Economic Crisis, Social Policy and Health Inequalities: A Systematic Review of the Research Literature

Purpose: The purpose of the systematic review is to collect and review research that has examined how economic crises have impacted on population health and health inequalities and to which degree the welfare state has played a modifying role. Based on the available evidence the ambition is further to develop testable theories and hypotheses for the empirical analyses to follow. The review is part of a larger project funded by the Norwegian Research Council which will use comparative data sets to study health-related consequences of the current downturn in Europe.

Background and Research questions: We will draw from insights and findings from Brenner’s earlier studies of business cycles and mortality and Ruhm’s more recent studies.  Also experience from countries that have undergone deep crisis or transformations like Russia and other Eastern European countries will be scrutinized. Further, the experience of recessions in the two Nordic countries during the early 1990s, Sweden and Finland, will be examined, in particular the hypothesis that the welfare state was able to buffer the detrimental consequences of the economic downturn. Studies of the current recession by e.g. Stuckler and collaborators will certainly provide valuable material. In the review, we will try to identify the following dimensions of crises that we suspect will have an impact on the outcomes: What kinds of crisis are we facing, (economic, political, fiscal, social), what is the speed with which it has evolved, how has the state responded to meet the crisis, and what are the changes in social and health policy?        

Methods: We will comply with guidelines issued for instance by the Campbell collaboration by developing clear inclusion/exclusion criteria, having an explicit search strategy, and a systematic coding and analysis of included studies.