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Aletta Jacobs School of Public Health

Together for more healthy years
Agenda Junior Research Meet-up

Parallel session 1A: Welfare, wellbeing and the welfare state

Liza A. Hoveling - Socioeconomic differences in depression development among adults: explained by lifestyle-, psychological- and social factors

The incidence of depression strongly varies by socioeconomic status (SES). Lifestyle-, psychological- and social factors could be mechanisms explaining the SES-depression relationship, but little is known about their mediating role in the general adult population. This study aims to longitudinally assess the association between SES measures, education, income and occupational prestige, and incident depression, whether and to what extent the associations are mediated by lifestyle-, psychological- and social factors and whether the associations between SES and depression development are moderated by sex and depression history.

Methods
A subsample of the adult Lifelines Cohort Study without depression at baseline will be used. Major depression will be measured at baseline and the second assessment defined according to the Mini International Neuropsychiatric Interview (MINI). Direct associations between SES, lifestyle-, psychological- and social factors and incident depression will be estimated using multivariable logistic regression analyses. The moderating effect of sex and depression history on the association between SES and depression development will also be estimated using multivariable logistic regression analyses. The mediating percentages of the lifestyle-, psychological- and social factors explaining the association between SES and incident depression will be estimated using R. Analyses will be controlled for age, sex, the other SES measures and follow-up time.

Expected results
Years of education, household equivalent income and occupational prestige will be inversely associated with the development of depression, although differently. Lifestyle-, psychological- and social factors will explain the associations between SES and incident depression partly.

Expected conclusions
Individuals with more years of education, a higher household equivalent income or a higher occupations prestige will show a decreased risk to develop depression. This will mainly be explained by the psychological and social factors and to a lesser extent by the lifestyle factors.

Keywords: Major depression, Socioeconomic Factors, Longitudinal Studies

Lara Bister - Economic crisis at time of birth and health functioning at young adulthood – the case of post-reunification East Germany

In the first decade after the German reunification, East Germany experienced a severe economic crisis leading to mass unemployment and persisting economic insecurity. Extensive research has been done on the relationship between health this as well as other economic crises, for example the global financial crisis, for adults and children. However, not much is known about the long-term health implications of the exposure to economic crisis during vulnerable phases of the life course. This is highly relevant as it can shed light on policy measures protecting children from the consequences of economic crises. Using the German reunification as a natural experiment, we investigate the association between economic crises at birth in East Germany on health functioning at young adulthood. We use all waves of the German Socioeconomic Panel (SOEP) between 1984 and 2018 to reconstruct relevant individual and family information of individuals being born in East Germany and thereby being exposed to the economic crisis (N = 2,762). We compare them with individuals from West Germany and for a subsample (n = 528). Our health variable is the SF-12 score for mental (MCS) and physical health functioning (PCS). We apply logistic regression to predict the probabilities of scoring below the SF-12 sample average and how the childhood exposure to the economic crisis in Germany has affected this. Preliminary results show that individuals being born in East Germany have higher probabilities to score lower in the MCS, especially for those who have been exposed to the crises between the ages of 5 and 14. Additionally, we will focus on the role of direct family exposure to the economic crises by considering parental unemployment.

Eline Linthorst - Towards responsive law in changing welfare states: the genealogy of personalization in public social services provision

Welfare states across Europe are currently under critique: they are said to create administrative pressure for professionals and uniform ‘one size fits all’ services for citizens. As a reaction and rooted in ideas of ‘street level bureaucracy’, various welfare states recently made a transition towards responsive law and the idea of ‘personalization’ by taking into account social contexts and personal needs of citizens (Nonet and Selznick 2009, Needham 2011). In theory, this transition supposedly creates more discretionary space for municipalities and their frontline workers to promote personalization as a public value. However, earlier research shows that the implementation of ‘personalization’ is difficult because it is subject to multiple interpretations (Linthorst & Oldenhof 2020). In this article, a case of responsive law in the Netherlands: the Dutch Social Support Act (Wmo 2015) is evaluated to investigate the personal centered turn in the Dutch public service delivery. How has this idea of tailored services, as opposed to a one-size-fits-all approach become the model for providing public services? And what different meanings are given to this idea at the time of introduction of the Wmo 2015? This case provides revealing insights into the ambiguous meaning of personalization and responsive law in times of budget cuts and the tensions that arise between different Rule of Law values such as equality and legal certainty.

Methods
To evaluate the personalized turn, a narrative policy analysis is conducted of the Wmo 2015 and different policy documents. To get an in-depth understanding of how the value of personalization is introduced in public discourse, documents were analyzed such as policy guidelines of municipalities. Jointly, these different data were analyzed for value tensions and multiple interpretations.

Keywords: responsive law, personalization, narrative policy analysis

Last modified:14 January 2021 7.40 p.m.