ArticleInternational journal for equity in health2016
Income inequality and foregone medical care in Europe during The Great Recession: multilevel analyses of EU-SILC surveys 2008-2013.
Article in International journal for equity in health, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers.
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Who cites it
26 citing papers in PubMed, 47 citations in OpenAlex.
- Equity Meets Primary-Care-Sensitive Performance: A Longitudinal Benchmark of Cost-Related Unmet Care and Avoidable Hospitalization in Europe.Healthcare (Basel, Switzerland) · 2026Article
- Forgone and delayed care in Germany- inequalities and perceived health risk of unmet need.International journal for equity in health · 2025Article
- Global, regional, and national burden of atrial fibrillation and atrial flutter from 1990 to 2021: sex differences and global burden projections to 2046-a systematic analysis of the Global Burden of Disease Study 2021.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2025Article
- Utilization of Health Care Services and Accessibility Challenges among Adults Aged 50+ before and after Austerity Measures across 27 European Countries: Secular Trends in the SHARE Study from 2004/05 to 2019/20.Healthcare (Basel, Switzerland) · 2024Article
- Deconstructing subjective unmet healthcare needs: a South Korean case study with policy implications.Frontiers in public health · 2024Article
- Two sides of the same coin? Absolute income and perceived income inadequacy as social determinants of health.International journal for equity in health · 2023Article
- Determinants of individual income in EU countries: implications for social policy targeting.Frontiers in sociology · 2023Article
- Changes in Barriers That Cause Unmet Healthcare Needs in the Life Cycle of Adulthood and Their Policy Implications: A Need-Selection Model Analysis of the Korea Health Panel Survey Data.Healthcare (Basel, Switzerland) · 2022Article
- Foregone healthcare during the COVID-19 pandemic: early survey estimates from 39 low- and middle-income countries.Health policy and planning · 2022Article
- Understanding the Effect of Economic Recession on Healthcare Services: A Systematic Review.Iranian journal of public health · 2022Review
- Characteristics Associated With Financial or Non-financial Barriers to Healthcare in a Universal Health Insurance System: A Longitudinal Analysis of Korea Health Panel Survey Data.Frontiers in public health · 2022Article
- Investigating unmet need for healthcare using the European Health Interview Survey: a cross-sectional survey study of Luxembourg.BMJ open · 2021Article
- Determining the reasons for unmet healthcare needs in South Korea: a secondary data analysis.Health and quality of life outcomes · 2021Article
- The unequal effects of austerity measures between income-groups on the access to healthcare: a quasi-experimental approach.International journal for equity in health · 2021Article
- Income-related inequalities in unmet dental care needs in Spain: traces left by the Great Recession.International journal for equity in health · 2020Article
- Medical crowdfunding in a healthcare system with universal coverage: an exploratory study.BMC public health · 2020Article
- Reasons for unmet needs for health care: the role of social capital and social support in some western EU countries.International journal of health economics and management · 2020Article
- Observational
- How Does Economic Inequality Affect Infanticide Rates? An Analysis of 15 Years of Death Records and Representative Economic Data.International journal of environmental research and public health · 2019Article
- The geography and economics of forgoing medical examinations or therapeutic treatments in Italy during the economic crisis.BMC public health · 2019Article
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Authors and funding
1 author at 1 institution in 1 country.
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Abstract
backgroundThe association between income inequality and societal performance has been intensely debated in recent decades. This paper reports how unmet need for medical care has changed in Europe during The Great Recession, and investigates whether countries with smaller income differences have been more successful than inegalitarian countries in protecting access to medical care during an economic crisis.
methodsSix waves of EU-SILC surveys (2008-2013) from 30 European countries were analyzed. Foregone medical care, defined as self-reported unmet need for medical care due to costs, waiting lists, or travel difficulties, was examined among respondents aged 30-59 years (N = 1.24 million). Countries' macro-economic situation was measured by Real Gross Domestic Product (GDP) per capita. The S80/S20 ratio indicated the country's level of income inequality. Equity issues were highlighted by separate analyses of disadvantaged respondents with limited economic resources and relatively poor health. Cross-tabulations and multilevel linear probability regression models were utilized.
resultsForegone medical care increased 2008-2013 in the majority of the 30 countries, especially among the disadvantaged parts of the population. For the disadvantaged, unmet need for medical care tended to be higher in countries with larger income inequalities, regardless of the average economic standard in terms of GDP per capita. Both for disadvantaged and for other parts of the samples, a decline in GDP had more severe effects on access in inegalitarian countries than in countries with less income inequality.
conclusionsDuring The Great Recession, unmet need for medical care increased in Europe, and social inequalities in foregone medical care widened. Overall, countries with a more egalitarian income distribution have been more able to protect their populations, and especially disadvantaged groups, against deteriorated access to medical care when the country is confronted with an economic crisis.
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