title: The recent economic recession and self-rated health in Estonia, Lithuania and Finland: a comparative cross-sectional study in 2004-2010.
abstract: BACKGROUND
  The late-2000s financial crisis had a severe impact on the national economies on a global scale. In Europe, the Baltic countries were among those most affected with more than a 20% decrease in per capita gross domestic product in 2008-2009. In this study, we explored the effects of economic recession on self-rated health in Estonia and Lithuania using Finland, a neighbouring Nordic welfare state, as a point of reference.
  
  
  METHODS
  Nationally representative cross-sectional data for Estonia (n=10 966), Lithuania (n=7249) and Finland (n=11 602) for 2004-2010 were analysed for changes in age-standardised prevalence rates of less-than-good self-rated health and changes in health inequalities using logistic regression analysis.
  
  
  RESULTS
  The prevalence of less-than-good self-rated health increased slightly (albeit not statistically significantly) in all countries during 2008-2010. This was in sharp contrast to the statistically significant decline in the prevalence of less-than-good health in 2004-2008 in Estonia and Lithuania. Health disparities were larger in Estonia and Lithuania when compared to Finland, but decreased in 2008-2010 (in men only). In Finland, both the prevalence of less-than-good health and health disparities remained fairly stable throughout the period.
  
  
  CONCLUSIONS
  Despite the rapid economic downturn, the short-term health effects in Estonia and Lithuania did not differ from those in Finland, although the recession years marked the end of the previous positive trend in self-rated health. The reduction in health disparities during the recession indicates that different socioeconomic groups were affected disproportionately; however, the reasons for this require further research.
authors.affiliation: Department of Public Health, University of Tartu, Tartu, Estonia Institute of Social Studies, University of Tartu, Tartu, Estonia.
authors.forename: Rainer
authors.initials: R
authors.lastname: Reile
authors.affiliation: Department of Lifestyle and Participation, National Institute for Health and Welfare (THL), Helsinki, Finland.
authors.forename: Satu
authors.initials: S
authors.lastname: Helakorpi
authors.affiliation: Institute for Health Research, Public Health Faculty, Lithuanian University of Health Sciences, Kaunas, Lithuania.
authors.forename: Jurate
authors.initials: J
authors.lastname: Klumbiene
authors.affiliation: Department of Epidemiology and Biostatistics, National Institute for Health Development, Tallinn, Estonia.
authors.forename: Mare
authors.initials: M
authors.lastname: Tekkel
authors.affiliation: Department of Epidemiology and Biostatistics, National Institute for Health Development, Tallinn, Estonia Stockholm Centre on Health of Societies in Transition, Södertörn University, Huddinge, Sweden.
authors.forename: Mall
authors.initials: M
authors.lastname: Leinsalu
mesh_terms: D000328:Adult; D017677:Age Distribution; D003431:Cross-Cultural Comparison; D003430:Cross-Sectional Studies; D057172:Economic Recession; D004522:Educational Status; D004651:Employment; D004957:Estonia / Q000453:epidemiology; D005006:Ethnicity; D005260:Female; D005387:Finland / Q000453:epidemiology; D054624:Health Status Disparities; D006306:Health Surveys; D006801:Humans; D008097:Lithuania / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D057566:Self Report; D017678:Sex Distribution; D012923:Social Class; D055815:Young Adult
keywords: Eastern Europe; Health inequalities; Self-Rated Health; Socio-Economic