Inequalities in health and health behaviours between couple and lone mothers before and during the financial crisis in Spain (2003-2012)

Lone mothers report worse health and adopt more risky health behaviours than couple mothers, as largely documented in several European countries, but not deeply in Spain. The primary aim of this study was to identify the possible existence of inequalities in health and health behaviours between couple and lone mothers in Spain by occupational social class and employment status. A second aim was to explore whether any inequalities were influenced by the economic crisis beginning in 2008, analysing changes in inequalities between 2003-2004 and 2011-2012. Two waves of the cross-sectional Spanish National Health Survey data were used. Analyses were restricted to mothers aged 16-64 years, with at least one child aged 18 years or younger. The sample consisted of 2982 mothers in 2003-2004 and 3070 in 2011-2012, representing more than 80% of couple mothers. Two health outcomes and two health behaviour measurements were used. Robust Poisson regression was run to estimate inequalities between couple and lone mothers, calculating prevalence ratios adjusted by age and stratified by social class and employment status. We found inequalities in health and health behaviours between couple and lone mothers in Spain amongst the manual social class, with lone mothers reporting a more than 30% higher prevalence of poor self-perceived health and being smoker in both time points of study compared with couple mothers. Furthermore, lone mothers were at 50% higher risk of having at least one selected chronic condition and 86% higher probability of sleeping less than 6 hours/day in 2011-2012 This study could not confirm that inequalities between couple and lone mothers changed in Spain during the study period, although some patterns were noticeable. Inequalities pointed towards an increase amongst mothers in the manual social class with paid employment, while inequalities amongst unemployed mothers (both manual and non-manual social class) pointed towards a decrease

How does employment status influence the effects of residential insecurity on health? ¿Cómo influye la situación laboral en los efectos de la inseguridad residencial sobre la salud?

Altres ajuts: Agència de Salut Pública de Barcelona; Recercaixa.Objective: This study aims to analyse the effects of housing insecurity on health and whether they are modified by employment status of people belonging to the Treball als Barris programme in Barcelona (Spain) between 2015 and 2016. Method: We conducted a longitudinal study using a survey which included sociodemographic, employment and housing status information. This was administered to 469 individuals at baseline and after one year of follow-up. We then carried out a descriptive analysis and fitted regression models to estimate the effects of housing insecurity and employment status on health, and the interaction between them. Results: Among women, we found negative effects of housing insecurity on health (the prevalence ratio [PR] of poor self-reported health among women with housing insecurity was 2.29, with a 95% confidence interval [95%CI] of 1.36-3.84, compared to those in secure housing), while, among men, the main effects on health were due to employment status (PR of poor self-reported health among men who were unemployed without subsidy was 3.16 [95%CI: 1.02-6.15] compared to those who were employed after follow-up). In addition, the results suggest an interaction between housing and employment status on mental health among men. Conclusion: Housing insecurity rates have increased in recent years. It produces negative effects on health and can interact with other social determinants such as employment, mainly on men's mental health

Decline in fertility induced by economic recession in Spain Disminución de la fertilidad inducida por la crisis económica en España

To describe trends in fertility in Spain before (pre-recession; 1998-2008) and during (recession period; 2009-2013) the economic crisis of 2008, taking into account women's age and regional unemployment in 2010. The study consisted of a panel design including cross-sectional ecological data for the 17 regions of Spain. We describe fertility trends in Spain in two time periods, pre-recession (1998-2008) and recession (2009-2013). We used a cross-sectional, ecological study of Spanish-born women to calculate changes in fertility rates for each period using a linear regression model adjusted for year, period, and interaction between them. We found that compared to the pre-recession period, the fertility rate in Spain generally decreased during the economic recession. However, in some regions, such as the Canary Islands, this decrease began before the onset of the recession, while in other regions, such as the Basque country, the fertility rate continued to grow until 2011. The effects of the recession on the fertility rate are clearly observed in women aged 30-34 years. The current economic recession has disrupted the positive trend in fertility that began at the start of this century. Since Spain already had very low fertility rates, the further decline caused by the economic recession could jeopardize the sustainability of welfare-state systems

Trends in cancer mortality in Spain : the influence of the financial crisis Evolución de la mortalidad por cáncer en España: influencia de la crisis económica

Objective: To determine if the onset of the economic crisis in Spain affected cancer mortality and mortality trends. Method: We conducted a longitudinal ecological study based on all cancer-related deaths and on specific types of cancer (lung, colon, breast and prostate) in Spain between 2000 and 2013. We computed age-standardised mortality rates in men and women, and fit mixed Poisson models to analyse the effect of the crisis on cancer mortality and trends therein. Results: After the onset of the economic crisis, cancer mortality continued to decline, but with a significant slowing of the yearly rate of decline (men: RR = 0.987, 95%CI = 0.985-0.990, before the crisis, and RR = 0.993, 95%CI = 0.991-0.996, afterwards; women: RR = 0.990, 95%CI = 0.988-0.993, before, and RR = 1.002, 95%CI = 0.998-1.006, afterwards). In men, lung cancer mortality was reduced, continuing the trend observed in the pre-crisis period; the trend in colon cancer mortality did not change significantly and continued to increase; and the yearly decline in prostate cancer mortality slowed significantly. In women, lung cancer mortality continued to increase each year, as before the crisis; colon cancer continued to decease; and the previous yearly downward trend in breast cancer mortality slowed down following the onset of the crisis. Conclusions: Since the onset of the economic crisis in Spain the rate of decline in cancer mortality has slowed significantly, and this situation could be exacerbated by the current austerity measures in healthcare

Social and material determinants of health in participants in an active labor market program in Barcelona

Background: Unemployment affects the physical and mental health of affected individuals, which can be explained by its direct effect on worsening finances due to the lack of income as well as by its negative psychosocial effects. "Employment in the Neighborhoods" return to work program was implemented in Barcelona specifically in the neighborhoods characterized with a greater economic deprivation and by high unemployment to improve personal and occupational abilities and skills of the participants to reintegrate them into the workforce. The aim of this study is to determine the association between the lack of economic resources and psychosocial factors with respect to mental health and self-rated health in unemployed persons participating in the program "Employment in the Neighborhoods". Methods: Cross-sectional study. Data collected from a self-administered questionnaire. Generalized linear models were constructed, adjusted by age and social class, to estimate prevalence ratios and analyze any possible association between economic resources, psychosocial factors and poor self-rated health and mental health. Results: Nine hundred forty-eight persons of 2763 participants in the "Employment in the Neighborhoods" program completed the questionnaire. 46.9% were women. 72.5% of women and 61.9% of men were at risk of poor mental health and 25.5% of women and 21.1% of men reported poor self-rated health. Low self-esteem [women: PR 1.88 95%CI (1.24-2.84); men: PR 2.51 95%CI (1.57-4.02)] and medium social support [2.01 (1.30-3.09)], in men, and low social support [1.74 (1.13-2.68)] in women are associated with worsening of self-rated health. In men, low self-esteem [1.40 (1.19-1.64)] and delay in paying bills [1.38 (1.17-1.64)] were associated with the risk of poor mental health; in women were associated low self-esteem [1.27 (1.11-1.44)] and received a non-contributory allowance [1.37 (1.09-1.74)]. Conclusions: Economic resources, self-esteem and social support are necessary for good general and mental health among unemployed persons. The high prevalence of poor mental health among persons participating in the active labor market program "Employment in the Neighborhoods" could be due to a substantial deficit in these factors

Relationship between non-standard work arrangements and work-related accident absence in Belgium

Objectives: The main objective of this study is to examine the relationship between indicators of nonstandard work arrangements, including precarious contract, long working hours, multiple jobs, shift work, and work-related accident absence, using a representative Belgian sample and considering several socio-demographic and work characteristics. Methods: This study was based on the data of the fifth European Working Conditions Survey (EWCS). For the analysis, the sample was restricted to 3343 respondents from Belgium who were all employed workers. The associations between non-standard work arrangements and work-related accident absence were studied with multivariate logistic regression modeling techniques while adjusting for several confounders. Results : During the last 12 months, about 11.7% of workers were absent from work because of work-related accident. A multivariate regression model showed an increased injury risk for those performing shift work (OR 1.546, 95% CI 1.074-2.224). The relationship between contract type and occupational injuries was not significant (OR 1.163, 95% CI 0.739-1.831). Furthermore, no statistically significant differences were observed for those performing long working hours (OR 1.217, 95% CI 0.638-2.321) and those performing multiple jobs (OR 1.361, 95% CI 0.827-2.240) in relation to work-related accident absence. Those who rated their health as bad, low educated workers, workers from the construction sector, and those exposed to biomechanical exposure (BM) were more frequent victims of work-related accident absence. No significant gender difference was observed. Conclusion : Indicators of nonstandard work arrangements under this study, except shift work, were not significantly associated with work-related accident absence. To reduce the burden of occupational injuries, not only risk reduction strategies and interventions are needed but also policy efforts are to be undertaken to limit shift work. In general, preventive measures and more training on the job are needed to ensure the safety and well-being of all workers

Budgetary Impact of Gender Mainstreaming and Its Implementations in the EU and Turkey

This chapter focuses on the implementation of the gender mainstreaming (GM) strategy through gender-responsive budgeting (GRB). In doing so, it first looks at the legal improvements that have been achieved within the scope of GM and GRB in Turkey since 1980. Then, drawing on a Turkish local government as a case study, it evaluates the GRB initiatives and the projects and the role of the EU in setting up a GRB agenda. The chapter concludes with a discussion on the limitations of the EU in generating sustainable changes in the lives of women and girls, mostly arising from domestic institutional factors and the lack of resonance of the EU’s norms in Turkey. © 2021, The Author(s)