Impact-A

Background

Health inequalities are closely related to variations in social and economic determinants of health. This work is aimed at studying how the economic downturn has affected the relationship between socioeconomic status (SES) and health for Spanish population, and how these changes might explain the emergence of health inequalities in different regions of Spain, with a specific focus in Andalusia.

Methods

In this study, we use quantitative data from the project IMPACT-A, in particular information from the Spanish Health Barometers (2005-2014), to explain the variations between SES and health in Spain during the recent economic crisis. The contextual effect of social and macroeconomic indicators is analyzed through the use of multilevel regression models.

Results

Despite the effect of economic indicator is moderated by the Spanish universal system of health provision, our results show that recent changes on individual and contextual socioeconomic factors have a significant impact on health, especially between groups in risk of social exclusion. The multilevel analysis technique describes the complex relationship between the changes in socioeconomic and health inequalities, which could be related with the recent variation in health and social policies.

Conclusions

The present work studies the changes in socioeconomic determinants of health and analyzes the evolution in this relationship for the period 2005–2014 in Spain. This study supports the existence of contextual effects among Spanish regions that varies the association between SES measures and health, and therefore points out the relevance of socioeconomic context in explaining the differences in individuals’ states of health. In addition, our model indicates that more attention should be paid to less studied SES measures, especially those related to the position of individuals in globalized labor markets.

Key messages:

• This study describes the complex relationship between the changes in socioeconomic and health inequalities

• Supports the existence of contextual effects among Spanish regions that varies the association between SES and health