2008 economic crisis impact on perinatal and infant mortality in Southern European countries

J.N. Doetsch*, R. Almendra, M. Severo, T. Leao, E. Pilot, T. Krafft, H. Barros

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


IntroductionThe 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. ObjectiveTo 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. MethodsAssociations 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. ResultsIMR 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. ConclusionOur 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.
Original languageEnglish
Pages (from-to)305-314
Number of pages10
JournalJournal of Epidemiology and Community Health
Issue number5
Early online date1 Feb 2023
Publication statusPublished - May 2023


  • public health
  • epidemiology
  • health policy
  • health services
  • health inequalities
  • CARE


Dive into the research topics of '2008 economic crisis impact on perinatal and infant mortality in Southern European countries'. Together they form a unique fingerprint.

Cite this