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01.12.2015 | Research article | Ausgabe 1/2015 Open Access

BMC Public Health 1/2015

Health and health behaviours before and during the Great Recession, overall and by socioeconomic status, using data from four repeated cross-sectional health surveys in Spain (2001–2012)

BMC Public Health > Ausgabe 1/2015
Xavier Bartoll, Veronica Toffolutti, Davide Malmusi, Laia Palència, Carme Borrell, Marc Suhrcke
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​s12889-015-2204-5) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

XB, VT, MS were involved in design and planning the study. XB prepared the data, performed the statistical analysis and wrote the first draft of the manuscript. DM, LP, CB commented on the manuscript and contributed to the results and discussion sections. VT and MS commented on and contributed to the final version of the manuscript. All authors read and approved the final manuscript.



The objective of this study was to estimate changes over time in health status and selected health behaviours during the Great Recession, in the period 2011/12, in Spain, both overall, and according to socioeconomic position and gender.


We applied a before-after estimation on data from four editions of the Spanish National Health Survey: 2001, 2003/04, 2006/07 and 2011/12. This involved applying linear probability regression models accounting for time-trends and with robust standard errors, using as outcomes self-reported health and health behaviours, and as the main explanatory variable a dummy “Great Recession” for the 2011/12 survey edition. All the computations were run separately by gender. The final sample consisted of 47,156 individuals aged between 25 and 64 years, economically active at the time of the interview. We also assessed the inequality of the effects across socio-economic groups.


The probability of good self-reported health increased for women (men) by 9.6 % (7.6 %) in 2011/12, compared to the long term trend. The changes are significant for all educational levels, except for the least educated. Some healthy behaviours also improved but results were rather variable. Adverse dietary changes did, however, occur among men (though not women) who were unemployed (e.g., the probability of declaring eating fruit daily changed by −12.1 %), and among both men (−21.8 %) and women with the lowest educational level (−15.1 %).


Socioeconomic inequalities in health and health behaviour have intensified, in the period 2011/12, in at least some respects, especially regarding diet. While average self-reported health status and some health behaviours improved during the economic recession, in 2011/12, this improvement was unequal across different socioeconomic groups.
Additional file 1: Extended definition of variables and descriptive statistics. (DOC 103 kb)
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