PT  - JOURNAL ARTICLE
AU  - Julia Nadine Doetsch
AU  - Ricardo Almendra
AU  - Milton Severo
AU  - Teresa Leão
AU  - Eva Pilot
AU  - Thomas Krafft
AU  - Henrique Barros
TI  - 2008 economic crisis impact on perinatal and infant mortality in Southern European countries
AID  - 10.1136/jech-2022-219639
DP  - 2023 May 01
TA  - Journal of Epidemiology and Community Health
PG  - 305--314
VI  - 77
IP  - 5
4099  - http://jech.bmj.com/content/77/5/305.short
4100  - http://jech.bmj.com/content/77/5/305.full
SO  - J Epidemiol Community Health2023 May 01; 77
AB  - Introduction The study of crisis events provides important lessons to prepare for upcoming events. The Great Recession’s impact on perinatal health in Europe can provide relevant insights into the healthcare and social protection systems’ response to the protection of the health of the most vulnerable groups.Objective To assess time trends and international disparities in perinatal mortality rates (PMR) and infant mortality rates (IMR), following the Great Recession, and their association with socioeconomic indicators in Portugal, Greece, Italy and Spain.Methods Associations were assessed through generalised linear models for all four countries. A Poisson joinpoint regression model was applied to explore PMR and IMR trend changes between 2000 and 2018. Country disparities were analysed using mixed-effects multilevel models.Results IMR and PMR have decreased overall in the four selected countries between 2000 and 2018. Still, whereas in Spain, Italy and Portugal the decreasing pace was attenuated after 2009, in Greece a positive trend was found after the 2008 crisis. IMR and PMR were significantly associated with socioeconomic indicators in all four countries. National disparities in the evolution of IMR and PMR were significantly associated with most socioeconomic indicators between 2000 and 2018.Conclusion Our results confirm the impact of the Great Recession on PMR and IMR trends in all four countries, taking recurring associations between macroeconomic cycles, variations in mortality trends, macroeconomic volatility and stagnation of IMR and PMR into account. The association with socioeconomic indicators stresses the need to strengthen social protection and healthcare systems to better protect the population’s health from the earliest days.All data relevant to the study are included in the article or uploaded as supplementary information.