IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v19y2022i23p15447-d980301.html
   My bibliography  Save this article

Local Welfare Systems and Health Inequalities: The Effects of Institutional Overlapping and Local Variations

Author

Listed:
  • María Jesús Rodríguez-García

    (Center for Sociology and Urban Policies, Pablo de Olavide University, 41013 Sevilla, Spain)

  • Clemente J. Navarro-Yáñez

    (Center for Sociology and Urban Policies, Pablo de Olavide University, 41013 Sevilla, Spain)

  • Ángel R. Zapata-Moya

    (Center for Sociology and Urban Policies, Pablo de Olavide University, 41013 Sevilla, Spain)

Abstract

A growing research agenda shows the importance of local welfare systems in understanding socio-spatial inequalities in health. Welfare services provided by local governments overlap with those provided by other levels of government. Thus, differences in the provision of welfare services between municipalities could explain differences in residents’ health, moderating the magnitude of health inequalities if local governments deploy actions capable of positively influencing the social determinants of health. This article attempts to analyse this idea in the Spanish case, exploring the influence of local policies according to the orientation of municipal spending on three indicators of the population’s health status: self-perceived health, healthy practices and activity limitations due to health problems. A multilevel cross-sectional study was designed using information from two waves of the 2006–2007 and 2011–2012 National Health Survey for the population aged 15 years and older (N = 31,378) residing in Spanish municipalities of 20,000 inhabitants or over (N = 373). The results show that the magnitude of inequalities in self-perceived health, in the adoption of healthy practices and in daily activity limitations by social class are smaller as municipalities” spending was oriented towards policy areas considered as redistributive. Therefore, the proposed institutional overlap thesis could help understand the role of subnational governments on the magnitude of health inequalities, as well as in comparative analysis between countries with institutional systems in which local governments have a greater or lesser capacity to provide welfare services.

Suggested Citation

  • María Jesús Rodríguez-García & Clemente J. Navarro-Yáñez & Ángel R. Zapata-Moya, 2022. "Local Welfare Systems and Health Inequalities: The Effects of Institutional Overlapping and Local Variations," IJERPH, MDPI, vol. 19(23), pages 1-16, November.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:23:p:15447-:d:980301
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/19/23/15447/pdf
    Download Restriction: no
    File URL: https://www.mdpi.com/1660-4601/19/23/15447/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Eikemo, Terje Andreas & Bambra, Clare & Judge, Ken & Ringdal, Kristen, 2008. "Welfare state regimes and differences in self-perceived health in Europe: A multilevel analysis," Social Science & Medicine, Elsevier, vol. 66(11), pages 2281-2295, June.
    2. Bernard, Paul & Charafeddine, Rana & Frohlich, Katherine L. & Daniel, Mark & Kestens, Yan & Potvin, Louise, 2007. "Health inequalities and place: A theoretical conception of neighbourhood," Social Science & Medicine, Elsevier, vol. 65(9), pages 1839-1852, November.
    3. Clemente J. Navarro Yáñez & Annick Magnier & M. Antonia Ramírez, 2008. "Local Governance as Government–Business Cooperation in Western Democracies: Analysing Local and Intergovernmental Effects by Multi‐Level Comparison," International Journal of Urban and Regional Research, Wiley Blackwell, vol. 32(3), pages 531-547, September.
    4. Claudia Costa & Paula Santana & Sani Dimitroulopoulou & Bo Burstrom & Carme Borrell & Jürgen Schweikart & Dagmar Dzurova & Nicolás Zangarini & Klea Katsouyanni & Patrick Deboseree & Ângela Freitas & C, 2019. "Population Health Inequalities Across and Within European Metropolitan Areas through the Lens of the EURO-HEALTHY Population Health Index," IJERPH, MDPI, vol. 16(5), pages 1-17, March.
    5. Ferrera, Maurizio, 2005. "The Boundaries of Welfare: European Integration and the New Spatial Politics of Social Protection," OUP Catalogue, Oxford University Press, number 9780199284672.
    6. Chris Hamnett, 1996. "Social Polarisation, Economic Restructuring and Welfare State Regimes," Urban Studies, Urban Studies Journal Limited, vol. 33(8), pages 1407-1430, October.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Scharpf, Fritz W., 2007. "Reflections on multilevel legitimacy," MPIfG Working Paper 07/3, Max Planck Institute for the Study of Societies.
    2. Spielman, Seth E. & Yoo, Eun-hye, 2009. "The spatial dimensions of neighborhood effects," Social Science & Medicine, Elsevier, vol. 68(6), pages 1098-1105, March.
    3. Chris Hamnett, 2003. "Gentrification and the Middle-class Remaking of Inner London, 1961-2001," Urban Studies, Urban Studies Journal Limited, vol. 40(12), pages 2401-2426, November.
    4. Dorte Sindbjerg Martinsen & Gabriel Pons Rotger, 2017. "The fiscal impact of EU immigration on the tax-financed welfare state: Testing the ‘welfare burden’ thesis," European Union Politics, , vol. 18(4), pages 620-639, December.
    5. Chiara Scaratti & Matilde Leonardi & Fabiola Silvaggi & Carolina C. Ávila & Amalia Muñoz-Murillo & Panayiota Stavroussi & Olga Roka & Helena Burger & Klemens Fheodoroff & Beata Tobiasz-Adamczyk & Carl, 2018. "Mapping European Welfare Models: State of the Art of Strategies for Professional Integration and Reintegration of Persons with Chronic Diseases," IJERPH, MDPI, vol. 15(4), pages 1-20, April.
    6. repec:bla:jcmkts:v:44:y:2006:i::p:845-864 is not listed on IDEAS
    7. Thomas Maloutas, 2009. "Urban Outcasts: A Contextualized Outlook on Advanced Marginality," International Journal of Urban and Regional Research, Wiley Blackwell, vol. 33(3), pages 828-834, September.
    8. Garthwaite, Kayleigh & Bambra, Clare, 2017. "“How the other half live”: Lay perspectives on health inequalities in an age of austerity," Social Science & Medicine, Elsevier, vol. 187(C), pages 268-275.
    9. M Lyons, 1999. "Professionalisation, Feminisation, and Sociospatial Polarisation in London, 1971–1991," Environment and Planning A, , vol. 31(3), pages 493-506, March.
    10. Teresa Leão & Inês Campos-Matos & Clare Bambra & Giuliano Russo & Julian Perelman, 2018. "Welfare states, the Great Recession and health: Trends in educational inequalities in self-reported health in 26 European countries," PLOS ONE, Public Library of Science, vol. 13(2), pages 1-14, February.
    11. Jean-Claude Barbier & Fabrice Colomb, 2011. "The unbearable foreignness of EU law in social policy, a sociological approach to law-making," Université Paris1 Panthéon-Sorbonne (Post-Print and Working Papers) halshs-00639906, HAL.
    12. Diesenreiter, Carina & Österle, August, 2021. "Patients as EU citizens? The implementation and corporatist stakeholders’ perceptions of the EU cross-border health care directive in Austria," Health Policy, Elsevier, vol. 125(11), pages 1498-1505.
    13. Loukas Tsoukalis, 2006. "The JCMS Lecture: Managing Diversity and Change in the European Union," Journal of Common Market Studies, Wiley Blackwell, vol. 44(1), pages 1-15, March.
    14. Brian Burgoon, 2009. "Social Nation and Social Europe," European Union Politics, , vol. 10(4), pages 427-455, December.
    15. Francesca Modena & Fabio Sabatini, 2012. "I would if I could: precarious employment and childbearing intentions in Italy," Review of Economics of the Household, Springer, vol. 10(1), pages 77-97, March.
    16. Terje A Eikemo & Rasmus Hoffmann & Margarete C Kulik & Ivana Kulhánová & Marlen Toch-Marquardt & Gwenn Menvielle & Caspar Looman & Domantas Jasilionis & Pekka Martikainen & Olle Lundberg & Johan P Mac, 2014. "How Can Inequalities in Mortality Be Reduced? A Quantitative Analysis of 6 Risk Factors in 21 European Populations," PLOS ONE, Public Library of Science, vol. 9(11), pages 1-1, November.
    17. Jonathan Pratschke & Enrica Morlicchio, 2012. "Social Polarisation, the Labour Market and Economic Restructuring in Europe: An Urban Perspective," Urban Studies, Urban Studies Journal Limited, vol. 49(9), pages 1891-1907, July.
    18. C Hamnett & D Cross, 1998. "Social Polarisation and Inequality in London: The Earnings Evidence, 1979–95," Environment and Planning C, , vol. 16(6), pages 659-680, December.
    19. Steffen Andreas Schüle & Gabriele Bolte, 2015. "Interactive and Independent Associations between the Socioeconomic and Objective Built Environment on the Neighbourhood Level and Individual Health: A Systematic Review of Multilevel Studies," PLOS ONE, Public Library of Science, vol. 10(4), pages 1-31, April.
    20. Zwiers, Merle & Kleinhans, Reinout & van Ham, Maarten, 2015. "Divided Cities: Increasing Socio-Spatial Polarization within Large Cities in the Netherlands," IZA Discussion Papers 8882, Institute of Labor Economics (IZA).
    21. Chris Hamnett, 2011. "Urban Social Polarization," Chapters, in: Ben Derudder & Michael Hoyler & Peter J. Taylor & Frank Witlox (ed.), International Handbook of Globalization and World Cities, chapter 32, Edward Elgar Publishing.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:19:y:2022:i:23:p:15447-:d:980301. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.