Unemployment, public-sector healthcare spending and stomach cancer mortality in the European Union, 1981-2009.
OBJECTIVES: We sought to determine the association between changes in unemployment, healthcare spending and stomach cancer mortality. METHODS: Multivariate regression analysis was used to assess how changes in unemployment and public-sector expenditure on healthcare (PSEH) varied with stomach cancer...
| Autori principali: | , , , , , , , |
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| Natura: | Journal article |
| Lingua: | English |
| Pubblicazione: |
Lippincott Williams and Wilkins
2014
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| _version_ | 1826271559096991744 |
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| author | Maruthappu, M Painter, A Watkins, J Williams, C Ali, R Zeltner, T Faiz, O Sheth, H |
| author_facet | Maruthappu, M Painter, A Watkins, J Williams, C Ali, R Zeltner, T Faiz, O Sheth, H |
| author_sort | Maruthappu, M |
| collection | OXFORD |
| description | OBJECTIVES: We sought to determine the association between changes in unemployment, healthcare spending and stomach cancer mortality. METHODS: Multivariate regression analysis was used to assess how changes in unemployment and public-sector expenditure on healthcare (PSEH) varied with stomach cancer mortality in 25 member states of the European Union from 1981 to 2009. Country-specific differences in healthcare infrastructure and demographics were controlled for 1- to 5-year time-lag analyses and robustness checks were carried out. RESULTS: A 1% increase in unemployment was associated with a significant increase in stomach cancer mortality in both men and women [men: coefficient (R)=0.1080, 95% confidence interval (CI)=0.0470-0.1690, P=0.0006; women: R=0.0488, 95% CI=0.0168-0.0809, P=0.0029]. A 1% increase in PSEH was associated with a significant decrease in stomach cancer mortality (men: R=-0.0009, 95% CI=-0.0013 to -0.005, P<0.0001; women: R=-0.0004, 95% CI=-0.0007 to -0.0001, P=0.0054). The associations remained when economic factors, urbanization, nutrition and alcohol intake were controlled for, but not when healthcare resources were controlled for. Time-lag analysis showed that the largest changes in mortality occurred 3-4 years after any changes in either unemployment or PSEH. CONCLUSION: Increases in unemployment are associated with a significant increase in stomach cancer mortality. Stomach cancer mortality is also affected by public-sector healthcare spending. Initiatives that bolster employment and maintain public-sector healthcare expenditure may help to minimize increases in stomach cancer mortality during economic downturns. |
| first_indexed | 2024-03-06T21:58:33Z |
| format | Journal article |
| id | oxford-uuid:4dc9ef1f-bf51-4b4e-a0a1-9b549f436d0c |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T21:58:33Z |
| publishDate | 2014 |
| publisher | Lippincott Williams and Wilkins |
| record_format | dspace |
| spelling | oxford-uuid:4dc9ef1f-bf51-4b4e-a0a1-9b549f436d0c2022-03-26T15:57:28ZUnemployment, public-sector healthcare spending and stomach cancer mortality in the European Union, 1981-2009.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:4dc9ef1f-bf51-4b4e-a0a1-9b549f436d0cEnglishSymplectic Elements at OxfordLippincott Williams and Wilkins2014Maruthappu, MPainter, AWatkins, JWilliams, CAli, RZeltner, TFaiz, OSheth, HOBJECTIVES: We sought to determine the association between changes in unemployment, healthcare spending and stomach cancer mortality. METHODS: Multivariate regression analysis was used to assess how changes in unemployment and public-sector expenditure on healthcare (PSEH) varied with stomach cancer mortality in 25 member states of the European Union from 1981 to 2009. Country-specific differences in healthcare infrastructure and demographics were controlled for 1- to 5-year time-lag analyses and robustness checks were carried out. RESULTS: A 1% increase in unemployment was associated with a significant increase in stomach cancer mortality in both men and women [men: coefficient (R)=0.1080, 95% confidence interval (CI)=0.0470-0.1690, P=0.0006; women: R=0.0488, 95% CI=0.0168-0.0809, P=0.0029]. A 1% increase in PSEH was associated with a significant decrease in stomach cancer mortality (men: R=-0.0009, 95% CI=-0.0013 to -0.005, P<0.0001; women: R=-0.0004, 95% CI=-0.0007 to -0.0001, P=0.0054). The associations remained when economic factors, urbanization, nutrition and alcohol intake were controlled for, but not when healthcare resources were controlled for. Time-lag analysis showed that the largest changes in mortality occurred 3-4 years after any changes in either unemployment or PSEH. CONCLUSION: Increases in unemployment are associated with a significant increase in stomach cancer mortality. Stomach cancer mortality is also affected by public-sector healthcare spending. Initiatives that bolster employment and maintain public-sector healthcare expenditure may help to minimize increases in stomach cancer mortality during economic downturns. |
| spellingShingle | Maruthappu, M Painter, A Watkins, J Williams, C Ali, R Zeltner, T Faiz, O Sheth, H Unemployment, public-sector healthcare spending and stomach cancer mortality in the European Union, 1981-2009. |
| title | Unemployment, public-sector healthcare spending and stomach cancer mortality in the European Union, 1981-2009. |
| title_full | Unemployment, public-sector healthcare spending and stomach cancer mortality in the European Union, 1981-2009. |
| title_fullStr | Unemployment, public-sector healthcare spending and stomach cancer mortality in the European Union, 1981-2009. |
| title_full_unstemmed | Unemployment, public-sector healthcare spending and stomach cancer mortality in the European Union, 1981-2009. |
| title_short | Unemployment, public-sector healthcare spending and stomach cancer mortality in the European Union, 1981-2009. |
| title_sort | unemployment public sector healthcare spending and stomach cancer mortality in the european union 1981 2009 |
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