From Income Inequalities to Social Exclusion: The Impact of the Great Recession on Self-Rated Health in Spain During the Onset of the Economic Crisis

The impact of the Great Recession on health stands out due to its implications for the wellbeing of the population. The available empirical evidence suggests that macrosocial inequalities can be a central element in explaining differences in the impact of the crisis on the health of the population during its early years (2008-2011). Specifically, it is necessary to analyze the role played by the processes constituting a model of inequalities based on social exclusion. This study addresses the topic by using longitudinal data taken from the European Union statistics on income and living conditions (EU-SILC) survey (n = 5.924), with a hierarchical structure of four measurement moments nested in 5,924 individuals nested in 17 regions. Variables from two levels of analysis are considered: individual and ecological (regional) variables. The findings show that personal socioeconomic status (income and education) are significantly associated with changes in self-rated health during the onset of the crisis. The findings for ecological variables show that the variables measuring exclusion (material deprivation and low work intensity) play a significant role in the explanation of inequalities in health and how they changed during the crisis. Both indicators are negatively associated with self-rated health, while the Gini index and the proportion of the population in long-term unemployment do not have a consistent significant effect. These findings support the hypothesis that there are higher risks to wellbeing in more unequal societies compared with more equal societies.