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Who benefits from social investment? The gendered effects of family and employment policies on cardiovascular disease in Europe
  1. Katherine Ann Morris1,
  2. Jason Beckfield1,
  3. Clare Bambra2
  1. 1 Department of Sociology, Harvard University, Cambridge, Massachusetts, USA
  2. 2 Newcastle University, Institute for Health and Society, Newcastle upon Tyne, UK
  1. Correspondence to Ms Katherine Ann Morris, Department of Sociology, Harvard University, Cambridge MA 02138, USA; kmorris{at}


Background In the context of fiscal austerity in many European welfare states, policy innovation often takes the form of ‘social investment’, a contested set of policies aimed at strengthening labour markets. Social investment policies include employment subsidies, skills training and job-finding services, early childhood education and childcare and parental leave. Given that such policies can influence gender equity in the labour market, we analysed the possible effects of such policies on gender health equity.

Methods Using age-stratified and sex-stratified data from the Global Burden of Disease Study on cardiovascular disease (CVD) morbidity and mortality between 2005 and 2010, we estimated linear regression models of policy indicators on employment supports, childcare and parental leave with country fixed effects.

Findings We found mixed effects of social investment for men versus women. Whereas government spending on early childhood education and childcare was associated with lower CVD mortality rates for both men and women equally, government spending on paid parental leave was more strongly associated with lower CVD mortality rates for women. Additionally, government spending on public employment services was associated with lower CVD mortality rates for men but was not significant for women, while government spending on employment training was associated with lower CVD mortality rates for women but was not significant for men.

Conclusions Social investment policies were negatively associated with CVD mortality, but the ameliorative effects of specific policies were gendered. We discuss the implications of these results for the European social investment policy turn and for future research on gender health equity.

  • health inequalities
  • gender
  • policy
  • cardiovascular disease

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  • Patient consent for publication Not required.

  • Contributors KAM cleaned and analysed the data. KAM and JB wrote the first draft of the paper in consultation with CB. All authors contributed sections of text and to critical revisions of the paper. KAM edited the final version.

  • Funding This article is part of the HiNEWS project—Health Inequalities in European Welfare States—funded by the NORFACE (New Opportunities for Research Funding Agency Cooperation in Europe) Welfare State Futures programme (grant reference: 462-14-110).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.