The differential impact of the financial crisis on health in Ireland and Greece: a quasi-experimental approach

Objectives: Greece and Ireland suffered an economic recession of similar magnitude, but whether their health has deteriorated as a result has not yet been well established. Study design: Based on five waves (2006-2010) of the European Union Statistics of Income and Living Conditions (EU-SILC) survey we implemented a difference-in-differences (DID) approach that compared trends in self-rated health in Greece and Ireland before and after the crisis with trends in a ‘control’ population (Poland) that did not experience a recession and had health trends comparable to both countries before the crisis. Methods: Logistic regression using a difference-in-differences (DID) approach. Results: A simple examination of trends suggests that there was no significant change in health in Greece or Ireland following the onset of the financial crisis. However, DID estimates that incorporated a control population suggest an increase in the prevalence of poor-self rated health in Greece (OR=1.216; CI=1.11 - 1.32). Effects were most pronounced for older individuals and those living in high-density areas, but effects in Greece were overwhelmingly consistent in different population sub-groups. In contrast, DID estimates revealed no effect of the financial crisis on the prevalence of poor self-rated health in Ireland (OR=0.97; CI=0.81-1.16). Conclusions: DID estimates suggest that the financial crisis led to higher prevalence of reporting poor health in Greece but not in Ireland. Although our research design does not allow us to directly assess the role of specific policies, contextual factors including policy responses may have contributed to the different effect of the crisis on the health of the two countries.