ArticleInternational journal of epidemiology2018
The Great Recession and inequalities in access to health care: a study of unemployment and unmet medical need in Europe in the economic crisis.
Article in International journal of epidemiology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 25 citations in OpenAlex.
- Macroeconomic shock-response functions of health system resilience and equity: a global simulation study.npj health systems · 2026Article
- The impact of socioeconomic crisis on cancer patient outcomes in Lebanon, 2018-2020.Journal of comparative effectiveness research · 2026Article
- Unmet need for healthcare services among unemployed people - findings from a national survey in Finland.BMC health services research · 2025Article
- Unmet health care needs among the working-age population: Evidence from the Great Recession in Spain (2008-2012).Anales del sistema sanitario de Navarra · 2024Article
- Social environment, health cognition, and health behavior: how individuals with non-fixed employment end up with adverse health outcomes in China under the era of VUCA?-findings from PLS-SEM and fsQCA.Frontiers in public health · 2024Article
- Austerity, economic hardship and access to medications: a repeated cross-sectional population survey study, 2013-2020.Journal of epidemiology and community health · 2023Article
- Health-Related Quality of Life during COVID-19 Pandemic: Assessing Impacts of Job Loss and Financial Support Programs in Japan.Applied research in quality of life · 2022Article
- Investigating unmet need for healthcare using the European Health Interview Survey: a cross-sectional survey study of Luxembourg.BMJ open · 2021Article
- Forgoing health care under universal health insurance: the case of France.International journal of public health · 2020Article
- 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
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Unmet medical need (UMN) had been declining steadily across Europe until the 2008 Recession, a period characterized by rising unemployment. We examined whether becoming unemployed increased the risk of UMN during the Great Recession and whether the extent of out-of-pocket payments (OOP) for health care and income replacement for the unemployed (IRU) moderated this relationship. Methods: We used the European Survey on Income and Living Conditions (EU-SILC) to construct a pseudo-panel (n = 135 529) across 25 countries to estimate the relationship between unemployment and UMN. We estimated linear probability models, using a baseline of employed people with no UMN, to test whether this relationship is mediated by financial hardship and moderated by levels of OOP and IRU. Results: Job loss increased the risk of UMN [β = 0.027, 95% confidence interval (CI) 0.022-0.033] and financial hardship exacerbated this effect. Fewer people experiencing job loss lost access to health care in countries where OOPs were low or in countries where IRU is high. The results are robust to different model specifications. Conclusions: Unemployment does not necessarily compromise access to health care. Rather, access is jeopardized by diminishing financial resources that accompany job loss. Lower OOPs or higher IRU protect against loss of access, but they cannot guarantee it. Policy solutions should secure financial protection for the unemployed so that resources do not have to be diverted from health.
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