Understanding Recession and Self-Rated Health with the Partial Proportional Odds Model: An Analysis of 26 Countries

Introduction: Self-rated health is demonstrated to vary substantially by both personal socio-economic status and national economic conditions. However, studies investigating the combined influence of individual and country level economic indicators across several countries in the context of recent global recession are limited. This paper furthers our knowledge of the effect of recession on health at both the individual and national level. Methods: Using the Life in Transition II study, which provides data from 19,759 individuals across 26 European nations, we examine the relationship between self-rated health, personal economic experiences, and macro-economic change. Data analyses include, but are not limited to, the partial proportional odds model which permits the effect of predictors to vary across different levels of our dependent variable. Results: Household experiences with recession, especially a loss of staple good consumption, are associated with lower self-rated health. Most individual-level experiences with recession, such as a job loss, have relatively small negative effects on perceived health; the effect of individual or household economic hardship is strongest in high income nations. Our findings also suggest that macroeconomic growth improves self-rated health in low-income nations but has no effect in high-income nations. Individuals with the greatest probability of “good” self-rated health reside in wealthy countries ($23,910 to $50, 870 GNI per capita). Conclusion: Both individual and national economic variables are predictive of self-rated health. Personal and household experiences are most consequential for self-rated health in high income nations, while macroeconomic growth is most consequential in low-income nations.