Health Inequalities, Economic Crisis, and the Welfare State

To what extent are individual unemployment transitions during the Great Recession in Europe associated with deteriorating health? Investigations of the individual health effects of unemployment transition suggest that unemployment has negative effects on health. However, this project indicates that these effects are found to be less detrimental in countries providing generous unemployment benefits and services. There is some evidence for a mediating effect of financial strain, but little indication of a mediating effect of declining income on the health effects of individual unemployment. Declining income per se does not seem to be the mechanism explaining the health effects of unemployment. Another central question in this project has been to explore how people in ill-health fare in the labour market in times of the current recession and under different institutional circumstances. A set of studies have thus investigated cross-national differences in hiring, firing, and health. A first finding is that labor market deregulation, i.e. weak employment protection and more temporary work contracts is not beneficial for people with ill health. As regards the potential impact of societal institutions, stronger employment protection legislation seems to improve the situation, although people with health problems tend to be among the first to lose their jobs during an economic downturn. The Scandinavian welfare states have apparently kept the unemployed in good health, showing the importance of reasonably generous unemployment benefits. It appears that the composition of the unemployed population is of vital importance for why the unemployment health relationship varies over time and geographical space. One study indicates that in countries that are hardest hit by the recession, the unemployed population is healthier than in countries that have experienced a milder downturn suggesting that during mass-unemployment many healthy people also loose their jobs.

A tension between a social investment and a welfare scepticism perspective underlies research on relationships between welfare states and social inequalities in health and the consequences of ill-health. The former perspective emphasizes that comprehensiv e welfare states benefit population health through the provision of collective resources. The latter holds that too generous welfare states will hamper economic growth and hence wealth and health, and ultimately lead to low levels of employment because of weak work-incentives. This project seeks to strengthen the research basis for this debate by a cross-European comparative study using data from the EU-SILC (annual surveys covering about 270,000 adults, sampled from most European countries), in combinati on with country information on economic indicators and social policies. The project will focus on developments over the past decade through research organized in three work packages (WPs). WP1 assesses country changes in socioeconomic and gender inequalit ies in illness and its consequences before and under the crisis.WP1 is based on cross-sectional data.By means of panel data WP2 addresses country patterns in transitions from work to economic inactivity among the ill, and the social consequences of such t ransitions. WP3 adopts a case approach and compare developments in a small number of countries (Norway, Sweden, Germany and the UK). The aim is to examine in detail how the impact of the crisis, and the political responses to it, have affected how disadva ntaged groups fare in the labour market before and under the crisis. The project, organized from Oslo and Akershus University College, will have extensive collaboration with the two new EU-projects "DRIVERS" and "DEMETRIQ". Two doctoral students will be r ecruited on the project. Main dissemination methods will be through articles in international academic journals, and papers presented at international conferences.