title: A systematic review on health resilience to economic crises.
abstract: BACKGROUND
  The health effects of recent economic crises differ markedly by population group. The objective of this systematic review is to examine evidence from longitudinal studies on factors influencing resilience for any health outcome or health behaviour among the general population living in countries exposed to financial crises.
  
  
  METHODS
  We systematically reviewed studies from six electronic databases (EMBASE, Global Health, MEDLINE, PsycINFO, Scopus, Web of Science) which used quantitative longitudinal study designs and included: (i) exposure to an economic crisis; (ii) changes in health outcomes/behaviours over time; (iii) statistical tests of associations of health risk and/or protective factors with health outcomes/behaviours. The quality of the selected studies was appraised using the Quality Assessment Tool for Quantitative Studies. PRISMA reporting guidelines were followed.
  
  
  RESULTS
  From 14,584 retrieved records, 22 studies met the eligibility criteria. These studies were conducted across 10 countries in Asia, Europe and North America over the past two decades. Ten socio-demographic factors that increased or protected against health risk were identified: gender, age, education, marital status, household size, employment/occupation, income/ financial constraints, personal beliefs, health status, area of residence, and social relations. These studies addressed physical health, mortality, suicide and suicide attempts, mental health, and health behaviours. Women's mental health appeared more susceptible to crises than men's. Lower income levels were associated with greater increases in cardiovascular disease, mortality and worse mental health. Employment status was associated with changes in mental health. Associations with age, marital status, and education were less consistent, although higher education was associated with healthier behaviours.
  
  
  CONCLUSIONS
  Despite widespread rhetoric about the importance of resilience, there was a dearth of studies which operationalised resilience factors. Future conceptual and empirical research is needed to develop the epidemiology of resilience.
authors.affiliation: ECOHOST-The Centre of Health and Social Change, London School of Hygiene and Tropical Medicine, London, United Kingdom.
authors.forename: Ketevan
authors.initials: K
authors.lastname: Glonti
authors.affiliation: ECOHOST-The Centre of Health and Social Change, London School of Hygiene and Tropical Medicine, London, United Kingdom.
authors.forename: Vladimir S
authors.initials: VS
authors.lastname: Gordeev
authors.affiliation: Norwich Medical School, University of East Anglia, Norwich, United Kingdom.
authors.forename: Yevgeniy
authors.initials: Y
authors.lastname: Goryakin
authors.affiliation: Department of Sociology, Oxford University, Oxford, United Kingdom.
authors.forename: Aaron
authors.initials: A
authors.lastname: Reeves
authors.affiliation: ECOHOST-The Centre of Health and Social Change, London School of Hygiene and Tropical Medicine, London, United Kingdom; Department of Sociology, Oxford University, Oxford, United Kingdom.
authors.forename: David
authors.initials: D
authors.lastname: Stuckler
authors.affiliation: ECOHOST-The Centre of Health and Social Change, London School of Hygiene and Tropical Medicine, London, United Kingdom.
authors.forename: Martin
authors.initials: M
authors.lastname: McKee
authors.affiliation: ECOHOST-The Centre of Health and Social Change, London School of Hygiene and Tropical Medicine, London, United Kingdom.
authors.forename: Bayard
authors.initials: B
authors.lastname: Roberts
mesh_terms: D004467:Economics; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D055500:Resilience, Psychological