Social Protection Policies: Methods to evaluate policies that reduce health inequalities
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"Social Protection Policies: Methods to evaluate policies that reduce health inequalities" by Pat O'Campo and Carles Muntaner, in the framework of the final conference of the European research project SOPHIE. 29th September 2015, Brussels
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Social Protection Policies: Methods to evaluate policies that reduce health inequalities
- 1. Toronto Team: Pat O’Campo, Carles Muntaner, Anges Molnar, Emilie Renahy, Edwin Ng, Ketan Shankardass, Christiane Mitchell, Amanda Duncan, Jongnam Hwang, Mireia Julia WP2. Social Protec/on Policies: Methods to evaluate policies that reduce health inequali/es
- 2. Austerity policies in response to the GR have not worked
- 3. Social protection model guiding our research • Welfare Regime *(EU-SILC) Social Protection Policies • *Family Support Policies (RSR) • *Policies impacted by Austerity • Fuel poverty reduction in England and North Ireland (S+MECS) Labor Market Policies • *Unemployment Insurance (RR, EU-SILC) Labor Market expenditures (EU GSS) Health & Poverty Outcomes • Mortality • SRH • Mental Health • Poverty 3
- 4. Unemployment Poverty (Relative and absolute poverty, Material hardship) Poor health outcomes (physical health, mental health, well-‐being, health behaviours) Unemployment Insurance (Eligibility criteria, replacement rate, replacement duration, waiting periods) Note: For the purpose of this paper, the framework does not represent reverse causality (potential impact of poor health on both unemployment and poverty Political, economic, social and cultural context RR of UI impacts on poverty and health
- 5. Associa/on between labour market policy expenditures and self-‐rated health *Individual factors (age, educa5on, employment status , welfare regimes, GDP growth and GDP per capita included Model1 Men Women OR (95% CI) p-‐value OR (95% CI) p-‐value 0.48(0.30-‐0.77) <0.01* 0.53(0.31-0.88) 0.02 Model2* Men Women OR (95% CI) p-‐value OR (95% CI) p-‐value 0.49(0.26-0.89) 0.02 0.60(0.35-‐1.05) 0.07 § Ac/ve expenditures by gender
- 6. Figure 1: Participants selected to be in the EU-SILC employment trajectories and health analysis, total sample (pre-imputation)
- 7. Figure 1. Population attributable fraction for onset of new chronic conditions.
- 8. Explanatory Multiple Case Study 1. St. Michael’s (Toronto): Fuel poverty polices and programs that have been cut in England. 2. UK/Belgium: Fuel poverty policies and programs in Northern Ireland that have been maintained or strengthened. 3. Barcelona ASPB: Gender budgeting in the autonomous community of Andalusia as a gender mainstreaming policy. Gender budgeting is an ongoing process of keeping a gender perspective in policy /program formulation. 5. Italy: Temporary layoff policies that allow for companies to temporarily stand down workers for a limited period on a reduced salary.
- 9. To achieve population health reduce the burden of chronic conditions • increase UI generosity – Eligibility criteria – Income replacement – Duration – No waiting periods • Increase ALMP spending – Training – Matching
- 10. • With austerity policies failing to reverse social and health inequalities • There are more call from EU voters to increase social spending • Realist methods provide evidence as to where this social spending can be more effective
- 11. • Policy action includes creating research networks to evaluate policies to reduce health inequalities across the EU • Create EU intersectoral commissions to incorporate health equity into the evaluation of new policies.