Expenditure Cuts and Access to Healthcare Under the Great Recession in Europe: Income Groups Are Unequally Affected

Background: The Great Recession, starting in 2008, was characterized by an overall reduction in living standards. This pushed several governments across Europe to restrict expenditures, also in the area of healthcare. These austerity measures are known to have affected access to healthcare, probably unevenly among social groups. This study examines the unequal effects of retrenchment in healthcare expenditures on access to medical care for different income groups across European countries. Method: Using data of two waves (2008 and 2014) of the European Union Statistics of Income and Living Conditions survey (EU-SILC), a difference-in-differences (DD) approach was used to analyse the overall change in unmet medical needs over time within and between countries. By adding another interaction, the differences in the effects between income quintiles (difference-in-difference-in-differences: DDD) were estimated. To do so, comparisons between two pairs of a treatment and a control case were made: Iceland versus Sweden, and Ireland versus the United Kingdom. These comparisons are made between countries with recessions equal in magnitude, but with different levels of healthcare cuts. This strategy allows isolating the effect of cuts, net of the severity of the recession. Results: The DD-estimates show a higher increase of unmet medical needs during the Great Recession in the treatment cases (Iceland vs. Sweden: + 3.24 pp.; Ireland vs. the United Kingdom: + 1.15 pp). The DDD-estimates show different results over the two models. In Iceland, the lowest income groups had a higher increase in unmet medical needs. This was not the case in Ireland, where middle-class groups saw their access to healthcare deteriorate more. Conclusion: Restrictions on health expenditures during the Great Recession caused an increase in self-reported unmet medical needs. The burden of these effects is not equally distributed; in some cases, the lower-income groups suffer most. The case of Ireland, nevertheless, shows that certain policy measures may relatively spare lower-income groups while affecting middle-class income groups more. These results bring in evidence that policies can reduce and even overshoot the general effect of income inequalities on access to healthcare

The unequal effects of austerity measures between income-groups on the access to healthcare : a quasi-experimental approach

Background The Great Recession, starting in 2008, was characterized by an overall reduction in living standards. This pushed several governments across Europe to restrict expenditures, also in the area of healthcare. These austerity measures are known to have affected access to healthcare, probably unevenly among social groups. This study examines the unequal effects of retrenchment in healthcare expenditures on access to medical care for different income groups across European countries. Method Using data of two waves (2008 and 2014) of the European Union Statistics of Income and Living Conditions survey (EU-SILC), a difference-in-differences (DD) approach was used to analyse the overall change in unmet medical needs over time within and between countries. By adding another interaction, the differences in the effects between income quintiles (difference-in-difference-in-differences: DDD) were estimated. To do so, comparisons between two pairs of a treatment and a control case were made: Iceland versus Sweden, and Ireland versus the United Kingdom. These comparisons are made between countries with recessions equal in magnitude, but with different levels of healthcare cuts. This strategy allows isolating the effect of cuts, net of the severity of the recession. Results The DD-estimates show a higher increase of unmet medical needs during the Great Recession in the treatment cases (Iceland vs. Sweden: + 3.24 pp.; Ireland vs. the United Kingdom: + 1.15 pp). The DDD-estimates show different results over the two models. In Iceland, the lowest income groups had a higher increase in unmet medical needs. This was not the case in Ireland, where middle-class groups saw their access to healthcare deteriorate more. Conclusion Restrictions on health expenditures during the Great Recession caused an increase in self-reported unmet medical needs. The burden of these effects is not equally distributed; in some cases, the lower-income groups suffer most. The case of Ireland, nevertheless, shows that certain policy measures may relatively spare lower-income groups while affecting middle-class income groups more. These results bring in evidence that policies can reduce and even overshoot the general effect of income inequalities on access to healthcare

M & L Jaargang 29/6

Mimi Debruyn De wondere wereld van een 18de-eeuws receptenboek voor Kunst-Schilders, Vernissers, Vergulders en Marmelaers. [The wondrous world of an 18th century book of recipes for painters, varnishers, gilders and marblers.]In 1777 publiceerden de gebroeders Gimblet in Gent een receptenboek voor de kunst- en decoratieschilders van hun tijd. Dit encyclopedisch kookboek viel onder de aandacht van Mimi Debruyn, die er enthousiast in grasduinde op zoek naar wetenswaardigheden over de materialen en technieken van de toenmalige exterieurafwerking en binneninrichting.Ilse Boeren, Kris Vandekerkhove, Sara Adriaenssens, Dries Tys, Koen Deforce, Kristof Haneca en Jan Bastiaens - Relicten van houtskoolmeilers in het Zoerselbos. [Remnants of charcoal kilns in the old woodland Zoerselbos.]Thans één van de meest waardevolle bosgebieden in Vlaanderen was het Zoerselbos, tot het begin van de 19de eeuw, het tafereel van een belangrijke economische activiteit: de productie van houtskool. De overblijfselen hiervan recent en bij toeval ontdekt zijn slechts voor een geoefend oog zichtbaar en in Vlaanderen nauwelijks gekend. In opdracht van het agentschap Ruimte en Erfgoed trok een team van wetenschappers op verder onderzoek uit en werden de meilers in het Zoerselbos geïnventariseerd, onderzocht en geëvalueerd met het oog op hun behoud voor de toekomst.Guido Cuyt Archeologisch onderzoek door vrijwilligers in Vlaanderen. [Archaeological research by voluntary workers in Flanders.]De directeur van de Nationale Dienst voor Opgravingen wist het 30 jaar geleden al: Er zijn maar twee soorten archeologen, namelijk goeie en slechte. En beide soorten vind je zowel bij de beroeps- als bij de amateurarcheologen. De amateurarcheoloog, vroeger verguisd en later geherwaardeerd, dreigt de dag van vandaag opnieuw verdrongen te worden. Is er nog een toekomst? Guido Cuyt - zelf een gepassioneerd amateurarcheoloog - schetst de evolutie van de amateurarcheologie in Vlaanderen en pleit meteen ook voor bezinning en herprofilering.Lieve Viaene-Awouters Heraldiek in Vlaanderen. Dertig jaar Vlaamse Heraldische Raad. [Heraldry in Flanders. Thirty years of Flemisch Heraldic Council.]Wapenborden en heraldische voorstellingen zijn sinds de vroege middeleeuwen in Vlaanderen van grote historische betekenis. Al 30 jaar waakt een raad van deskundigen over het historisch en heraldisch verantwoord toekennen van nieuwe wapens en over hun uniform gebruik. De raad formuleert tevens adviezen ten behoeve van de bevoegde minister en probeert een antwoord te bieden op de wildgroei aan logos die hand over hand toeneemt. Een overzicht van drie decennia Vlaamse Heraldische Raad door Lieve Viaene-Awouters.Summar

Evaluating the Effects of SARS-CoV-2 Spike Mutation D614G on Transmissibility and Pathogenicity.

Global dispersal and increasing frequency of the SARS-CoV-2 spike protein variant D614G are suggestive of a selective advantage but may also be due to a random founder effect. We investigate the hypothesis for positive selection of spike D614G in the United Kingdom using more than 25,000 whole genome SARS-CoV-2 sequences. Despite the availability of a large dataset, well represented by both spike 614 variants, not all approaches showed a conclusive signal of positive selection. Population genetic analysis indicates that 614G increases in frequency relative to 614D in a manner consistent with a selective advantage. We do not find any indication that patients infected with the spike 614G variant have higher COVID-19 mortality or clinical severity, but 614G is associated with higher viral load and younger age of patients. Significant differences in growth and size of 614G phylogenetic clusters indicate a need for continued study of this variant

Evaluating the Effects of SARS-CoV-2 Spike Mutation D614G on Transmissibility and Pathogenicity

Global dispersal and increasing frequency of the SARS-CoV-2 spike protein variant D614G are suggestive of a selective advantage but may also be due to a random founder effect. We investigate the hypothesis for positive selection of spike D614G in the United Kingdom using more than 25,000 whole genome SARS-CoV-2 sequences. Despite the availability of a large dataset, well represented by both spike 614 variants, not all approaches showed a conclusive signal of positive selection. Population genetic analysis indicates that 614G increases in frequency relative to 614D in a manner consistent with a selective advantage. We do not find any indication that patients infected with the spike 614G variant have higher COVID-19 mortality or clinical severity, but 614G is associated with higher viral load and younger age of patients. Significant differences in growth and size of 614G phylogenetic clusters indicate a need for continued study of this variant

Een unieke kijk op bosecologie en bosbeheer in de 18de eeuw: het plantageboek van Zoerselbos

Deze bijdrage wil plantageboeken als geschreven bron voor de historische ecologie in het daglicht stellen. Als voorbeeld nemen we het plantageboek voor Zoerselbos, een groot boscomplex te Zoersel (~380 ha) dat 563 jaar in eigendom en beheer is geweest van de cisterciënzers van de Sint-Bernardusabdij (1233 – 1796). Het plantageboek is een notitieboek waarin jaar per jaar de diverse beheersmaatregelen werden opgetekend. Het boek behandelt een ononderbroken periode van 1725 tot 1796 en bevat informatie over de ingrepen die plaats vonden in het landschap, met verdere details over het tijdstip van de activiteiten, hoeveelheden, oppervlaktes en prijzen. Deze schat aan gegevens verschaft ons nieuwe inzichten in de bosecologie en het bosbeheer in de achttiende-eeuwse Antwerpse Kempen