Thursday, February 16, 2012

[EQ] Health, wealth and ways of life: What can we learn from the Swedish, US and UK experience?

Health, wealth and ways of life:
What can we learn from the Swedish, US and UK experience?

Social Science & Medicine  Volume 74, Issue 5,  March 2012

Available at:

Table of Content

Introduction to the commentaries   

Monica Desai, Jeremiah A. Barondess, Sven-Olof Isacsson, David Misselbrook      


2.         Health, wealth and ways of life: What can we learn from the Swedish, US and UK experience? Overview   

Sarah Curtis, Giovanni S. Leonardi         


3.          Economic crises: Some thoughts on why, when and where they (might) matter for health—A tale of three countries


George A. Kaplan

Center for Social Epidemiology and Population Health, University of Michigan, Ann Arbor, Michigan, USA




That we have been in the midst of a global economic crisis since 2008, should surprise no one. However, there is less agreement as to the potential downstream and future effects of a crisis that has led to both personal and societal pain, trillions of dollars of wealth lost, near collapse of some governments, dangerously high levels of unemployment in some places, and a palpable sense to many that this crisis will leave an imprint on future generations.


In what follows, I will ask if it is reasonable to expect that this imprint will extend to the health of populations, how health may be affected, and whether we can expect that the impacts on health will be felt equally across countries. I acknowledge at the outset, that there no clear answers. In the absence of clear data-driven signposts, I will provide a framework for exploring the potential health implications of economic crises. I will be focusing on three wealthy countries, Sweden, the United Kingdom, and the United States, but we should recognize that the effects will be more extreme among those poor countries that are already highly vulnerable.





Why might economic crises have an effect on health?

Do these social determinants impact health in Sweden, the United States, and the United Kingdom?

Impact of unemployment on health

Impact of income and wealth on health

Impact of education on health

Neighborhood quality and health

Availability of health care and health

Might we expect economic crises to have differential effects in the three countries?

Importance of a life course perspective


4.         Will the recession be bad for our health? It depends    -Marc Suhrcke, David Stuckler

5.         Sweden – Socioeconomic factors and health    -Bo Burström

6.         United States – Challenges of economic and demographic trends    -Lisa F. Berkman           

7.         Explaining health inequality: Evidence from the UK    - Mel Bartley    

8.         Impact of socioeconomic determinants on psychosocial factors and lifestyle - implications for health servi The Swedish experience 
            Margareta Kristenson

9.         Health inequalities by class and race in the US: What can we learn from the patterns?    Paula Braveman

10.        The Swedish perspective – A puzzle    - Sven Bremberg           

11.        Addressing health inequalities in the US: A life course health development approach   -Neal Halfon        

12.        Re-engineering health systems: The U.S. experience    - Gail R. Wilensky        


13.        How can our health systems be re-engineered to meet the future challenges? The Swedish experience   - Johan Calltorp   

14.        Sustainable policies to improve health and prevent climate change    - Andy Haines

15.        Health systems, health and wealth: The argument for investment applies now more than ever   - Martin McKee, Sanjay Basu, David Stuckler

16.        Economic growth and health progress in England and Wales: 160 years of a changing relation  

            José A. Tapia Granados

Economic growth and health progress in England and Wales are analyzed in 1840–2000. The increase in life expectancy at birth (LEB) or the decrease in mortality rates are used as indicators of health progress.  A negative relation is found between GDP growth and health progress – the lower the rate of growth of the economy, the greater the annual increase in LEB for both males and females.

 The effect is much stronger in 1900–1950 than in 1950–2000, and is very weak in the 19th century, and appears basically at lag zero.  These results add to an emerging consensus that mortality rates drop faster during recessions than during expansions.          

17.        Social support, volunteering and health around the world: Cross-national evidence from 139 countries  

            Santosh Kumar, Rocio Calvo, Mauricio Avendano, Kavita Sivaramakrishnan, Lisa F. Berkman

18.        Utilization of epidemiological research for the development of local public health policy in the Netherlands:
           Joyce de Goede, Kim Putters, Hans van Oers      


19.        Practitioner opinions on health promotion interventions that work: Opening the 'black box' of a linear evidence-based approach  
            Maarten O. Kok, Lenneke Vaandrager, Roland Bal, Jantine Schuit

20.        Coping with health care expenses among poor households: Evidence from a rural commune in Vietnam  
            Kim Thuy Nguyen, Oanh Thi Hai Khuat, Shuangge Ma, Duc Cuong Pham, Giang Thi Hong Khuat, Jennifer Prah Ruger

            Lost income and indirect costs comprise near half the health payment burden for households in a Vietnamese rural commune.
            Poor households are most vulnerable to consequences of funding health treatments through debt and food reduction.
            Policy must account for all health treatment costs, especially self-treatments and lost income.
            Stronger risk-pooling mechanisms should be developed, and official and unofficial payments should be regulated.              

21.        Socioeconomic pathways to depressive symptoms in adulthood: Evidence from the National Longitudinal Survey of Youth

             Amélie Quesnel-Vallée, Miles Taylor

Parents' education had an inverse relationship with respondents' depressive symptoms in adulthood.
This relationship was fully explained by respondents' education. In turn, the effect of respondent's education was also largely mediated by their household
income. Adult depressive symptoms are the outcome of life course pathways of social attainment rooted in parents' education.  Increasing educational opportunities may break the intergenerational transmission of low status and poor mental health.     

22.        Chinese and Korean immigrants' early life deprivation:
             An important factor for child feeding practices and children's body weight in the United States            

            Charissa S.L. Cheah, Jennifer Van Hook

Child feeding practices of Chinese and Korean American immigrants were influenced by their early material deprivation and current acculturation. ► Less acculturated parents' early life food insecurity predicted desires for more heavy children and children's soda/sweets consumption. ► Less acculturated parents' early material deprivation predicted more laissez-faire child feeding practices. ► Thus, child feeding practices and beliefs are shaped by parents' childhood material hardship, which fade with acculturation.         

23.        Uses and abuses of the resilience construct: Loss, trauma, and health-related adversities    -George A. Bonanno          

24.        Protective factors and predictors of vulnerability to chronic stress: A comparative study of 4 communities after 7 years of continuous rocket

            Marc Gelkopf, Rony Berger, Avraham Bleich, Roxane Cohen Silver           

25.        Scientific tools, fake treatments, or triggers for psychological healing: How clinical trial participants conceptualise placebos  

             Felicity L. Bishop, Eric E. Jacobson, Jessica R. Shaw, Ted J. Kaptchuk

              At their most negative, US trial participants conceptualised placebo effects as illusory effects produced by fake treatments.
              At their most positive, placebo effects were valued and conceptualised as examples of psychological healing mechanisms.
              Negative conceptualisations of placebo effects led participants to see placebo responders as gullible.
              Information for clinical trial participants should accurately reflect current scientific knowledge about placebo effects.  

26.        A 'beautiful death': Mortality, death, and holidays in a Mexican municipality  

            José L. Wilches-Gutiérrez, Luz Arenas-Monreal, Alfredo Paulo-Maya, Ingris Peláez-Ballestas, Alvaro J. Idrovo

First study to explore the relationship between mortality and public holidays in a Latin American context (Morelos, Mexico). ► Incorporates quantitative and qualitative methods within the framework of cultural epidemiology. ► Suggests that Mexican cultural and religious beliefs guide the interpretation of death as a 'beautiful' process.          

27.        Therapeutic landscapes and postcolonial theory: A theoretical approach to medical tourism    - Christine N. Buzinde, Careen Yarnal 

28.        Medical ideology as a double-edged sword: The politics of cure and care in the making of Alzheimer's disease  
            Claudia Chaufan, Brooke Hollister, Jennifer Nazareno, Patrick Fox

            The medicalization of senility legitimized the Alzheimer's disease social movement and helped raise awareness of the problems of aging.
            The medicalization of senility also undermined advocacy for long-term care.  Medicalizing health-related social problems
            can backfire on social movements seeking redress to their grievances.  Activists must demand that needs and humanity of all persons
            be acknowledged as sources of legitimacy in themselves.              

29.        'Doing the "Right" Thing': How parents experience and manage decision-making for children's 'Normalising' surgeries  

             Pauline Anne Nelson, Ann-Louise Caress, Anne-Marie Glenny, Susan A. Kirk


 Parents' decisions for children's elective, 'normalising' surgeries in England were examined using cleft lip and palate as an exemplar.  Parents saw the pursuit of 'normalising' surgeries to facilitate their child's social inclusion as a 'moral' obligation.  Specialist practitioners were firmly trusted, but parents could be vulnerable to unequal power relationships with them.  Parents' decision-making in this context is complex and involves strong emotional, social and cultural influences.  Services could support parents by gauging their emotional/decisional needs and helping them consider all available options.     




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