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Exploring the Complex Associations Among Social Determinants of Health in Andalusia After the 2008 Financial Crisis

Author

Listed:
  • Javier Álvarez-Gálvez

    (Universidad de Cádiz)

  • María Luisa Rodero-Cosano

    (Universidad Loyola Andalucía)

  • José A. Salinas-Pérez

    (Universidad Loyola Andalucía)

  • Diego Gómez-Baya

    (Universidad de Huelva)

Abstract

In this study, we disentangle the complex relationship between structural and intermediary social determinants of health in Andalusia (Spain) after the period of economic downturn, with the aim to understand the factors that might be addressed to reduce future health inequalities in socioeconomically vulnerable regions. Data from the IMPACT-A project were used. Our sample included 1200 individuals randomly selected using a stratified sampling process according to gender, age group and eight provinces in Andalusia (Spain). Structural equation modeling was conducted to test the goodness of fit of our data with the previous theoretical background. Our results indicated that socioeconomic factors and demographics are associated to health by influencing lifestyles, socioeconomic experiences during the crisis, and personal wellbeing. Additionally, several remarkable contributions from the results can be highlighted: (a) important differences in health outcomes were found in Andalusian females, (b) there was no relationship between income and lifestyles, (c) people with unmet medical needs demonstrated a higher perception of social discrimination, and (d) discrimination and happiness had a mediating effect on health. The final model accounts for more than one-third of the variance in health and describes the complex association of social determinants that might be addressed to reduce inequities in health in this region.

Suggested Citation

  • Javier Álvarez-Gálvez & María Luisa Rodero-Cosano & José A. Salinas-Pérez & Diego Gómez-Baya, 2019. "Exploring the Complex Associations Among Social Determinants of Health in Andalusia After the 2008 Financial Crisis," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 141(2), pages 873-893, January.
    • Handle: RePEc:spr:soinre:v:141:y:2019:i:2:d:10.1007_s11205-018-1845-z
    DOI: 10.1007/s11205-018-1845-z
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    1. Wilkinson, Richard G & Pickett, Kate E., 2006. "Income inequality and population health: A review and explanation of the evidence," Social Science & Medicine, Elsevier, vol. 62(7), pages 1768-1784, April.
    2. Peter Adams & Michael D. Hurd & Daniel L. McFadden & Angela Merrill & Tiago Ribeiro, 2004. "Healthy, Wealthy, and Wise? Tests for Direct Causal Paths between Health and Socioeconomic Status," NBER Chapters, in: Perspectives on the Economics of Aging, pages 415-526, National Bureau of Economic Research, Inc.
    3. Lawrence, Elizabeth M. & Rogers, Richard G. & Wadsworth, Tim, 2015. "Happiness and longevity in the United States," Social Science & Medicine, Elsevier, vol. 145(C), pages 115-119.
    4. Ketevan Glonti & Vladimir S Gordeev & Yevgeniy Goryakin & Aaron Reeves & David Stuckler & Martin McKee & Bayard Roberts, 2015. "A Systematic Review on Health Resilience to Economic Crises," PLOS ONE, Public Library of Science, vol. 10(4), pages 1-22, April.
    5. Blodorn, Alison & Major, Brenda & Kaiser, Cheryl, 2016. "Perceived discrimination and poor health: Accounting for self-blame complicates a well-established relationship," Social Science & Medicine, Elsevier, vol. 153(C), pages 27-34.
    6. Gallo, Pedro & Gené-Badia, Joan, 2013. "Cuts drive health system reforms in Spain," Health Policy, Elsevier, vol. 113(1), pages 1-7.
    7. Marmot, M. & Allen, J.J., 2014. "Social determinants of health equity," American Journal of Public Health, American Public Health Association, vol. 104(S4), pages 517-519.
    8. Javier Alvarez-Galvez & Luis Salvador-Carulla, 2013. "Perceived Discrimination and Self-Rated Health in Europe: Evidence from the European Social Survey (2010)," PLOS ONE, Public Library of Science, vol. 8(9), pages 1-1, September.
    9. Cervero-Liceras, Francisco & McKee, Martin & Legido-Quigley, Helena, 2015. "The effects of the financial crisis and austerity measures on the Spanish health care system: A qualitative analysis of health professionals’ perceptions in the region of Valencia," Health Policy, Elsevier, vol. 119(1), pages 100-106.
    10. Mackenbach, Johan P., 2012. "The persistence of health inequalities in modern welfare states: The explanation of a paradox," Social Science & Medicine, Elsevier, vol. 75(4), pages 761-769.
    11. Frijters, Paul & Haisken-DeNew, John P. & Shields, Michael A., 2005. "The causal effect of income on health: Evidence from German reunification," Journal of Health Economics, Elsevier, vol. 24(5), pages 997-1017, September.
    12. Frijters, Paul & Haisken-DeNew, John P. & Shields, Michael A., 2005. "The causal effect of income on health: Evidence from German reunification," Journal of Health Economics, Elsevier, vol. 24(5), pages 997-1017, September.
    13. Dahl, Espen & van der Wel, Kjetil A., 2013. "Educational inequalities in health in European welfare states: A social expenditure approach," Social Science & Medicine, Elsevier, vol. 81(C), pages 60-69.
    14. Seung-Sup Kim & David R Williams, 2012. "Perceived Discrimination and Self-Rated Health in South Korea: A Nationally Representative Survey," PLOS ONE, Public Library of Science, vol. 7(1), pages 1-8, January.
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