--64, between 2006/07 and 2011/12. An increase in poor mental health was found for men, PR=1.15 95%CI 1.04--1.26, especially those aged 35--54, those with secondary and primary education, those from semi--qualified social class, and breadwinner. None of these associations remained after adjusting for working status. The RII by social class increased for men from 1.02 to 1.08 (p=0.001). A slight decrease in poor mental health was found for women, PR=0.92 95%CI 0.87--0.98, without any significant change in health inequality.
Psychiatry research, 2018
The economic crisis had a detrimental impact on the economies of several European countries, namely in Portugal. The literature emphasizes that periods of economic turmoil potentiate the appearance of mental health issues, such as stress, anxiety, and depression, and decrease populations' well-being. The present study, conducted in Portugal, was performed with a sample of 729 individuals, 33.9% males and 66.1% females, with an average age of 36.99 years old. Its' aim was to assess the relationship between economic stress factors (economic hardship, financial threat, and financial well-being) and stress, anxiety, and depression, as well as to test the moderating effect of social support on this relationship. Structural equation modeling (SEM) was used to examine the relationships defined. When comparing the results obtained in the models without and with social support as a moderator, statistically significant differences were observed on the relationships between financial t...
Epidemiology and Psychiatric Sciences, 2018
AimsPortugal was one of the European countries most affected by the period of economic recession initiated in 2008. Social inequalities are likely to widen during such periods and disproportionately affect people with mental disorders. The present study aims to compare self-reported changes in indicators of socioeconomic position during the economic recession in Portugal among people with and without mental disorders in the beginning of this period. Three dimensions were assessed, namely employment situation, experiences of financial hardship and subjective social status.MethodsData from the World Mental Health Survey Initiative Portugal (2008/2009) and from the National Mental Health Survey Follow-up (2015/2016) were used (n = 911). Multinomial and logistic recession models were performed to examine the association between the presence of any 12-month mood or anxiety mental disorder in 2008/2009 and indicators of socioeconomic position in 2015/2016. All analyses were adjusted for g...
Psychosocial Correlates of Mental Health and Well-Being During the COVID-19: The Spanish Case
Frontiers in Psychology, 2020
BackgroundThe COVID-19 pandemic has hit almost all countries around the globe, seriously affecting the welfare of populations. Spain is especially hard-hit. In this context, the purpose of the present study is to analyze social, demographic, and economic correlates of mental health during the COVID-19 pandemic in the population residing in Spain.MethodThe sample of this cross-sectional study was comprised of 801 participants aged 18 or older and residing in Spain. Data collection was carried out during March and April 2020. Data of mental health (GHQ12) and well-being (Positive and Negative Affect Schedule) indicators, and those of a wide number of social, demographic, and economic variables were recorded. Linear regression models were built to value associations between mental health and social, demographic, and economic indicators.ResultsMental health morbidity was higher in women, younger people, individuals with medium studies, people with fewer children, singles, students, and ...
Socio-economic factors linked with mental health during the recession: a multilevel analysis
International Journal for Equity in Health, 2017
Background: Periods of financial crisis are associated with higher psychological stress among the population and greater use of mental health services. The objective is to analyse contextual factors associated with mental health among the Spanish population during the recession. Methodology: Cross-sectional, descriptive study of two periods: before the recession (2006) and after therecession (2011-2012). The study population comprised individuals aged 16+ years old, polled for the National Health Survey. There were 25,234 subjects (2006) and 20,754 subjects (2012). The dependent variable was psychic morbidity. Independent variables: 1) socio-demographic (age, socio-professional class, level of education, nationality, employment situation, marital status), 2) psycho-social (social support) and 3) financial (GDP per capita, risk of poverty, income per capita per household), public welfare services (health spending per capita), labour market (employment and unemployment rates, percentage of temporary workers). Multilevel logistic regression models with mixed effects were constructed to determine change in psychic morbidity according to the variables studied. Results: The macroeconomic variables associated with worse mental health for both males and females were lower health spending per capita and percentage of temporary workers. Among women, the risk of poor mental health increased 6% for each 100€ decrease in healthcare spending per capita. Among men, the risk of poor mental health decreased 8% for each 5-percentage point increase in temporary workers. Conclusions: Higher rates of precarious employment in a region have a negative effect on people's mental health; likewise lower health spending per capita. Policies during periods of recession should focus on support and improved conditions for vulnerable groups such as temporary workers. Healthcare cutbacks should be avoided in order to prevent increased prevalence of poor mental health.
Social Indicators Research, 2018
In this study, we disentangle the complex relationship between structural and intermediary social determinants of health in Andalusia (Spain) after the period of economic downturn, with the aim to understand the factors that might be addressed to reduce future health inequalities in socioeconomically vulnerable regions. Data from the IMPACT-A project were used. Our sample included 1200 individuals randomly selected using a stratified sampling process according to gender, age group and eight provinces in Andalusia (Spain). Structural equation modeling was conducted to test the goodness of fit of our data with the previous theoretical background. Our results indicated that socioeconomic factors and demographics are associated to health by influencing lifestyles, socioeconomic experiences during the crisis, and personal wellbeing. Additionally, several remarkable contributions from the results can be highlighted: (a) important differences in health outcomes were found in Andalusian females, (b) there was no relationship between income and lifestyles, (c) people with unmet medical needs demonstrated a higher
Individuals with low socioeconomic status generally have worse mental health outcomes than their wealthier counterparts; a tendency that is exacerbated during financial crises. However, social support might buffer the effects of stress on mental health. In this study, we tested whether social support mitigated the effects of economic hardship on psychological distress on an at-risk sample from two of the European countries most affected by the 2008 economic downturn: Spain and Portugal. Participants were 249 caregivers enrolled in Child Welfare Services (73.0% women). Results showed that economic hardship and a negative indicator of social support (network dys-functionality) were significant predictors of belonging to the psychological distress clinical group (OR: 2.35 and 1.80, respectively). However, no significant interaction effects were observed, thereby refuting the buffering effect hypothesis. When we conducted an in depth analysis of the clinical group, a significant moderation effect emerged. Our results suggest that, for at-risk populations, the detrimental effects of dysfunctional networks on mental health can outweigh the benefits of positive assistance and that social support is a potential stress buffer only for individuals in the clinical spectrum. These findings indicate that the protective effect of social support during circumstances of intense economic adversity is limited.