THE FINANCIAL AND ECONOMIC CRISES AND THEIR IMPACT ON HEALTH AND SOCIAL WELL-BEING Edited by Vicente Navarro and Carles Muntaner POLICY, POLITICS, HEALTH AND MEDICINE SERIES Vicente Navarro, Series Editor Baywood Publishing Company, Inc Amityville, New York Copyright © 2014 by Baywood Publishing Company, Inc., Amityville, New York All rights reserved No part of this book may be reproduced or utilized in any form or by any means electronic or mechanical, including photo-copying, recording, or by any information storage or retrieval system, without permission in writing from the publisher Printed in the United States of America on acid-free recycled paper Baywood Publishing Company, Inc 26 Austin Avenue P.O Box 337 Amityville, NY 11701 (800) 638-7819 E-mail: baywood@baywood.com Web site: baywood.com Library of Congress Catalog Number: 2014008221 ISBN: 978-0-89503-878-4 (cloth : alk paper) ISBN: 978-0-89503-879-1 (paper) ISBN: 978-0-89503-880-7 (e-pub) ISBN: 978-0-89503-881-4 (e-pdf) http://dx.doi.org/10.2190/TFA Library of Congress Cataloging-in-Publication Data The financial and economic crises and their impact on health and social well-being / edited by Vicente Navarro and Carles Muntaner p ; cm (Policy, politics, health and medicine series) The contributions in this volume, articles selected from the International Journal of Health Services, contrast explicitly with conventional approaches to population health and offer new insights and results that advance a critical understanding of public health Includes bibliographical references ISBN 978-0-89503-878-4 (cloth : alk paper) ISBN 978-0-89503-879-1 (pbk : alk paper) ISBN 978-0-89503-880-7 (e-pub) ISBN 978-0-89503-881-4 (e-pdf) I Navarro, Vicente, editor II Muntaner, Carles, 1957- editor III International journal of health services Contained in (work): IV Series: Policy, politics, health, and medicine series (Unnumbered) [DNLM: Health Policy Collected Works Public Health– economics Collected Works Social Determinants of Health Collected Works Socioeconomic Factors Collected Works WA 530.1] RA410.5 362.1068’1 dc23 2014008221 Credit line: INDUSTRIAL WORKERS OF THE WORLD: “Pyramid of Capitalist System, issued by Nedeljkovich, Brashick and Kuharich, Cleveland: The International Publishing Co., 1911.” Used with permission Contents Introduction Vicente Navarro and Carles Muntaner PART I The Causes of the Crisis Edwin Ng Neoliberalism as a Class Ideology; Or, The Political Causes of the Growth of Inequalities Vicente Navarro The Crisis and Fiscal Policies in the Peripheral Countries of the Eurozone Vicente Navarro 23 PART II The Crisis and Its Consequences for Welfare Services and Transfers 30 Edwin Ng The Effects of Health Care Reforms on Health Inequalities: A Review and Analysis of the European Evidence Base Elena Gelormino, Clare Bambra, Teresa Spadea, Silvia Bellini, and Giuseppe Costa Ditching the Single-Payer System in the National Health Service: How the English Department of Health is Learning the Wrong Lessons from the United States Lucy Reynolds, Clare Gerada, and Martin McKee Visits to Family Physicians or Specialists by Elderly Persons in Canada and the United States: An Exploratory Comparative Study Mark S Kaplan, Nathalie Huguet, David Feeny, Bentson H McFarland, and Stacey S Williams 32 54 62 Minimum Income Protection and European Integration: Trends and Levels of Minimum Benefits in Comparative Perspective, 1990–2005 73 Kenneth Nelson iii iv / The Financial and Economic Crises PART III The Crisis and Changes in the Labor Market 95 Edwin Ng Employment Relations and Global Health: A Typological Study of World Labor Markets Haejoo Chung, Carles Muntaner, Joan Benach, and the EMCONET Network 97 The Impact of Public Employment on Health and Health Inequalities: Evidence from China 122 Wei Zhang Ensuring a Healthy and Productive Workforce: Comparing the Generosity of Paid Sick Day and Sick Leave Policies in 22 Countries 153 Jody Heymann, Hye Jin Rho, John Schmitt, and Alison Earle 10 Overstretched and Unreciprocated Commitment: Reviewing Research on the Occupational Health and Safety Effects of Downsizing and Job Insecurity 175 Michael Quinlan and Philip Bohle 11 Employer-Sponsored Health Insurance Erosion Accelerates in the Recession 218 Elise Gould 12 How Do Macro-Level Contexts and Policies Affect the Employment Chances of Chronically Ill and Disabled People? The Impact of Recession and Deindustrialization 256 Paula Holland, Bo Burström, Margaret Whitehead, Finn Diderichsen, Espen Dahl, Ben Barr, Lotta Nylén, Wen-Hao Chen, Karsten Thielen, Kjetil A van der Wel, Stephen Clayton, and Sharanjit Uppal PART IV Changes in the Welfare States 275 Edwin Ng 13 Different Welfare States—Different Policies? An Analysis of the Substance of National Health Promotion Policies in Three European Countries 277 Elisabeth Fosse Contents / v 14 Social Inequalities in “Sickness”: Does Welfare State Regime Type Make a Difference? A Multilevel Analysis of Men and Women in 26 European Countries 295 Kjetil A van der Wel, Espen Dahl, and Karsten Thielen 15 Welfare State Regime Life Courses: The Development of Western European Welfare State Regimes and Age-Related Patterns of Educational Inequalities in Self-Reported Health 316 Clare Bambra, Gopalakrishnan Netuveli, and Terje A Eikemo 16 Variation of Socioeconomic Gradients in Children’s Developmental Health Across Advanced Capitalist Societies: Analysis of 22 OECD Nations 337 Arjumand Siddiqi, Ichiro Kawachi, Lisa Berkman, S V Subramanian, and Clyde Hertzman 17 Gender Policy Developments and Policy Regimes in 22 OECD Countries, 1979–2008 362 Mona C Backhans, Bo Burström, and Staffan Marklund 18 Analyzing Differences in the Magnitude of Socioeconomic Inequalities in Self-Perceived Health by Countries of Different Political Tradition in Europe 391 Carme Borrell, Albert Espelt, Maica Rodriguez-Sanz, Bo Burström, Carles Muntaner, M Isabel Pasarin, Joan Benach, Chiara Marinacci, Albert-Jan Roskam, Maartje Schaap, Enrique Regidor, Giuseppe Costa, Paula Santana, Patrick Deboosere, Anton Kunst, and Vicente Navarro PART V Changes in Class Inequalities 411 Edwin Ng 19 Class Divisions and Health Chances in Brazil 413 José Alcides Figueiredo Santos 20 Wealth Inequality and Health: A Political Economy Perspective 432 Nadine R Nowatzki 21 The Other Side of the Chinese Economic Miracle 454 Wei Zhang vi / The Financial and Economic Crises PART VI Focus on Solutions 473 Edwin Ng 22 Social Class, Politics, and the Spirit Level: Why Income Inequality Remains Unexplained and Unsolved 475 Carles Muntaner, Nanky Rai, Edwin Ng, and Haejoo Chung 23 The Solution Space: Developing Research and Policy Agendas to Eliminate Employment-Related Health Inequalities 488 Carles Muntaner, Sanjeev Sridharan, Haejoo Chung, Orielle Solar, Michael Quinlan, Montserrat Vergara, Joan Benach, and the EMCONET Network 24 Why We Don’t Spend Enough on Public Health: An Alternative View 494 Vicente Navarro About the Editors 497 About the Authors 499 Introduction Vicente Navarro and Carles Muntaner Most parts of the globalized world are facing economic crises and political turmoil not seen since the Great Depression of the 1930s and 1940s Daily reports of the current global recession are as predictable as they are discouraging: “Economy Expected to Show Sluggish Growth” (1); “Eurozone Unemployment Rate Remains at Record High 12.2 Per Cent” (2); “Britain Reels as Austerity Cuts Begin” (3) Now and again, bleak economic forecasts are interrupted by the promise of economic recovery; however, these promises have proved to be overly optimistic: “Hopes for Faster Global Growth Dashed” (4) Moreover, the ongoing crisis has triggered new or has exacerbated existing health problems, including, for example, increasing rates of intravenous drug use, HIV/AIDS, and suicides, as well as falling fertility rates (5–7) Clearly, the global recession has had negative effects on the larger economy as a whole and on the health of individuals as a population The proverbial light at the end of the tunnel seems farther away than ever, especially since the so-called Troika—the European Commission, the European Central Bank, and the International Monetary Fund—has prescribed that debt-ridden nations should follow a harsh regimen of austerity measures, prioritizing debt over people, rather than stimulus measures, which protect people during economically vulnerable times Explanations for why the economic crisis occurred in the first place and how to solve the crisis are abundant Not surprisingly, most explanations implicate the failings of individuals and financial interest groups in causing the crisis (e.g., individuals with poor credit and insufficient incomes took on too much personal debt and created a housing bubble) Dominant explanations also favor neoliberal solutions to encourage economic recovery (e.g., cost-cutting policies that scale back social spending, reduce the size of governments, and privatize public goods) Placing the onus on individuals and dismantling welfare states have the injurious effects of overlooking unequal power relations, accepting the status quo, and shifting the balance of political power toward the right and its preference for fiscal conservatism / The Financial and Economic Crises Rather than the current crisis being viewed as a direct consequence of unequal political and economic relations, the Great Recession is often understood as a normal, temporary glitch of an otherwise workable system In more concrete terms, this line of thinking contends that capitalist relations, banking institutions, multinational corporations, and sovereign governments are interrelated parts that, in theory, effectively and efficiently work together to promote economic growth, maximize worker productivity, and generate global levels of financial prosperity In practice, however, the contradictions and consequences of this social system have been known for decades and made crystal-clear in recent years during the economic crisis On the one hand, welfare capitalism is charged with the task of regulating financial activities and providing social protections to the unemployed, disabled, and elderly, for example Democratically elected state governments are expected to organize the distribution and redistribution of economic resources by legislating rules of exchange between the state, market, and family On the other hand, these rules of exchange and social protections are now expected to undergo necessary self-corrections that overwhelmingly favor the interests of business and markets over the interests of families and workers As a result, the global recession has reframed the interactions between the state and the market in a way that empowers the latter Through generous corporate bailouts, weaker labor unions, and strengthened ties with pro-market political parties, business has been able to increase its economic power, political influence, and cultural dominance during the downs of the Great Recession Given that most attention is paid to figuring out the motivations and behaviors of individuals and interest groups, our understanding of how economic, political, and ideological contexts contributed to the crisis in the first place and how these contexts exacerbate the negative consequences of the crisis remains at best limited and at worst detrimental Possessing a limited focus comes at a tremendous intellectual and public health cost—researchers remain largely ignorant of how economic crises occur, why crises occur with some regularity, and, perhaps most important for our discussion, what the health consequences of capitalist relations are that create economic cycles of “booms and busts.” These questions should challenge public health researchers to explicitly consider solutions, strategies, and interventions that bring about desired change that, in turn, improves health and reduces health inequalities Taken together, our central argument is that the current global recession should serve as a clarion call for fellow public health researchers to think more critically about population health and health inequalities Thinking critically involves developing a better understanding of how economic, political, and cultural forms of power are unequally distributed in capitalist societies, and how these unequal power relations affect the well-being of populations The underlying claims are that economic and political events not unfold in vacuums, are not randomly distributed, and reflect the ongoing social struggle between more powerful and less powerful actors over valuable resources From a social conflict perspective, Introduction / economic and political events mirror unequal distributions of power and, in particular, the unequal distribution of social class relations, or capitalist versus working-class power Although a consideration of social class is forbidden (by some), forgotten (by others), and controversial (for most), structured relations between employers, managers, and workers persist as a defining feature of unequal power relations in capitalist societies and remain underexamined within the context of the current recession Our position is three-fold: first, privateproperty rights allow some actors to own productive means; second, these rights empower owners to control the labor of workers to their own advantage; and third, private-property rights function as a primary determinant of unequal power relations and health outcomes An understanding of social class relations is essential to understanding the connections between the current economic crisis and population health, especially given that social class plays such a dominant role in generating and reproducing social inequalities at different levels and through different pathways Examples of the power of social classes are plentiful: social class relations influence the ability of political parties to win elections (e.g., political lobbying and financing of election campaigns), shape popular views on the advantages or disadvantages of labor unions (e.g., increasing wages, job security, and class solidarity), and institutionalize the degree to which employer-worker relations are exploitative (e.g., adopting and enforcing occupational safety measures) Among the most prominent mechanisms by which social class relations affect health inequalities is through the production and reproduction of ideology By influencing dominant value-generating systems such as schools, workplaces, and media outlets, dominant ideologies are often presented with ample justification as to why a certain approach is the only or best option for moving forward Neoliberalism serves as a prime example From the perspective of class ideology, neoliberalism argues that the current economic crisis was caused in large part by welfare state expansion If welfare states are the problem, the ensuing logic claims that economic recovery requires a drastic restructuring and retrenchment of welfare state regulations, programs, and services Neoliberalism encompasses a whole series of public interventions, also known as austerity policies, which reduce health-promoting resources provided through the welfare state (8, 9) Much like Thatcher’s “there is no alternative” slogan during the 1980s, the current economic crisis has produced its own neoliberal mantra: austerity is the panacea for all our economic woes Needless to say, social class relations alone not fully or adequately explain the complex roots and consequences of the economic crisis Other unequal power relations, including those related to gender (sexism), race/ethnicity (racism), and immigrant/migrant status (xenophobia), among other unjust inequalities, are important determinants of social inequalities in health However, the key idea is that social class has generated, and continues to generate, avoidable inequalities in capitalist societies In fact, these inequalities have increased dramatically About the Editors VICENTE NAVARRO is a professor of health and public policy at the Johns Hopkins University (JHU) He is also an honorary professor at the Pompeu Fabra University (UPF) in Barcelona, in the Department of Political and Social Science, and serves as director of the JHU-UPF Public and Social Policy Program He has written extensively on the political, economic, and social determinants of health, as well as in the area of health, quality of life, and social well-being Dr Navarro has authored twenty-five books, published in several languages According to the Agency of International Scientific Information of the University of Pennsylvania (Lauder Institute of Management and International Studies), he is one of the most quoted scientists in the international social science literature (including the areas of political science, economics, and sociology, among others) Dr Navarro has served as an advisor to many international institutions, including the United Nations, World Health Organization, and Pan American Health Organization, as well as to several governments: Chile’s Unidad Popular government; the Cuban government, on its work in reforming the national health service; the Swedish social democratic government; the socialist government of Spain; the progressive government of Catalonia; and the U.S government, where he worked in the White House on the health care reform task force led by Hillary Clinton A recipient of many awards from various institutions, he holds honorary doctoral degrees from the University of Lleida and the University of Malaga, Spain Dr Navarro recently received the Ernest Lyman Stebbins Medal, annually awarded to an outstanding faculty member of the Johns Hopkins Bloomberg School of Public Health He is the founder and editor-in-chief of the International Journal of Health Services CARLES MUNTANER, M.D., Ph.D., is a Professor in the Faculty of Nursing, Dalla Lana School of Public Health, and in the Department of Psychiatry, Faculty of Medicine, at the University of Toronto He is also with the Center of Research in Inner City Health (CRICH) at St Mike’s Hospital in Toronto Since the 1990s, he has conducted research on social inequalities in health in the United States, European Union, Latin America, and Western Africa, integrating the public health fields of occupational health and social epidemiology Originally from Barcelona, Dr Muntaner studied at the Lycộe Franỗais, University of Barcelona, and Johns Hopkins University He completed his postdoctoral training at the Laboratory of Socio-Environmental Studies, National Institute of Mental Health, in the United States His research focuses on the study of work organization in relation to psychiatric disorders, the conceptualization and 497 498 / Crisis and the Welfare Regime measurement of social class and racism, comparative politics, welfare state, labor markets, precarious employment and health, and philosophy of epidemiology Dr Muntaner has worked with the World Health Organization, Pan American Health Organization, U.S and Spanish unions, and the Ministries of Health of the Bolivarian Republic of Venezuela and the Republic of Chile Dr Muntaner was a co-chair of the Employment Condition’s Network of the WHO Commission on Social determinants of Health and a founding member of GREDS/EMCONET at the Pompeu Fabra University He is the recipient of the Wade Hampton Frost Award from the American Health Association Dr Muntaner is also associate editor of the International Journal of Health Services About the Authors MONA C BACKHANS is a doctoral student in the Department of Public Health Sciences, Karolinska Institute, Stockholm She received an M.Sc in sociology from Stockholm University (2004) She worked for several years at the National Institute of Public Health, with a focus on public health aspects of the labor market Her Ph.D project aims to enhance knowledge on gender policy and gender equality as determinants of health CLARE BAMBRA is a lecturer in public health policy in the Department of Geography, Durham University, England She was formerly a lecturer in public health policy in the School for Health, Durham University; lecturer in sociology and social policy at Sheffield Hallam University She has a B.Soc.Sc in political science from the University of Birmingham (1998) and M.A Econ in European politics and policy (1999) and Ph.D (2002) both from the University of Manchester Bambra’s research interests include the influence of welfare state policies and political structures on international variations in public health and health inequalities, and labor markets and the relationships between work, worklessness, and health BEN BARR is a research fellow at the University of Liverpool He studied anthropology at University College London, trained as a nurse, and undertook post-graduate studies in public health and epidemiology at the London School of Hygiene and Tropical Medicine and the National Health Service He was awarded a National Institute for Health Research doctoral fellowship in 2010 and has a consulting post with NHS Blackburn with Darwen SILVIA BELLINI is an epidemiologist at the Epidemiologic Observatory of the Regional Health Service, Grugliasco, Turin, Italy She has a medical degree from the University “Insubria” of Varese, Italy (2001), and postgraduate degree in public health from the University of Turin 2005) Her publications include, as coauthor, “Inequalities in Female Cancer Screening Rates: A Review of the Impact of Interventions Promoting Participation” and “The Effects of Health Care Reform on Health Inequalities: A Review and Analysis of the European Evidence Base” (both in Tackling Health Inequalities in Europe (Eurothine), Final Report, 2007) Bellini’s research interests are in the field of social inequalities in health and health care 499 500 / The Financial and Economic Crises JOAN BENACH leads the Health Inequalities Research Group/Employment Conditions Network GREDS/EMCONET) at Pompeu Fabra University in Barcelona He studied medicine, history, and public health in Barcelona and obtained a Ph.D at the Johns Hopkins University Most of his teaching and research have taken place at Pompeu Fabra University His main fields of scientific research include health inequalities, employment and working conditions, precarious employment, small-area geographic analysis, and health policy— areas in which he has published extensively during the past decade He has worked with several public health networks around the world and in the WHO Commission on Social Determinants of Health, chairing the Employment Conditions Knowledge Network (EMCONET) LISA BERKMAN, Ph.D., is the Thomas D Cabot Professor in Public Policy and Epidemiology at the Harvard School of Public Health, chair of the Department of Society, Human Development and Health, and chair of the Harvard Center for Society and Health She is an internationally recognized social epidemiologist whose work focuses extensively on social influences and health outcomes She edited, with Ichiro Kawachi, Social Epidemiology, the first systematic account of the field of social determinants of health Berkman is past president of the Society for Epidemiologic Research and a member of the Institute of Medicine PHILIP BOHLE, Ph.D., is a professor and leader of the Work and Health Research Team in the Ageing, Work and Health Research Unit, Faculty of Health Sciences, University of Sydney For more than 20 years, his research has concentrated principally on occupational health His key research interests currently include working hours, work–life conflict, and health; the impact of workplace death on victims’ families; aging, employment, and occupational health and safety; and the health and safety of precarious employees CARME BORRELL is a specialist in family medicine and in preventive medicine and public health, and is head of the Health Information Systems Service of the Agència de Salut Pública de Barcelona, with responsibility for analysis of the health situation of Barcelona city She received her M.D and Ph.D at Universitat Autònoma de Barcelona Her main field of research is inequalities in health, and she has led many research projects and had many publications in this field She was editor of the 2004 report of the Spanish Society of Public Health on inequalities in health, and of the two Catalan reports on inequalities in health (2003 and 2005) BO BURSTRÖM, M.D., Ph.D., is a professor of social medicine in the Department of Public Health Sciences, Karolinska Institute, Stockholm, where he has worked for the past 15 years His prime research interests are in inequalities in health and health care, and in social and economic consequences of disease He is engaged in international projects, including comparative studies on the impact of health and social policies on the health of disadvantaged groups in the United Kingdom and Sweden About the Authors / 501 WEN-HAO CHEN is an economist at the Organization for Economic Cooperation and Development and a senior researcher at Statistics Canada He received his Ph.D in economics from Michigan State University (2004) His research focuses on income inequality, poverty, mobility within and across generations, and social policy evaluation, in particular employment insurance He has published articles in the Review of Economics and Statistics, Canadian Journal of Economics, Demography, Review of Income and Wealth, Applied Economics, and Research in Labor Economics HAEJOO CHUNG is an assistant professor in health policy at the Korea University College of Health Sciences and a research scientist for the employment relations HUB of the WHO Commission on Social Determinants of Health She received a master’s degree from the Department of Pharmacy, Seoul National University, and a Ph.D in health and social policy from the Department of Health Policy and Management at the Johns Hopkins University Bloomberg School of Public Health (2006) Chung’s research deals with the political economy of health, especially the impact of welfare states on health care systems and population health Her most recent contributions include an analysis of the effects of welfare state regime type on population health STEPHEN CLAYTON is a university teacher and research fellow in the Department of Public Health and Policy at the University of Liverpool He received his Ph.D in social policy from the University of Essex (2004) He has conducted qualitative social research in several different settings and has a specific interest in the politics of social policy formulation and implementation Clayton has recently been involved in comparative studies of the impacts of active labor market policies aimed at people with long-term illnesses and disabilities GIUSEPPE COSTA is a professor of public health at Turin University, Italy He was formerly an epidemiologist at the Epidemiologic Observatory of the Regional Health Service (in the Turin Unit, 1979–93; director of the Grugliasco Unit, 1994–2009) He has a medical degree (1977) and postgraduate degrees in occupational medicine (1980) and public health (1988), all from Turin University Costa’s research interests are in the fields of epidemiology of occupational risks, environmental risks, and social inequalities in health, and in health services research ESPEN DAHL is a professor of health and social policy at Oslo University College He received his Ph.D from the University of Oslo in 1994 His research focuses on health inequalities, social policy, labor market policy, and social exclusion, and he has published extensively on these topics PATRICK DEBOOSERE has been in charge of the unlocking of administrative data for scientific research in Belgium and was project leader in several interuniversity research projects on, among other topics, the future of the Belgian census He has a master’s in political sciences and Ph.D in sociology from the Vrije Universiteit Brussel His research focused for some years on the evolution of households and household composition in Belgium In recent years, his 502 / The Financial and Economic Crises main research interests have moved toward causes and evolution of inequalities in health, mortality, and aging FINN DIDERICHSEN, M.D., is a specialist in social medicine He is a professor in prevention in public health and head of the Social Medicine Section in the Department of Public Health, University of Copenhagen His research has primarily been in social epidemiology, on mechanisms generating social inequalities in health and health policy issues He is currently chairing the Danish Review on Social Inequalities in Health ALISON EARLE is co-director of the Project on Global Working Families, Harvard School of Public Health, Boston TERJE A EIKEMO is a postdoctoral fellow in the Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, Netherlands His past positions include researcher at SINTEF Health Services Research, Trondheim, Norway; research fellow in the Department of Sociology and Political Contributors/ 571Science, Norwegian University of Science and Technology, Trondheim; and trainee at the Royal Norwegian Embassy, Prague He received a bachelor’s degree in sociology, Nordic languages, and German at the Norwegian University of Science and Technology (2001), and master’s in sociology (2003) and Ph.D (2008) at the Norwegian University of Science and Technology His research is in the fields of medical sociology and social epidemiology ALBERT ESPELT is a social epidemiologist working in the Public Health Agency of Barcelona and is responsible for the Drug Information System He is a teaching assistant in epidemiology at the Pompeu Fabra University and professor in econometrics at the Universitat Oberta de Catalunya Espelt is trained as a statistician and received his M.P.H at Pompeu Fabra University His main research area is inequalities in health, especially in diabetes, in selfperceived health, and in the drug field DAVID FEENY is senior investigator at the Center for Health Research, Kaiser Permanente Northwest, and was formerly at the University of Alberta and McMaster University He received his Ph.D from the University of Wisconsin– Madison in 1976 His publications, with coauthors, include “Multi-Attribute and Single-Attribute Utility Functions for the Health Utilities Index Mark System (Medical Care, 2002); “Comparing Directly Measured Standard Gamble Scores to HUI2 and HUI3 Utility Scores: Group- and Individual-Level Comparisons” (Social Science and Medicine, 2004); and “Understanding the Determinants of Health for People with Type Diabetes” (American Journal of Public Health, 2006) Feeny’s research interests are in health-related quality of life and population health ELISABETH FOSSE is an associate professor in the Department of Health Promotion and Development, University of Bergen, Norway Her areas of research are policy analysis, health policies and health promotion policies, and social inequalities in health Since 2009 she has been work package leader in the European research project GRADIENT (Tackling the Gradient: Applying About the Authors / 503 Public Health Policies to Effectively Reduce Health Inequalities amongst Families and Children), a project funded by the European Union’s 7th Framework program Fosse has publications (in Norwegian and English) on Norwegian health promotion policies and Norwegian and European policies to reduce social inequalities in health ELENA GELORMINO is a public health consultant at the Epidemiologic Observatory of the Regional Health Service, Grugliasco, Turin, Italy She was formerly an epidemiologist at the Cancer Epidemiologic Centre–Piedmont She has a medical degree (1995), postgraduate degree in public health (2005), and M.Sc in health economics and policy (2007), all from Turin University Gelormino’s research interests are in health policy, health economics, and knowledge transfer from the academy to the political arenas CLARE GERADA is a general practitioner in south London and has held a number of local and national leadership positions, including director of primary care for the National Clinical Governance Team and senior medical advisor to the Department of Health She is medical director of the Practitioner Health Programme and serves as the Chair of Council of the Royal College of General Practitioners ELISE GOULD, Ph.D., is director of health policy research at the Economic Policy Institute Her research areas include employer-sponsored health insurance, poverty, the burden of health costs, income inequality and health, the employer tax exclusion, and retiree coverage She has authored a chapter on health in The State of Working America (2008–2009), co-authored a book on health insurance coverage in retirement, and published in academic journals She holds a master’s degree in public affairs from the University of Texas and a Ph.D in economics from the University of Wisconsin CLYDE HERTZMAN has been on the faculty in the Department of Health Care and Epidemiology at the University of British Columbia since 1985 He completed his training in medicine, community medicine, and epidemiology at McMaster University in Hamilton, Ontario, between 1976 and 1985 Through the Canadian Institute for Advanced Research, he has played a central role in developing the conceptual framework for the determinants of health and elucidating the special role of early childhood development as a determinant of health JODY HEYMANN is founding director of the Institute for Health and Social Policy, McGill University, Montreal PAULA HOLLAND is a lecturer in public health and director of a distancelearning Ph.D in public health in the Division of Health Research at Lancaster University in England She received her Ph.D from the University of Liverpool (2006) Her research focuses on gender and social inequalities in the employment and financial consequences of chronic illness Holland has published on the employment consequences of epilepsy (Epilepsia, 2009), ischemic heart disease (Scandinavian Journal of Public Health, 2009), musculoskeletal 504 / The Financial and Economic Crises disorders (Rheumatology, 2006), and diabetes (Diabetic Medicine, 2006) She is conducting qualitative research on the employment experiences of people with chronic illness in the United Kingdom NATHALIE HUGUET, Ph.D., is a research associate at the Center for Public Health Studies, Portland State University, Oregon She received a Ph.D in urban studies from Portland State University Her current studies examine healthy aging and veterans’ suicide Huguet’s most recent publication, with coauthors, is “Socioeconomic Status and Health-Related Quality of Life among Elderly People: Results from the Joint Canada/United States Survey of Health” (Social Science and Medicine, 2008) Her research interests are in aging and health, health care systems, and chronic care MARK S KAPLAN is a professor of community health at Portland State University, Oregon, and holds adjunct appointments in psychiatry at the Oregon Health & Science University and in epidemiology and community medicine at the University of Ottawa He received his Dr.P.H from the University of California, Berkeley, and also has an M.S.W and M.P.H His research, funded by the National Institute of Mental Health, National Institute on Aging, and private foundations, focuses on using population-wide data to understand depression and health behavior in elderly populations As a 2004 Fulbright Scholar, Kaplan studied the Canadian approach to population health ICHIRO KAWACHI is a professor of social epidemiology and director of the Harvard Center for Society and Health at the Harvard School of Public Health, in Boston Kawachi is the author of several recent books, including The Health of Nations (with Bruce Kennedy; New Press, 2002); Neighborhoods and Health (with Lisa Berkman; Oxford University Press, 2003); and Globalization and Health (with Sarah Wamala; Oxford University Press, 2006) ANTON KUNST is a medical demographer and social epidemiologist (Ph.D.) working as associate professor in the Department of Public Health, Academic Medical Centre, University of Amsterdam His key research interests are in geographic, socioeconomic, and ethnic inequalities in mortality, ill health, health risks, and health care Besides his studies on health inequalities in the Netherlands, he has coordinated comparative studies at the European and global levels CHIARA MARINACCI works at the Regional Epidemiology Unit of Piemonte, Italy, with a permanent position as a senior statistician (since April 2001) She is a researcher at the International Centre for Birth Defects, and was formerly at the National Institute of Social Medicine (1996–1998) and received a grant from the Agency for Public Health of Lazio region (1998–2001) From 2006 to 2008 she was head of the Epidemiology Unit in the Health Authority of La Spezia Marinacci receive a degree in statistical sciences and a postgraduate degree in operational research and decision strategy at the University “La Sapienza” of Rome About the Authors / 505 STAFFAN MARKLUND is a professor of work and health at the Karolinska Institute, Stockholm He finished his doctoral degree in sociology at Umeå University in 1975, and became a professor at the National Institute for Working Life in 2000 His main research has been on social welfare, sickness absence, and occupational health BENTSON H MCFARLAND is professor of psychiatry, public health, and preventive medicine at Oregon Health & Science University and affiliate investigator at the Kaiser Permanente Center for Health Research in Portland, Oregon, and is a senior scientist at the Oregon Research Institute in Eugene, Oregon He received his M.D and Ph.D in biostatistics from the University of Washington in Seattle Board-certified in general and geriatric psychiatry, McFarland is nationally known for his research on quality of behavioral health care In addition to his research, McFarland maintains a clinical practice focused on psychopharmacology MARTIN MCKEE trained in internal medicine and public health and is a professor of European public health at the London School of Hygiene and Tropical Medicine He manages a large research team working on health and health policy in countries undergoing political, social, and economic transition to market-based economies KENNETH NELSON is a researcher at the Swedish Institute for Social Research, Stockholm University, and teachers comparative social research methodology in the Department of Sociology, Stockholm University His work has focused on comparative welfare state research, particularly on minimum income benefits and social insurance He has previously written about income redistribution and power in welfare democracies GOPALAKRISHNAN NETUVELI is a research fellow at the International Centre for Life Course Studies in Society and Health, Department of Primary Care and Social Medicine, Imperial College London His past positions include program director at Jahra School Health Program, Kuwait, and vice dean and professor at S.D.M College of Dental Sciences, Dharwad, Karnataka, India Netuveli received a B.Sc from the University of Kerala (1971); B.D.S from the Medical College, University of Kerala (1976); M.D.S from the Postgraduate Institute of Medical Education and Research, Chandigarh (1980); and Ph.D in epidemiology and public health from University College London (2002) EDWIN NG earned his BSW and MSW degrees from the Universities of Windsor and Toronto, respectively He completed his PhD in Social Science and Health in the Dalla Lana School of Public Health, University of Toronto His research interests include the political dimensions of population health— testing the health effects of welfare generosity and leftist politics; the NeoMarxian concept of social class—advancing exploitation and domination as relational determinants of health inequalities; and the clustering of welfare states into regimes—exploring interrelationships among global welfare clusters, social inequalities, and population health 506 / The Financial and Economic Crises NADINE R NOWATZKI, Ph.D., recently completed a post-doctoral fellowship with the Centre on Aging at the University of Manitoba in Winnipeg, Canada She received her doctorate in sociology from the University of Manitoba (2011) Her primary areas of interest are poverty, inequality, and health LOTTA NYLÉN is a researcher in the Department of Public Health Sciences, Division of Social Medicine, at the Karolinska Institute, Stockholm She received her Ph.D at the Karolinska Institute (2006) Her research focuses on inequalities in the area of work and health Currently she is involved in studies on social consequences of ill health, especially attachment to the labor market Nylén has 20 years of research experience at the Swedish National Institute for Working Life, focusing on work environment matters, living conditions, work-home relationships, and their health effects M ISABEL PASARÍN is head of the Community Health Service in the Public Health Agency of Barcelona and associate professor at the Pompeu Fabra University Her main areas of interest in work and research are analysis of health and its determinants, analysis of inequalities in health, primary health care evaluation, and primary prevention in health, mainly in the adolescent population MICHAEL QUINLAN, Ph.D., is a professor of industrial relations at the University of New South Wales, Australia (since 1994), and holds an adjunct post at Middlesex University in the United Kingdom His research has focused on occupational health and safety, especially its intersection with industrial relations, regulation, and the impact of precarious employment He has been an expert witness in court/tribunal hearings and has undertaken government inquiries and investigations into occupational health and safety, including changed work arrangements and the Beaconsfield mine rockfall in 2006 NANKY RAI is a medical student at the University of Toronto She received her master’s degree in public health from the Dalla Lana School of Public Health, University of Toronto, with a specialization in health promotion and global health (2011) Rai’s research interests include the political economy of migrant health, history of social medicine, and South-South cooperation models aimed at addressing health inequities Her most recent contributions include an analysis of Misión Milagro, a counter-hegemonic approach to eliminating avoidable blindness caused by cataracts across the Global South ENRIQUE REGIDOR, M.D., Ph.D., is assistant professor of preventive medicine and public health at Complutense University of Madrid His research is based on the relation between socioeconomic position and health, and he is also interested in measures of social inequalities in health LUCY REYNOLDS is a research fellow at the London School of Hygiene and Tropical Medicine She trained in molecular biology, finance, international development, and public health She has extensive experience in the private and non-governmental sectors around the world, including work in health care delivery in nine countries Her doctoral thesis was a case study of the functioning of a competitive market in health care About the Authors / 507 HYE JIN RHO is a research assistant at the Center for Economic and Policy Research in Washington, DC MAICA RODRÍGUEZ-SANZ is senior statistician in the Health Information Service of the Public Health Observatory at the Agency of Public Health of Barcelona She has responsibility for the mortality register and the Health Interview Surveys She received her M.P.H in 2004 Her field of research is the study of population health and health inequalities, and she has experience in the application of hierarchical models Rodríguez-Sanz is also a researcher at CIBERESP, the Spanish Research Network on Epidemiology and Public Health ALBERT-JAN ROSKAM is a psychologist and epidemiologist working for the Department of Public Health of Erasmus Medical Center, Rotterdam, The Netherlands He specializes in social inequalities in health, particularly obesity and related diseases and risk factors PAULA SANTANA is professor (in-cathedra) of geography and researcher at the University of Coimbra, Portugal She is broadly interested in urban social geography, but her research centers on determinants of health and well-being, with a focus on social and spatial inequalities and neighborhood influences on health in metropolitan areas She became associated with the IGU Commission on Health in 1995 and was first elected to the Steering Committee in 2001 In 2007 she was invited to support the Portuguese High Commissioner for Health (Health Ministry), coordinating a multidisciplinary group responsible for National Health Plan monitoring JOSÉ ALCIDES FIGUEIREDO SANTOS is a sociologist and associate professor in the Social Sciences Department at the Federal University of Juiz de Fora, Brazil He is author of the book The Structure of Class Positions in Brazil (2002) and has published articles on class, race, and gender inequalities in the leading social science periodicals in Brazil His research program is on social inequalities in Brazil, using a class typology MAARTJE SCHAAP is a researcher in the Department of Public Health at Erasmus Medical Center, the Netherlands (since 2005), working on her thesis in socioeconomic inequalities in smoking in Europe She has a master’s in public health sciences from Maastricht University JOHN SCHMITT is a senior economist at the Center for Economic and Policy Research in Washington, DC ARJUMAND SIDDIQI is a doctoral student in the Department of Health and Social Behavior and a research specialist in the Division of Public Health Practice at the Harvard School of Public Health She completed her training in occupational therapy at McGill University in Montreal, Canada, in 1997, and her M.P.H with an emphasis on policy and management, at Boston University in 1999 She is interested in socioeconomic determinants of health and the implications of these relationships for public policy ORIELLE SOLAR is currently Research Coordinator of Work, Employment and Health Equity Program (TEES) at Flasco–Chile and Professor of the 508 / The Financial and Economic Crises Dr Salvador Allende School of Public Health, Universidad de Chile She was previously a leader in the WHO Commission on Social Determinants of Health, working in Geneva, where she developed the commission’s framework, among other activities leading to the report “Closing the Gap in a Generation.” She was chief of cabinet of sub-secretary of public health of the Ministry of Health in Chile At the ministry, she worked on equity-related programs involving participatory democracy and on a national survey on work and health, among other endeavors TERESA SPADEA is a senior statistician and epidemiologist at the Epidemiology Unit of ASL TO3 Piedmont Region, Italy She was formerly a statistician at the Epidemiology Unit of the Regional Health Authority of Lazio She has a degree in statistical sciences (1986) and postgraduate degree in health statistics, both from University “La Sapienza” of Rome, and M.Phil in epidemiology from the University of Cambridge (1993) Spadea’s main research interests are in the field of social inequalities in health and health care, equity in clinical governance, monitoring immigrants’ health; she has been involved in various European networks working on these topics SANJEEV SRIDHARAN is a scientist at the Keenan Research Centre of the Li Ka Shing Knowledge Institute and director of the Evaluation Program at the Centre for Research on Inner City Health (CRICH), both at St Michael’s Hospital in Toronto He is also associate professor in health policy, management, and evaluation at the University of Toronto He received a B.Tech in civil engineering from the Indian Institute of Technology in Madras, M.S in public policy from Purdue University, and Ph.D in social ecology from the University of California, Irvine S V SUBRAMANIAN is an assistant professor in the Department of Society, Human Development and Health, School of Public Health, Harvard University, in Boston He has a Ph.D in geography with specialization in multilevel statistical methods and a master’s degree in development studies from University of Dehli The main focus of his research is on understanding how different contextual settings influence individual health outcomes and population disparities in health achievements Subramanian has published more than 85 articles, book chapters, books and working papers He is assistant editor for Social Science and Medicine, editorial consultant to the Lancet, member of the editorial board of Health and Place and BMC Public Health, and book review editor for Economics and Human Biology KARSTEN THIELEN is an assistant professor in the Department of Public Health at the University of Copenhagen He previously worked as occupational medical officer at the State Institute of Occupational Safety and Health in Düsseldorf, Germany (1996–2005) He qualified as a physician in Germany (1996) and has an M.P.H (2004) His current research and teaching are concerned with the effect of working environments on mental health and health/social disparities related to clinical and social rehabilitation Thielen’s most recent About the Authors / 509 publication is “Job Stress and the Use of Antidepressant Medicine” (Occupational and Environmental Health, 2011) SHARANJIT UPPAL is a senior economist with Statistics Canada He received his Ph.D in economics from the University of Manitoba (2002) His areas of research include labor economics, economics of aging, and population health He has published his work in International Journal of Manpower, Social Science and Medicine, Journal of World Health and Population, Applied Economics, Health Reports, Perspectives on Labour and Income, and Education Matters KJETIL A VAN DER WEL is a researcher at Oslo and Akershus University College of Applied Sciences, in Oslo, Norway He has a master’s degree in sociology (2005) and has recently submitted his Ph.D dissertation in sociology His research interests include long-term trends in social and health-related employment inequalities (published in Acta Sociologica, 2010), life-course employment consequences of poor health (forthcoming in Sociology of Health & Illness), and comparative analyses on effects of welfare state arrangements on social inequalities in sickness and employment (forthcoming in Social Science and Medicine) MONTSERRAT VERGARA studied statistics and public health in Barcelona, obtaining a Ph.D at Pompeu Fabra University (2009) She works in the Health Inequalities Research Group/Employment Conditions Network (GREDS/ EMCONET) Her main fields of scientific research include health inequalities, employment conditions, small-area geographic analysis, and health policy Her recent publications are mainly focused on small-geographic analysis of avoidable mortality in Catalonia and Spain Vergara also collaborates in some international networks, offering technical assistance, including EMCONET and GRAAL, which include some Latin American groups MARGARET WHITEHEAD, Ph.D., FFPH, is W H Duncan Professor of Public Health at the University of Liverpool, where she is head of the World Health Organization Collaborating Centre for Policy Research on Social Determinants of Health For more than 20 years, her research interests have focused on social inequalities in health and the most effective ways of tackling them She is currently senior advisor to the WHO European Review of Health Inequalities and the Health Divide STACEY S WILLIAMS is Farm to School Program Assistant in the Food & Farms Program at the conservation nonprofit Ecotrust in Portland, Oregon, and is editorial assistant for the International Journal of Men’s Health She received her B.A in cultural anthropology from the University of British Columbia in Vancouver in 2002 and her M.P.H in health promotion from Portland State University in 2008 Her publications include, with M Kaplan, “Suicide, Environment, and Ecology” (in Handbook of Suicide Behaviour, ed A Shrivastava; Royal College of Psychiatrists, in press) Williams’ research interests are in sustainable food systems and policy, the effects of farm-to-school initiatives on population health, and food equity 510 / The Financial and Economic Crises WEI ZHANG, Ph.D., received her doctorate in economics from the University of Massachusetts Amherst She was a post-doctoral fellow in the School of Public Health at Johns Hopkins University Her research emphasizes how countries’ political economies shape health and health policies She teaches at the School of Labor and Human Resources at Renmin University of China ... financial and economic crises and their impact on health and social well- being / edited by Vicente Navarro and Carles Muntaner p ; cm (Policy, politics, health and medicine series) The contributions.. .THE FINANCIAL AND ECONOMIC CRISES AND THEIR IMPACT ON HEALTH AND SOCIAL WELL- BEING Edited by Vicente Navarro and Carles Muntaner POLICY, POLITICS, HEALTH AND MEDICINE SERIES Vicente Navarro, ... toward the right and its preference for fiscal conservatism / The Financial and Economic Crises Rather than the current crisis being viewed as a direct consequence of unequal political and economic