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...

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Главные авторы: Maruthappu, M, Painter, A, Watkins, J, Williams, C, Ali, R, Zeltner, T, Faiz, O, Sheth, H
Формат: Journal article
Язык:English
Опубликовано: Lippincott Williams and Wilkins 2014
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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.
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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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