1,722,285 research outputs found
Amenable mortality in the EU - has the crisis changed its course?
No full textDid the global financial crisis and its aftermath impact upon the performance of health systems in Europe? We investigated trends in amenable and other mortality in the EU since 2000 across 28 EU countries. Methods: We use WHO detailed mortality files from 28 EU countries to calculate age-standardized deaths rates from amenable and other causes. We then use joinpoint regression to analyse trends in mortality before and after the onset of the economic crisis in Europe in 2008. Results: Amenable and other mortality have declined in the EU since 2000, albeit faster for amenable mortality. We observed increases in amenable mortality following the global financial crisis for females in Estonia [from 4.53 annual percentage change (APC) in 2005–12 to 0.03 APC in 2012–14] and Slovenia (from 4.22 APC in 2000–13 to 0.73 in 2013–15) as well as males and females in Greece(males: from 2.93 APC in 2000–10 to 0.01 APC in 2010–13; females: from 3.48 APC in 2000–10 to 0.06 APC in 2010–13). Other mortality continued to decline for these populations. Increases in deaths from infectious diseases before and after the crisis played a substantial part in reversals in Estonia, Slovenia and Greece. Conclusion: There is evidence that amenable mortality rose in Greece and, among females in Estonia and Slovenia. However, in most countries, trends in amenable mortality rates appeared to be unaffected by the crisis
The association between socioeconomic status and changes in health in Europe
No full textNumerous studies have found disparities in health between socioeconomic groups in modern societies (van Doorslaer, Wagstaff et al., 1997; Huisman, Kunst et al., 2004; Dalstra, Kunst et al., 2005). Many international studies targeted at measuring disparities in morbidity use self-perceived health as outcome, which is a broad, generic measure of health. Although many studies found that self-perceived health is a good predictor of mortality (Idler and Benyamini 1997), differences in reporting and expectations may influence this outcome. A more specific measure of morbidity is self-reported chronic diseases. Several country-specific longitudinal studies have examined socioeconomic disparities in chronic diseases such as heart disease and stroke (Mackenbach, Cavelaars et al., 2000; Avendano, Kunst et al., 2005). However, there are few European overviews of disparities in chronic disease incidence, as existing studies are based on cross-sectional data (Cavelaars, Kunst et al., 1998; Dalstra, Kunst et al., 2005) or mortality as an outcome (Mackenbach, Bos et al., 2003; Huisman, Kunst et al., 2004; Avendano, Kunst et al., 2005). Based on data from two waves of the SHARE study, this paper examines disparities between socioeconomic groups in incident chronic diseases, death, poor self-perceived health and disability. It is generally known that risk factors are not spread evenly over socioeconomic groups (Cavelaars, Kunst et al., 1998). Therefore, we also examined the association between socioeconomic status and incident health outcomes adjusting for modifiable risk factors
Socio-economic disparities in physical health in 10 European countries
No full textDuring the last few decades, European countries have attempted to solve one of the oldest problems in modern societies: the health gap between the rich and the poor. At the international level, the WHO (World Health Organisation) has initiated numerous campaigns and spent considerable efforts to eliminate these disparities. However, socioeconomic differences in health do not only prevail across Europe, but also seem to exist in all dimensions of health: Individuals with a lower socio-economic status have more health problems, face more disability and live shorter than those with a more privileged socio-economic position (Cambois, Robine and Hayward, 2001; Huisman, Kunst and Mackenbach, 2003). Furthermore, the health gap between the rich and the poor may be increasing with recent changes in European policy (Mackenbach et al., 2003). Thus, health disparities remain an unacceptable outcome in current European society and should be further examined. SHARE represents a unique opportunity to explore the nature and magnitude of health disparities in Europe. This contribution presents an overview of socio-economic disparities in physical health in Europe. Elderly populations experience a wide array of health problems; added to the detrimental impact of ageing, those in the lower classes experience an even larger burden of morbidity and disability. We collected data on a wide array of physical health problems and were able to explore how socio-economic status may have an impact on specific diseases or functional aspects of health. SHARE is one of the first studies to collect data on socio-economic and health variables using a standard instrument across many European countries
Health behaviour
No full textThere is evidence on the importance of health behaviour such as non-smoking, moderate alcohol consumption and moderate physical activity, as well as weight control, to lower mortality and improve functional capacity, also among elderly (Adams et al. 1990; Davis et al. 1994). Further, we know that improving these factors brings health benefits (Johansson and Sundqvist 1999). The SHARE project provides an excellent opportunity to study the prevalence and associations of health behaviours among the ageing European population. This contribution describes the prevalence of health behaviour such as smoking, alcohol consumption, and physical activity, and also body-mass-index among men and women, different age groups and different socio-economic groups in 10 SHARE countries
Changes in health-behaviour related determinants
No full textSmoking, a sedentary lifestyle and obesity are major determinants of cardiovascular disease, cancer and death (Murray, 1997). Positive changes in these determinants can improve the physical health of the elderly, and many of these improvements can be achieved by changes in behaviour (Ngaire M Kerse, 1999). Many theories and models have been developed on why people adopt, maintain and change their behaviour (Norman, 2000). Furthermore, governments have introduced policies such as smoke-free environments, ‘move for health’ campaign and encouraging physical activity. The likelihood of adopting change in behaviour is likely to be influenced by demographic characteristics, factors in the social environment and national level-policies (Norman 2000). For instance, as people age the prevalence of health problems increases, which can motivate changes in health behaviour. Consequently, we would expect older age to be associated with changes in factors such as smoking. Similarly, the extent of changes in behaviour may differ between countries with different policies. For example, in Spain where a smoking ban was recently introduced, we would expect more smokers to stop smoking. Studies have also shown that Europeans with lower socioeconomic status are less aware of the risks of unhealthy behaviour and have less control over their unhealthy habits (Bobak 2000). Therefore, we would expect lower education or wealth to be associated with fewer changes towards a healthier lifestyle. Understanding these health-behaviour related determinants is essential to develop effective policies targeted towards high-risk populations. The aim of this chapter is to examine the impact of demographic characteristics, socioeconomic status and country of residence on the likelihood of changes in health-behaviour related determinants. To address this question, we examine how these factors influence the likelihood of quitting smoking, becoming physically inactive and developing overweight and obesity among the elderly population
Public pensions and unmet medical need among older people: cross-national analysis of 16 European countries, 2004-2010
Full text linkBackground Since the onset of the Great Recession in Europe, unmet need for medical care has been increasing, especially in persons aged 65 or older. It is possible that public pensions buffer access to healthcare in older persons during times of economic crisis, but to our knowledge, this has not been tested empirically in Europe.
Methods We integrated panel data on 16 European countries for years 2004–2010 with indicators of public pension, unemployment insurance and sickness insurance entitlement from the Comparative Welfare Entitlements Dataset and unmet need (due to cost) prevalence rates from EuroStat 2014 edition. Using country-level fixed-effects regression models, we evaluate whether greater public pension entitlement, which helps reduce old-age poverty, reduces the prevalence of unmet medical need in older persons and whether it reduces inequalities in unmet medical need across the income distribution.
Results We found that each 1-unit increase in public pension entitlement is associated with a 1.11 percentage-point decline in unmet medical need due to cost among over 65s (95% CI −0.55 to −1.66). This association is strongest for the lowest income quintile (1.65 percentage points, 95% CI −1.19 to −2.10). Importantly, we found consistent evidence that out-of-pocket payments were linked with greater unmet needs, but that this association was mitigated by greater public pension entitlement (β=−1.21 percentage points, 95% CI −0.37 to −2.06).
Conclusions Greater public pension entitlement plays a crucial role in reducing inequalities in unmet medical need among older persons, especially in healthcare systems which rely heavily on out-of-pocket payments
Physical health
No full text‘Ageing’ is usually defined as the progressive loss of function with advancing age, and increasing rates of health problems including mortality are one of its main manifestations (Kirkwood and Austad 2000). Due to improvements in living standards, public health interventions and innovations in medical care, average life expectancy at birth has spectacularly increased during the twentieth century, to reach levels of around 75 years for men and 80 years for women throughout Western Europe (White 2002). Although most people develop some health problems long before the age of dying, there is large variability within and between populations in ‘healthy ageing’, as shown by comparisons of ‘health expectancies’ (years of life lived in good health) between European countries (Perenboom, van Oyen and Mutafova 2002) and between socio-economic groups within countries (Sihvonen, Kunst, Lahelma et al. 1998). SHARE offers excellent opportunities for studying the prevalence of age-related health problems in Western Europe, for looking at variations in this prevalence between populations and population subgroups, and for analysing the consequences of health problems for other domains such as employment and health care utilisation. This contribution introduces the main indicators of physical health that have been studied in SHARE, and presents some basic data on the prevalence of health problems among its respondents
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