Anne Grete Tøge

Unemployment transitions and self-rated health in Europe: A longitudinal analysis of EU-SILC from 2008 to 2011

The Great Recession of 2008 has led to elevated unemployment in Europe and thereby revitalised the question of causal health effects of unemployment. This article applies fixed effects regression models to longitudinal panel data drawn from the European Union Statistics on Income and Living Conditions for 28 European countries from 2008 to 2011, in order to investigate changes in self-rated health around the event of becoming unemployed. The results show that the correlation between unemployment and health is partly due to a decrease in self-rated health as people enter unemployment. Such health changes vary by country of domicile, and by individual age; older workers have a steeper decline than younger workers. Health changes after the unemployment spell reveal no indication of adverse health effects of unemployment duration. Overall, this study indicates some adverse health effects of unemployment in Europe--predominantly among older workers.

Health trends in the wake of the financial crisis—increasing inequalities?

Aim: The financial crisis that hit Europe in 2007–2008 and the corresponding austerity policies have generated concern about increasing health inequalities, although impacts have been less salient than initially expected. One explanation could be that health inequalities emerged first a few years into the crisis. This study investigates health trends in the wake of the financial crisis and analyses health inequalities across a number of relevant population subgroups, including those defined by employment status, age, family type, gender, and educational attainment. Methods: This study uses individual-level panel data (EU-SILC, 2010–2013) to investigate trends in self-rated health. By applying individual fixed effects regression models, the study estimates the average yearly change in self-rated health for persons aged 15–64 years in 28 European countries. Health inequalities are investigated using stratified analyses. Results: Unemployed respondents, particularly those who were unemployed in all years of observation, had a steeper decline in self-rated health than the employed. Respondents of prime working age (25–54 years) had a steeper decline than their younger (15–24) and older (55–64) counterparts, while single parents had a more favorable trend in self-rated health than dual parents. We did not observe any increasing health inequalities based on gender or educational attainment. Conclusions: Health inequalities increased in the wake of the financial crisis, especially those associated with employment status, age, and family type. We did not observe increasing health inequalities in terms of levels of educational attainment and gender.

Health Effects of Unemployment in Europe During the Great Recession The Impact of Unemployment Generosity

Social and economic security could be particularly important for health among the unemployed. Nevertheless, knowledge is still lacking as to whether and how different policy contexts affect health when people move into unemployment. This article investigates whether and to what degree the unemployment generosity explains why individual health effects of unemployment vary across Europe. The 2008–2011 longitudinal panel of the European Union statistics on income and living conditions (EU-SILC) and fixed-effects models are used to estimate the individual effects of unemployment on self-rated health (SRH). Social spending on unemployment is used as a proxy for unemployment generosity. The results show that unemployment generosity is associated with reduced negative effects of unemployment on SRH. For every increase in adjusted purchasing power standard spending, the negative effect of unemployment on SRH is reduced by 0.003 (SE = 0.001) and the change in SRH is improved by 0.002 (SE = 0.001) for each year following the transition, after controlling for time-variant confounders at the individual level and unemployment rate at the macro level. The association between spending on unemployment and cross-national differences in individual health changes that occur as people enter unemployment provides a robust indication of the mitigating health effects of unemployment generosity.

Material deprivation and health: a longitudinal study

BackgroundDoes material deprivation affect the consequences of ill health? Answering this question requires that we move beyond the effects of income. Longitudinal data on material deprivation, longstanding illness and limiting longstanding illness enables investigations of the effects of material deprivation on risk of limiting longstanding illness. This study investigates whether a shift from affording to not affording a car predicts the probability of limiting longstanding ill (LLSI).MethodsThe 2008–2011 longitudinal panel of Statistics on Income, Social Inclusion and Living Conditions (EU-SILC) is utilised. Longitudinal fixed effects logit models are applied, using LLSI as dependent variable. Transition from affording a car to not affording a car is used as a proxy for material deprivation. All models are controlled for whether the person becomes longstanding ill (LSI) as well as other time-variant covariates that could affect the results.ResultsThe analysis shows a statistically significant increased odds ratio of LLSI when individuals no longer can afford a car, after controlling for confounders and LSI in the previous year (1.129, CI = 1.022–1.248). However, when restricting the sample to observations where respondents report longstanding illness the results are no longer significant (1.032, CI = 0.910–1.171).ConclusionThe results indicate an individual level effect of material deprivation on LLSI, suggesting that material resources can affect the consequences of ill health.

Socioeconomic inequalities in health during the Great Recession: A scoping review of the research literature

Aims: The so-called ‘Great Recession’ in Europe triggered widespread concerns about population health, as reflected by an upsurge in empirical research on the health impacts of the economic crisis. A growing body of empirical studies has also been devoted to socioeconomic inequalities in health during the Great Recession. The aim of the current study is to summarise this health inequality literature by means of a scoping review. Methods: We have performed a scoping review of the research literature (English language) published in the years 2012–2017. Only empirical papers with (a) health status measured on the individual level, (b) information on socioeconomic position (i.e. employment status, educational level, income/wealth, and/or occupational class), and (c) data from European countries in both pre- and post-crisis years were considered relevant. In total, 49 empirical studies fulfilled these inclusion criteria. Results: The empirical findings in the 49 included studies predominantly show that socioeconomic inequalities in health either increased or remained stable from pre- to post-crisis years. Two-thirds (65%) of the studies found evidence of either increasing or partially increasing health inequalities. Thus, people in lower socioeconomic strata fared worse overall in terms of health during the Great Recession, compared to people with higher socioeconomic status. Conclusions: The Great Recession in Europe tends to be followed by increasing socioeconomic inequalities in health. Policymakers should take note of this finding. Widening socioeconomic inequalities in health is a major cause of concern, in particular if health deterioration among ‘vulnerable groups’ is caused by accelerating cumulative disadvantages.

Program theory within policy-initiated evaluations: the Norwegian low-income family study

ABSTRACT Using as an example a project where the Norwegian Labor and Welfare Directorate developed a comprehensive model for the follow-up of low-income families, this article demonstrates the process of developing a program theory for policy-initiated interventions. The data consist of interviews with program developers, political documents from early stages, and observations of the program’s development. The results demonstrate that, although research inspired the program developers, the program was also the outcome of policy priorities, experiences from earlier projects, and input from the practice field. Multiple sources contributed to its relevance for the practice field, however, increasing its complexity. The program includes several intervention levels and follow-up areas and partially builds on elements found to be important across interventions. Although a program theory can be difficult to conceptualize within policy-initiated interventions, it is important to articulate it prior to evaluation and, if necessary, reassess it when data have been analyzed.

A critical perspective on child care and social investment in Norway: what is in children’s best interest?: International and Critical Perspectives

This chapter by Knut Halvorsen, Amy A˜stertun Geirdal and Anne Grete TA¸ge critically examines child care policies and programmes in Norway. The experiences of Norwegian children in preschools, schools and families, and the impact on their happiness and mental health, are examined in relation to other European and Western children. The assumption that social investments in children and parents are always in the best interests of the well-being of children is questioned. Drawing on the United Nations Declaration of the Rights of the Child of 1989, the authors contend that human rights, capabilities and citizens’ perspectives should be considered, as an alternative to the social investment perspective. It is argued that the child’s present experience (being) should be balanced with future-oriented investments (becoming).

Success and failure in narrowing the disability employment gap: comparing levels and trends across Europe 2002–2014

BackgroundInternational comparisons of the disability employment gap are an important driver of policy change. However, previous comparisons have used the European Union Statistics on Income and Living Conditions (EU-SILC), despite known comparability issues. We present new results from the higher-quality European Social Survey (ESS), compare these to EU-SILC and the EU Labour Force Survey (EU-LFS), and also examine trends in the disability employment gap in Europe over the financial crisis for the first time.MethodsFor cross-sectional comparisons of 25 countries, we use micro-data for ESS and EU-SILC for 2012 and compare these to published EU-LFS 2011 estimates. For trend analyses, we use seven biannual waves of ESS (2002–2014) with a total sample size of 182,195, and annual waves of EU-SILC (2004–2014) with a total sample size of 2,412,791.Results(i) Cross-sectional: countries that have smaller disability employment gaps in one survey tend to have smaller gaps in the other surveys. Nevertheless, there are some countries that perform badly on the lower-quality surveys but better in the higher-quality ESS. (ii) Trends: the disability employment gap appears to have declined in ESS by 4.9%, while no trend is observed in EU-SILC – but this has come alongside a rise in disability in ESS.ConclusionsThere is a need for investment in disability measures that are more comparable over time/space. Nevertheless, it is clear to policymakers there are some countries that do consistently well across surveys and measures (Switzerland), and others that do badly (Hungary).

Erratum to: individual-level changes in self-rated health before and during the economic crisis in Europe

Unfortunately, after publication of this article [1], it was noticed that there errors within the article. In the Background and Conclusion sections, the two uses of the word “casual” was intended to be “causal”. In the Results section, the text “elven countries” should instead read “eleven countries”.