Scottish Longitudinal Study
Development & Support Unit
Recession, austerity and health: changing area socio-economic conditions and their relationship to individual health and wellbeing outcomes in Scotland
Sarah Curtis (Durham University)
Jamie Pearce (Univ of Edinburgh)
Chris Dibben (Univ of Edinburgh)
8 Dec 2015
The proposed research constitutes a collaboration between the Centre for Health Inequalities Research (CHIR) at Durham University and the Centre for Research on Environment (CRESH), Society led at Edinburgh University by Prof Pearce. The lead researcher is Sarah Curtis, Professor of Health and Risk at Durham University who will be partly based at CRESH during 2015-16 while on research leave.
It particularly focusses on the relatively under-researched issue of change in local area socio-economic conditions over time (in different geographical areas in Scotland), and how these relate to individual health outcomes for residents in these areas. The research has considerable potential to provide findings which will impact on policy for health and social care and economic development in Scotland, and will be of international interest, given the widespread conditions of economic recession and austerity being experienced in many countries. Pearce (2013) has reviewed the literature relating to the links between financial crisis and austerity and health outcomes, pointing to the need for further research on these relationships.
The proposed research will focus particularly on the period since 2007/8, when economic recession began to affect the UK. It will build on previous research undertaken by a team led by Sarah Curtis which used English Longitudinal Study Data from 1981 to 2007, linked to data on time trends in employment levels in local authorities to show that long-term labour market conditions were even more strongly associated with individual health outcomes recorded in the LS than were contemporary economic conditions (Riva & Curtis, 2012). Curtis (2014) and Pearce (2013) have also shown that local authorities and regions of England with higher levels of unemployment have relatively large proportions of the working population engaged in the health and social care sector, as well as being areas with relatively poor population health. This may mean that austerity measures affecting these sectors, combined with the recent general economic downturn in employment levels will tend to be cumulative in influencing the economic conditions impacting on health and on health and social care in more deprived parts of the country.
The project aims to contribute to policy relevant research concerned with the health and wellbeing implications of economic recession and austerity measures. The research will examine whether there are associations between the health of individuals in the SLS and changing economic conditions in their area of residence during the period since 2001. We will explore how such associations may be mediated or moderated by individual and family characteristics and by other aspects of the person’s community environment, including social capital and cohesion, and features of the physical environmental quality such as access to green space.
Specific research questions are as follows:
-Is there evidence of an association between health and health care use (among SLS members) and area trends in economic conditions in locality of residence, over the period 2001-2014?
-Is health and health care use (at individual level) also influenced by area trends in social conditions (including indicators of social cohesion/fragmentation derived from the 2001 and 2011 census) and physical environmental quality in locality of residence, over the period 2001-2014?
To research this question, additional derived variables for Scottish Census Data Zones (and related intermediate areas) in 2001 and 2011 will be linked to the SLS. These will be based on data for place of residence sourced from: area census data (for Data Zones) for 2001 and 2011; and labour market statistics for local authorities (Council Areas) and for parliamentary constituencies available from NOMIS, Durham University, showing employment levels, in all sectors and in the health and social care sectors. To protect confidentiality of individuals in the SLS, information for Data Zones (and if necessary for local authorities) will be aggregated into categories, similar to other Data Zone information already linked to the SLS.
Riva, M. & Curtis, S. (2012) Long term local area employment rates as predictors of individual mortality and morbidity: a prospective study in England spanning more than two decades. Journal of Epidemiology and Community Health, 66, 10, 919-926.
Curtis, S. (2014) Geographical health differentials and their association with employment levels – taking the ‘long view’ on healthcare and local economies. In Gilroy R. and Twedwr-Jones, M. (eds) Joining the Dots: making healthcare work better for the local economy. Smith Institute.
Pearce, J. (2013) Financial crisis, austerity policies and geographical inequalities in health. Environment and Planning A. (2013), 45, 2030-2045