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Aim
Comparative research on health and health inequalities has recently begun implementing a welfare regime perspective. The aim of the study was to review the existing evidence for identifying the determinants of health and health inequalities in highly developed welfare states and to develop a theoretical model for future research approaches.
Subject
A welfare state regime typology is applied to comparatively analyse (1) the relationship between the level of economic prosperity in a society and its respective level of overall population health and (2) the nature of the corresponding relationship between economic inequalities and health inequalities in different groups of countries.
Results
Although the Social Democratic welfare states have a relatively equal distribution of material wealth as well as the highest levels of population health, they are not characterised by the smallest levels of health inequality. Rather, with respect to health equality, conservative countries seem to perform better than social democracies. We propose a comprehensive theoretical model that takes into account different factors on the structural (macro), organisational (meso) and individual (micro) level in order to contribute to a better understanding of this important challenge for public health policy and practice.
Conclusion
Future research will require an appropriate theoretical model with the potential to explain health and health inequalities in different types of welfare states. On the basis of this model, future research should test the hypothesis that in highly developed countries not only economic, but also social, cultural and lifestyle factors are important in determining health outcomes in different segments of the population.
Objectives
Little is known about the impact of recessions on young people’s socioeconomic inequalities in health. This study investigates the impact of the economic recession in terms of youth unemployment on socioeconomic inequalities in psychological health complaints among adolescents across Europe and North America.
Methods
Data from the WHO collaborative ‘Health Behaviour in School-aged Children’ (HBSC) study were collected in 2005/06 (N = 160,830) and 2009/10 (N = 166,590) in 31 European and North American countries. Logistic multilevel models were used to assess the contribution of youth unemployment in 2009/10 (enduring recession) and the change in youth unemployment (2005–2010) to adolescent psychological health complaints and socioeconomic inequalities in complaints in 2009/10.
Results
Youth unemployment during the recession is positively related to psychological health complaints, but not to inequalities in complaints. Changes in youth unemployment (2005–2010) were not associated with adolescents’ psychological health complaints, whereas greater inequalities in complaints were found in countries with greater increases in youth unemployment.
Conclusions
This study highlights the need to tackle the impact of increasing unemployment on adolescent health and health inequalities during economic recessions.