Recommodification and the social determinants of health: unemployment benefits, pensions and health inequalities in Sweden and England, 1991-2011

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Background‘Recommodification’ describes the withdrawal of previously extended social welfare, making living standards more dependent on market position. Since health is influenced by living standards, recommodification is expected to be associated with increased health inequalities.AimThis study investigates the recommodification of two policy domains: unemployment insurance and pensions, and their link to health inequalities between 1991 and 2011.MethodsTwo case studies were used. Using data from Health Survey for England and the Swedish Study of Income and Living Conditions, the magnitudes of health inequalities between the employed and unemployed, and between high and low educated pensioners, were computed. The magnitudes were then associated with net replacement rates of pensions and unemployment benefits.ResultsRecommodification had a stronger association with health inequalities in Sweden than in England, and a stronger association with health inequalities between the employed and unemployed than in the retired population.ConclusionThe relationship between decommodification is not linear, but is shaped by other factors in the social context. However, recommodification has a positive or negligible association with health inequalities. In no case was there a negative association between recommodification and health inequalities.

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