Financial Problems and health disparities in Europe

this paper analyses the effects of financial difficulties on the determinants of self-reported health in europe, providing initial evidence on the pathway through which over indebtedness can influence physical health that is lacking in the literature. We argue, by contrast, that the common thread is the increasing assertiveness of the state as the guarantor of health care access, financial stability, and cost containment. thus, all three countries’ health sectors had authority dispersed across territorial and functional domains. a socioecological conceptual model for the analysis of socioeconomic determinants of health from the literature on health inequalities in europe is adapted in order to test if over-indebtedness and home ownership can be considered autonomous determinants of european individuals’ health. the data used are from the eurostat 2010–2014 waves of eu-SilC panel for 26 european countries (n=962,704). a set of random effects panel logit and Probit models are estimated for the probability of reporting poor physical health status, chronic conditions and limitations in daily life, while controlling for several demographic and socioeconomic (income, education, occupational status; measures for households over-indebtedness and house tenure status) individual characteristics. in order to deal with the potential endogeneity of the indebtedness-health relationship, we used an instrumental variables approach (two-stage residual inclusion approach) and bivariate recursive models. moreover, the estimation of recursive bivariate models with random effects is explored. Dispersed power and the varied models of self governance came into conflict with the central governments’ goals and ambitions as cost containment started to dominate the agenda of health policy-making as early as in the mid-1970s. as cost pressures mounted, expanding or maintaining citizens’ access to high quality health care increasingly meant that politicians and state bureaucracies directly intervened in organization and service delivery in health care to control costs while preserving access and improving quality. first results show that being in a household in arrears with payments and at risk of over-indebtedness is a consistent and robust predictor of poor health outcomes, whereas home ownership positively affects individual self-reported health. more importantly, among socio-economic determinants of health, over-indebtedness showed the largest odds ratios.