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

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Abstract

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.

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Funding

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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Authors and Affiliations

  1. Department of Biomedicine, Biotechnology and Public Health, Universidad de Cádiz, Avda. Ana de Viya, 52, 11009, Cádiz, Spain

    Javier Álvarez-Gálvez

  2. Department of Quantitative Methods, Universidad Loyola Andalucía, Campus Córdoba, C/Escritor Castilla Aguayo, 4, 14004, Córdoba, Spain

    María Luisa Rodero-Cosano

  3. Department of Quantitative Methods, Universidad Loyola Andalucía, Campus Sevilla, C/Energía Solar, 1. Building G, 41014, Seville, Spain

    José A. Salinas-Pérez

  4. Department of Social, Developmental and Educational Psychology, Universidad de Huelva, Avda. Fuerzas Armadas, 21007, Huelva, Spain

    Diego Gómez-Baya

Authors
  1. Javier Álvarez-Gálvez
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  2. María Luisa Rodero-Cosano
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  3. José A. Salinas-Pérez
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  4. Diego Gómez-Baya
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Corresponding author

Correspondence to Javier Álvarez-Gálvez.

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Table 5 Description of variables in the analysis
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Álvarez-Gálvez, J., Rodero-Cosano, M.L., Salinas-Pérez, J.A. et al. Exploring the Complex Associations Among Social Determinants of Health in Andalusia After the 2008 Financial Crisis. Soc Indic Res 141, 873–893 (2019). https://doi.org/10.1007/s11205-018-1845-z

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