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

Keywords

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

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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