Social Indicators Research

, Volume 141, Issue 2, pp 873–893 | Cite as

Exploring the Complex Associations Among Social Determinants of Health in Andalusia After the 2008 Financial Crisis

  • Javier Álvarez-GálvezEmail author
  • María Luisa Rodero-Cosano
  • José A. Salinas-Pérez
  • Diego Gómez-Baya


In this study, we disentangle the complex relationship between structural and intermediary social determinants of health in Andalusia (Spain) after the period of economic downturn, with the aim to understand the factors that might be addressed to reduce future health inequalities in socioeconomically vulnerable regions. Data from the IMPACT-A project were used. Our sample included 1200 individuals randomly selected using a stratified sampling process according to gender, age group and eight provinces in Andalusia (Spain). Structural equation modeling was conducted to test the goodness of fit of our data with the previous theoretical background. Our results indicated that socioeconomic factors and demographics are associated to health by influencing lifestyles, socioeconomic experiences during the crisis, and personal wellbeing. Additionally, several remarkable contributions from the results can be highlighted: (a) important differences in health outcomes were found in Andalusian females, (b) there was no relationship between income and lifestyles, (c) people with unmet medical needs demonstrated a higher perception of social discrimination, and (d) discrimination and happiness had a mediating effect on health. The final model accounts for more than one-third of the variance in health and describes the complex association of social determinants that might be addressed to reduce inequities in health in this region.


Social determinants of health Socioeconomic status Health inequalities Structural equation modeling Path analysis Andalusia 



Funding for the project ‘Socioeconomic Determinants of Health in Andalusia: Studying the Impact of the Economic Crisis on Andalusian Health’ (IMPACT-A) was provided by Centro de Estudios Andaluces, Junta de Andalucia, ES (Grant No. PRY120/14).


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© Springer Science+Business Media B.V., part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Biomedicine, Biotechnology and Public HealthUniversidad de CádizCádizSpain
  2. 2.Department of Quantitative MethodsUniversidad Loyola AndalucíaCórdobaSpain
  3. 3.Department of Quantitative MethodsUniversidad Loyola AndalucíaSevilleSpain
  4. 4.Department of Social, Developmental and Educational PsychologyUniversidad de HuelvaHuelvaSpain

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