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

Subsidized Household Services and Informal Employment: The Belgian Service Voucher Policy

Labour markets for personal and household services (PHS) are rife with informal employment. Some policies aim to combat informality in PHS with subsidized service vouchers, but their effects are poorly documented. This contribution evaluates the Belgian service vouchers (1) documenting their formalization effectiveness, and (2) accounting for the persistence of informal employment. To this end, we exploit several types of data and methods. A first analysis, based on Eurobarometer data, brings in evidence that informal PHS purchased were approximately halved under the policy introduced in 2001. Second, a discrete choice experiment shows that households prefer formal employment, including those that currently employ informally. Third, a survey in the Brussels metropolitan area shows that the persistence of informal employment lies in the relationship of informal employers with their domestic, from whom they are not willing to part. They nevertheless intend to switch to formal employment in the case of turnover. One thus expects partially delayed effects of formalization policies in general, and of the service voucher system in particular. Overall, these results are in line with Portes' claim that informality is facilitated by strong social relationships, and by differences in price and transaction costs

Estimating the Prostitution Population in the Netherlands and Belgium: A Capture-Recapture Application to Online Data

Evidence-based risk-prevention policies for people involved in prostitution require that reliable population estimates are built. This study proposes a methodological framework and novel data source for measuring their population in regions where the internet plays a predominant role in the industry. We derive single registration capture-recapture population estimates using the Zelterman approach. The resulting estimates for the Netherlands and Belgium are lower than previous rough estimates. We find that relative to the overall population of the two countries, the proportion of sex workers are roughly identical despite differing legal environments

De ongekende samenleving: schattingen en inzichten over irreguliere migranten en economische schaduwactiviteiten

Inleiding en probleemstelling: Overheden in landen met een hoge economische ontwikkeling beschikken doorgaans over een uitgebreid systeem om hun economie en bevolking te monitoren. Door de uitgebreidheid en de effectiviteit van deze systemen wordt er meestal van uitgegaan dat de gegevens van overheden een adequaat beeld schetsen van de werksituatie, het economische en het sociale leven ‘zoals ze zijn’. Niets is minder waar. De beschikbare informatie lijdt structureel onder het euvel dat ze voorbijgaat aan een samenleving die weliswaar reëel bestaat, maar die grotendeels verborgen blijft voor het oog van officiële waarneming en registratie. Deze ongekende samenleving geeft haar geheimen slechts mondjesmaat prijs. Tussen de gedocumenteerde werkelijkheid en het ware sociaaleconomische en werkzame leven van de inwoners van Vlaanderen gaapt een kloof. Over de oorzaken, de grootte en de veranderingen van deze kloof kan gedebatteerd worden ‑ en dat wordt daadwerkelijk gedaan – maar dat ze bestaat en significant is, wordt zelfs door oppervlakkige waarneming bevestigd. Waar hebben we het dan over, wanneer we spreken over een kloof tussen het werkelijke land en datgene dat gedocumenteerd is? Een drietal illustraties zal duidelijk maken waar het probleem zich situeert. ..

Consensus standards for acquisition, measurement, and reporting of intravascular optical coherence tomography studies

Objectives: The purpose of this document is to make the output of the International Working Group for Intravascular Optical Coherence Tomography (IWG-IVOCT) Standardization and Validation available to medical and scientific communities, through a peer-reviewed publication, in the interest of improving the diagnosis and treatment of patients with atherosclerosis, including coronary artery disease. Background: Intravascular optical coherence tomography (IVOCT) is a catheter-based modality that acquires images at a resolution of ∼10 μm, enabling visualization of blood vessel wall microstructure in vivo at an unprecedented level of detail. IVOCT devices are now commercially available worldwide, there is an active user base, and the interest in using this technology is growing. Incorporation of IVOCT in research and daily clinical practice can be facilitated by the development of uniform terminology and consensus-based standards on use of the technology, interpretation of the images, and reporting of IVOCT results. Methods: The IWG-IVOCT, comprising more than 260 academic and industry members from Asia, Europe, and the United States, formed in 2008 and convened on the topic of IVOCT standardization through a series of 9 national and international meetings. Results: Knowledge and recommendations from this group on key areas within the IVOCT field were assembled to generate this consensus document, authored by the Writing Committee, composed of academicians who have participated in meetings and/or writing of the text. Conclusions: This document may be broadly used as a standard reference regarding the current state of the IVOCT imaging modality, intended for researchers and clinicians who use IVOCT and analyze IVOCT data

Over de receptie van de sociologische canon. Nieuwe en oude Engelse vertalingen van Webers 'protestantse ethiek'

status: publishe

The economic ethic of religious denominations: contemporary analyses

A vivid but fragmented research tradition traces the economic ethic of people and groups to their religious beliefs and practices. This approach of a Weberian inspiration has mainly been applied in historical research. However, from time to time it resurges in contemporary popular discourse and analyses, but also in more valid attempts. The problem has a broad social-scientific relevance. It refers to the more general problem of the societal relevance of religious practices and convictions on the one hand, and to the relevance of non-economic phenomena for the economy on the other. In this paper, a theoretical framework mainly based on the Weberian approach of the economic ethic and religion is elaborated. We choose two important functions for the market economy: market anomie (the extent people are prepared to break moral rules in their economic life) and market perception (the conviction the market does not function in a trustworthy manner). Both market anomie and the market perception of people are measured through the second wave of the European Social Survey (2004), an extensive survey in 24 European countries. The relevance of religion as a causal factor of these dimensions of market morality is tested and compared to the competing materialist theory of market dispositions. This theory basically assumes that the social position (class or status group) determines attitudes toward the market. We hypothesize that the religious is most important for the anomie dimension, while market perception is more based on everyday experiences, thus on class or status group position. The data seem to support these hypotheses. Finally we tested whether denominational differences have an effect on market anomie. This seems to be the case: mainly protestant denominations have a moderating effect on market anomie.status: publishe