Unemployment, public-sector healthcare expenditure and colorectal cancer mortality in the European Union

1990–2009

Mahiben Maruthappu, Robert A. Watson, Johnathan Watkins, Callum Williams, Thomas Zeltner, Omar Faiz, Raghib Ali, Rifat Atun

    Research output: Contribution to journalArticle

    Abstract

    Objectives: We examined the association between unemployment and government spending on healthcare with colorectal cancer mortality. Methods: Retrospective observational study using data from the World Bank and WHO. Multivariate regression analysis was used, controlling for country-specific differences in infrastructure and demographics. Results: A 1 % increase in unemployment was associated with a significant increase in colorectal cancer mortality in both men and women [men: coefficient (R) = 0.0995, 95 % confidence interval (CI) 0.0132–0.1858, P = 0.024; women: R = 0.0742, 95 % CI 0.0160–0.1324, P = 0.013]. A 1 % increase in government spending on healthcare was associated with a statistically significant decrease in colorectal cancer mortality across both sexes (men: R = −0.4307, 95 % CI −0.6057 to −0.2557, P < 0.001; women: R = −0.2162, 95 % CI −0.3407 to −0.0917, P = 0.001). The largest changes in mortality occurred 3–4 years following changes in either economic variable. Conclusions: Unemployment rises are associated with a significant increase in colorectal cancer mortality, whilst government healthcare spending rises are associated with falling mortality. This is likely due, in part, to reduced access to healthcare services and has major implications for clinicians and policy makers alike.

    Original languageEnglish (US)
    Pages (from-to)119-130
    Number of pages12
    JournalInternational Journal of Public Health
    Volume61
    Issue number1
    DOIs
    StatePublished - Jan 1 2016

    Fingerprint

    Unemployment
    Public Sector
    European Union
    Health Expenditures
    Colorectal Neoplasms
    Delivery of Health Care
    Mortality
    Confidence Intervals
    Accidental Falls
    United Nations
    Administrative Personnel
    Observational Studies
    Multivariate Analysis
    Retrospective Studies
    Regression Analysis
    Economics
    Demography
    Databases

    Keywords

    • Cancer mortality
    • Colorectal cancer
    • European Union
    • Healthcare spending
    • Unemployment

    ASJC Scopus subject areas

    • Public Health, Environmental and Occupational Health

    Cite this

    Unemployment, public-sector healthcare expenditure and colorectal cancer mortality in the European Union : 1990–2009. / Maruthappu, Mahiben; Watson, Robert A.; Watkins, Johnathan; Williams, Callum; Zeltner, Thomas; Faiz, Omar; Ali, Raghib; Atun, Rifat.

    In: International Journal of Public Health, Vol. 61, No. 1, 01.01.2016, p. 119-130.

    Research output: Contribution to journalArticle

    Maruthappu, M, Watson, RA, Watkins, J, Williams, C, Zeltner, T, Faiz, O, Ali, R & Atun, R 2016, 'Unemployment, public-sector healthcare expenditure and colorectal cancer mortality in the European Union: 1990–2009', International Journal of Public Health, vol. 61, no. 1, pp. 119-130. https://doi.org/10.1007/s00038-015-0727-2
    Maruthappu, Mahiben ; Watson, Robert A. ; Watkins, Johnathan ; Williams, Callum ; Zeltner, Thomas ; Faiz, Omar ; Ali, Raghib ; Atun, Rifat. / Unemployment, public-sector healthcare expenditure and colorectal cancer mortality in the European Union : 1990–2009. In: International Journal of Public Health. 2016 ; Vol. 61, No. 1. pp. 119-130.
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    abstract = "Objectives: We examined the association between unemployment and government spending on healthcare with colorectal cancer mortality. Methods: Retrospective observational study using data from the World Bank and WHO. Multivariate regression analysis was used, controlling for country-specific differences in infrastructure and demographics. Results: A 1 {\%} increase in unemployment was associated with a significant increase in colorectal cancer mortality in both men and women [men: coefficient (R) = 0.0995, 95 {\%} confidence interval (CI) 0.0132–0.1858, P = 0.024; women: R = 0.0742, 95 {\%} CI 0.0160–0.1324, P = 0.013]. A 1 {\%} increase in government spending on healthcare was associated with a statistically significant decrease in colorectal cancer mortality across both sexes (men: R = −0.4307, 95 {\%} CI −0.6057 to −0.2557, P < 0.001; women: R = −0.2162, 95 {\%} CI −0.3407 to −0.0917, P = 0.001). The largest changes in mortality occurred 3–4 years following changes in either economic variable. Conclusions: Unemployment rises are associated with a significant increase in colorectal cancer mortality, whilst government healthcare spending rises are associated with falling mortality. This is likely due, in part, to reduced access to healthcare services and has major implications for clinicians and policy makers alike.",
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    T1 - Unemployment, public-sector healthcare expenditure and colorectal cancer mortality in the European Union

    T2 - 1990–2009

    AU - Maruthappu, Mahiben

    AU - Watson, Robert A.

    AU - Watkins, Johnathan

    AU - Williams, Callum

    AU - Zeltner, Thomas

    AU - Faiz, Omar

    AU - Ali, Raghib

    AU - Atun, Rifat

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    N2 - Objectives: We examined the association between unemployment and government spending on healthcare with colorectal cancer mortality. Methods: Retrospective observational study using data from the World Bank and WHO. Multivariate regression analysis was used, controlling for country-specific differences in infrastructure and demographics. Results: A 1 % increase in unemployment was associated with a significant increase in colorectal cancer mortality in both men and women [men: coefficient (R) = 0.0995, 95 % confidence interval (CI) 0.0132–0.1858, P = 0.024; women: R = 0.0742, 95 % CI 0.0160–0.1324, P = 0.013]. A 1 % increase in government spending on healthcare was associated with a statistically significant decrease in colorectal cancer mortality across both sexes (men: R = −0.4307, 95 % CI −0.6057 to −0.2557, P < 0.001; women: R = −0.2162, 95 % CI −0.3407 to −0.0917, P = 0.001). The largest changes in mortality occurred 3–4 years following changes in either economic variable. Conclusions: Unemployment rises are associated with a significant increase in colorectal cancer mortality, whilst government healthcare spending rises are associated with falling mortality. This is likely due, in part, to reduced access to healthcare services and has major implications for clinicians and policy makers alike.

    AB - Objectives: We examined the association between unemployment and government spending on healthcare with colorectal cancer mortality. Methods: Retrospective observational study using data from the World Bank and WHO. Multivariate regression analysis was used, controlling for country-specific differences in infrastructure and demographics. Results: A 1 % increase in unemployment was associated with a significant increase in colorectal cancer mortality in both men and women [men: coefficient (R) = 0.0995, 95 % confidence interval (CI) 0.0132–0.1858, P = 0.024; women: R = 0.0742, 95 % CI 0.0160–0.1324, P = 0.013]. A 1 % increase in government spending on healthcare was associated with a statistically significant decrease in colorectal cancer mortality across both sexes (men: R = −0.4307, 95 % CI −0.6057 to −0.2557, P < 0.001; women: R = −0.2162, 95 % CI −0.3407 to −0.0917, P = 0.001). The largest changes in mortality occurred 3–4 years following changes in either economic variable. Conclusions: Unemployment rises are associated with a significant increase in colorectal cancer mortality, whilst government healthcare spending rises are associated with falling mortality. This is likely due, in part, to reduced access to healthcare services and has major implications for clinicians and policy makers alike.

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    KW - Colorectal cancer

    KW - European Union

    KW - Healthcare spending

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