Economic Shocks and Health Resilience - Lessons from the Russian Federation

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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.