Economic Shocks and Health Resilience - Lessons from the Russian Federation

经济冲击和健康复原力——俄罗斯联邦的经验教训

• 批准号: ES/K003496/1
• 负责人: Bayard Roberts
• 金额: $ 15.67万
• 依托单位: London School of Hygiene & Tropical Medicine
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2013
• 资助国家: 英国
• 起止时间: 2013 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=ES%2FK003496%2F1
• 关键词: Economic; Shocks; Health; Resilience; Lessons

The project takes place in the context of the worst economic crisis in Europe since the Great Depression. This has already had an impact on health in the United Kingdom and elsewhere, with evidence showing the strong correlation between economic crises and worse health (Stuckler, Basu et al. 2011). There are fears this impact will increase given the persisting lack of economic growth, scarcity of job opportunities, and retrenchments of state services and support. This project seeks to understand how some people are better able than others to survive and maintain good health despite experiencing similar levels of economic shock at the individual and household level. While there is a large literature on the factors that leave people vulnerable to ill health during hard times, there is much less on the factors that may protect health and wellbeing. In order to address this, we apply the concept of resilience. This has been defined as a 'dynamic process by which individuals, communities and societies positively adapt in a context of significant adversity'(Luthar 2000). It focuses on the effect that a shock (e.g. economic shock) has on the individual (i.e. the ability to bounce back). While there is a considerable body of research on resilience (Rutter 2006; Castleden, McKee et al. 2011), it has yet to be applied specifically to the relationship of economic shocks and health.A challenge to the study of economic shock and resilience is that in most circumstances individuals exposed to significant external shocks comprise a relatively small proportion of the population. We have, however, identified an existing data source that overcomes this challenge. The Russian Longitudinal Monitoring Survey (RLMS) consists of panel data from 4,000 households between 1994 and 2010 which contains variables on health, economic status and resilience. The Russian population has faced a series of major economic crises and so has a much greater degree of exposure to shocks and variation of resilience factors than found in datasets in other countries, thus enabling us to ascertain effects which may be more difficult to observe in the United Kingdom and elsewhere.The aim of our project is to understand the factors that promote or diminish people's resilience to economic shocks, using a quantitative case-study of the Russian Federation in the post-Soviet period (using the RLMS dataset). The first objective is to identify the factors that promote or diminish resilience to economic shocks. The second objective is to evaluate resilience factors at individual, household, community, and population levels using multi-level modelling. We will firstly perform a systematic review to identify factors that modify health in times of economic crisis to identify potential factors influencing resilience to guide the RLMS data analysis. For the data analysis we will follow a retrospective cohort of persons who were employed in 1994 and follow their experiences until 2011 to evaluate individual and household characteristics and responses to comparable economic shocks (e.g. loss of a job) and the influence on their health outcomes (e.g. mortality, poor mental health). Potential resilience factors include education level, marital status, partner characteristics, social and political attitudes, social networks, labour market characteristics and social welfare support.We believe the project will benefit policymakers in the United Kingdom, Europe, Russia and other countries experiencing economic crises by providing evidence to develop policies that support individual and household resilience to economic shock and so alleviating social suffering and improving health. The conceptual, methodological and empirical contributions of the project will also benefit researchers from the disciplines of public health, economics and sociology. We will maximise the project benefits through active engagement with the relevant policy and academic communities.

该项目发生在欧洲大萧条以来最严重的经济危机的背景下。这已经对联合王国和其他地方的健康产生了影响，有证据表明，经济危机与健康状况恶化之间存在很强的相关性（Stuckler、Basu等人，2011年）。由于经济增长持续乏力，就业机会稀缺，国家服务和支持紧缩，人们担心这种影响会加剧。该项目旨在了解一些人如何在个人和家庭经历类似程度的经济冲击的情况下比其他人更能生存和保持良好的健康。虽然有大量文献介绍了在困难时期使人们容易生病的因素，但关于可能保护健康和福祉的因素的文献要少得多。为了解决这个问题，我们采用了弹性的概念。这被定义为“个人、社区和社会在重大不利环境中积极适应的动态过程”（Luthar 2000）。它侧重于冲击（如经济冲击）对个人的影响（即反弹能力）。虽然有相当多的关于弹性的研究（Rutter 2006; Castleden，McKee et al. 2011），但它还没有被专门应用于经济冲击和健康的关系。经济冲击和弹性研究的一个挑战是，在大多数情况下，暴露于重大外部冲击的个人占人口的比例相对较小。然而，我们已经确定了克服这一挑战的现有数据源。俄罗斯纵向监测调查（RLMS）由1994年至2010年4，000个家庭的面板数据组成，其中包含健康，经济状况和弹性变量。俄罗斯人口经历了一系列重大经济危机，因此比其他国家的数据集更容易受到冲击和弹性因素变化的影响，从而使我们能够确定在英国和其他地方可能更难观察到的影响。我们项目的目的是了解促进或减少人们对经济冲击的弹性的因素，使用后苏联时期俄罗斯联邦的定量案例研究（使用RLMS数据集）。第一个目标是确定促进或削弱经济冲击复原力的因素。第二个目标是利用多层次模型评估个人、家庭、社区和人口各级的复原力因素。我们将首先进行系统的回顾，以确定在经济危机时期改变健康的因素，以确定影响弹性的潜在因素，以指导RLMS数据分析。为了进行数据分析，我们将对1994年就业的人进行回顾性队列研究，并跟踪他们的经历，直到2011年，以评估个人和家庭特征以及对可比经济冲击（例如失业）的反应，以及对他们健康结果的影响（例如死亡率，精神健康状况不佳）。潜在的弹性因素包括教育水平、婚姻状况、伴侣特征、社会和政治态度、社交网络、劳动力市场特征和社会福利支持，我们相信该项目将使英国、欧洲、俄罗斯和其他经历经济危机的国家，提供证据，制定政策，支持个人和家庭抵御经济冲击，从而减轻社会痛苦和改善健康。该项目在概念、方法和经验方面的贡献也将使公共卫生、经济学和社会学等学科的研究人员受益。我们将通过与相关政策和学术界的积极接触，最大限度地提高项目效益。

项目成果

A systematic review on health resilience to economic crises.

• DOI: 10.1371/journal.pone.0123117
• 发表时间: 2015
• 期刊: PloS one
• 影响因子: 3.7
• 作者: Glonti K;Gordeev VS;Goryakin Y;Reeves A;Stuckler D;McKee M;Roberts B
• 通讯作者: Roberts B

Economic shocks and health resilience: lessons from the Russian Federation.

• DOI: 10.1093/pubmed/fdv166
• 发表时间: 2016-12-02
• 期刊: Journal of public health (Oxford, England)
• 作者: Gordeev VS;Goryakin Y;McKee M;Stuckler D;Roberts B
• 通讯作者: Roberts B