The 2008 Financial Crisis and Changes in Lifestyle-Related Behaviors in Italy, Greece, Spain, and Portugal: A Systematic Review
Abstract
:1. Introduction
2. Materials and Methods
2.1. Information Sources and Search Strategy
- Type of study: publications lacking primary data and/or explicit descriptions of the methods. Abstracts, editorials, correspondence, and commentaries were deemed acceptable for inclusion if they reported sufficient data;
- Methodology: pre–post comparison missing;
- Data not suitable for extraction (e.g., reporting data on a group of countries);
- Study population overlap.
2.2. Data Extraction, Quality Evaluation, and Synthesis of Results
3. Results
3.1. The Financial Crisis and Lifestyle-Related Behaviors
3.1.1. The Financial Crisis and Alcohol Consumption
3.1.2. The Financial Crisis and Smoking
3.1.3. The Financial Crisis and Healthy Diet
3.1.4. The Financial Crisis and Physical Activity
3.1.5. The Financial Crisis and Use of Antidepressant, Anxiolytic, and/or Antipsychotic Drugs
3.1.6. The Financial Crisis and Substance Abuse
4. Discussion
Strengths and Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Acknowledgments
Conflicts of Interest
References
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COUNTRY: SPAIN | ||||
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Author | Study Design, Sample Characteristics | Outcome Definition | Findings * | |
Aguilar-Palacio 2015 [13] | Cross-sectional Spanish National Health Survey (ENSE) Young people: 16–24 years N = 3701 (ENSE 2006: 2168; ENSE 2011/12: 1533) | Alcohol consumption in the last 2 weeks Daily/occasional smoker | Alcohol consumption Prevalence (%), 2006 vs. 2012 MEN: 61.9 vs. 56.3 (p = 0.015) WOMEN: 46.4 vs. 43.8 (ns) Smoking Daily/occasional smokers Prevalence (%), 2006 vs. 2012 MEN: 25.0 vs. 23.7 (ns) WOMEN: 28.9 vs. 21.9 (p < 0.001) Adjusted odds ratios (OR), 2012 vs. 2006: MEN: OR 0.97 (95% CI: 0.77–1.21) WOMEN: OR 0.79 (95% CI: 0.64–0.99) By socioeconomic status Adjusted odds ratios (OR), unemployed vs. working MEN 2006: OR 1.04 (95% CI: 0.64–1.69) 2012: OR 1.62 (95% CI: 1.00–2.62) WOMEN 2006: OR 0.97 (95% CI: 0.64–1.48) 2012: OR 1.24 (95% CI: 0.72–2.13) | |
Arroyo 2019 [15] | Cross-sectional Adults: >15 years N = 49,463 (2006–2007: 28,954; 2011–2012: 20,509) | Consumption of antidepressants or sedatives | Drugs Antidepressants Overall consumption (%), 2006–2007 vs. 2011–2012: 5.8 vs. 4.3 (p < 0.01) Sedatives Overall consumption (%), 2006–2007 vs. 2011–2012: 10.7 vs. 11.1 (ns) | |
Bartoll 2015 [16] | Cross-sectional Spanish National Health Survey (2001, 2003/04, 2006/07 and 2011/12) Economically active adults: 25–64 years N = 47,156 | Alcohol consumption in the last 2 weeks Heavy alcohol consumption more than 17 Standard Basic Units of alcohol per week Smoking habits Frequency of consumption of food Physical activity moderate or intense physical activity Tranquilizer or sleeping tablet intake at least 1 tablet in the last 2 weeks. | Alcohol Trend percentages (%) of consumption, 2001–2012 Last two weeks: MEN: −5.4 (p < 0.01); WOMEN: −6.9 (p < 0.01) Heavy alcohol consumption: MEN: +2.0 (p < 0.01); WOMEN: −0.4 (ns) By socioeconomic status Adjusted regression coefficients (%) and p-value of the interaction between economic recession dummy (2001–2006/2007 vs. 2011/2012) and employment status (employed; unemployed) WOMEN Last two weeks −5.0; −12.4 (p = 0.054) Adjusted regression coefficients (%) and p-value of the interaction between economic recession dummy (2001–2006/2007 vs. 2011/2012) and education level (university, high secondary, lower secondary or primary, without any qualification) MEN: Heavy alcohol consumption +0.2; +0.8; +3.1; +5.4 (p = 0.012) WOMEN: Heavy alcohol consumption −1.5; +0.1; +1.4; −0.2 (p = 0.012) Smoking Daily or occasional smokers Trend percentages (%), 2001–2012 MEN: −0.8 (ns); WOMEN: +4.4 (p < 0.01) Diet Trend percentages (%) of consumption, 2001–2012 Fruits: MEN: −9.1 (p < 0.01); WOMEN: −7.9 (p < 0.01) Vegetables: MEN: −0.2 (ns); WOMEN: −2.4 (ns) Legumes: MEN: +3.4 (p < 0.05); WOMEN: +4.3 (p < 0.01) Meat: MEN: −9.7 (p < 0.01); WOMEN: −10 (p < 0.01) Cold meat: MEN: −4.7 (p < 0.01); WOMEN: −3.7 (p < 0.05) By socioeconomic status Adjusted regression coefficients (%) and p-value of the interaction between economic recession dummy (2001–2006/2007 vs. 2011/2012) and employment status (employed; unemployed) MEN: Vegetables daily: +9.0; 6.3 (p = 0.004) Fruits daily: −7.4; −12.1 (p = 0.041) Legumes (3 times or more per week): +3.8; −7.4 (p = 0.041) Fish (3 times or more per week): +1.2; −6.4 (p = 0.055) WOMEN Vegetables daily: −1.7; −4.3 (p = 0.065) Adjusted regression coefficients (%) and p-value of the interaction between economic recession dummy (2001–2006/2007 vs. 2011/2012) and education level (university, high secondary, lower secondary or primary, without any qualification) MEN: Fruits daily: −4.5; −6.1; −11.4; −21.8 (p = 0.06) Sweet food (3 times or more per week): −1.7; +2.5; +3.1; −16.9 (p = 0.067) WOMEN: Vegetables daily: −1.3; +3.4; −3.0; −27.1 (p = 0.004) Physical activity Moderate or intense Trend percentages (%), 2001–2012 MEN: +3.2 (p < 0.05); WOMEN: +1.4 (ns) By socioeconomic status Adjusted regression coefficients (%) and p-value of the interaction between economic recession dummy (2001–2006/2007 vs. 2011/2012) and education level (university, high secondary, lower secondary or primary, without any qualification) WOMEN: +6.5; +4.6; −1.6; −0.7 (p = 0.014) Drugs Tranquilizers or sleeping pills Trend percentages (%) of consumption, 2001–2012 MEN: −0.5 (ns); WOMEN: −2.4 (p < 0.01) By socioeconomic status Adjusted regression coefficients (%) and p-value of the interaction between economic recession dummy (2001–2006/2007 vs. 2011/2012) and employment status (employed; unemployed) WOMEN −3.7; +0.1 (p < 0.001) Adjusted regression coefficients (%) and p-value of the interaction between economic recession dummy (2001–2006/2007 vs. 2011/2012) and education level (university, high secondary, lower secondary or primary, without any qualification) WOMEN: −2.6; −1.2; −2.1; −18.3 (p = 0.051) | |
Blázquez-Fernández 2019 [17] | Cross-sectional National Health Interview Survey Economically active adults: 18–65 years N = 29,677 (2006:14,696; 2011–2012: 14,981) | Drinker people consuming five or more drinks a week | Alcohol Prevalence (%), 2006 vs. 2011–2012 25.9 vs. 25.6 By socioeconomic status Adjusted OR: 2006 Unemployed less than 6 months: 0.87 (95% CI: 0.72–1.05) Education: Noncompulsory and pre-university secondary education: 0.90 (95% CI: 0.81–1.00) Specific labor training: 0.98 (95% CI: 0.85–1.14) University graduate: 0.85 (95% CI: 0.76–0.95) 2011–2012 Unemployed less than 6 months: 1.26 (95% CI: 1.06–1.50) Noncompulsory and pre-university secondary education: 1.36 (95% CI: 1.19–1.56) Specific labor training: 1.35 (95% CI: 1.13–1.61) University graduate: 1.37 (95% CI: 1.19–1.58) | |
Colell 2015 [20] | Cross-sectional Economically active adults: 50–64 years N = 62,440 | Daily average of alcohol intake in the last 30 days (grams of pure ethanol) Heavy drinkers above ≥ 40 g for men and ≥ 24 g for women Binge drinking 5 or more drinks on a single drinking occasion (within 2 h) at least once in the previous month in editions 2005 and 2007. Editions 2009 and 2011: 5 or more drinks for men and four or more for women Hypnotics/sedatives Sporadic users: use from 1 to 9 days in the last 30 days Heavy users: use from 10 to 30 days in the last 30 days | Alcohol Daily average of alcohol intake (g/day), 2005–2007 vs. 2009–2011 MEN: 16.9 vs. 15.1 (p < 0.001) WOMEN: 7.7 vs. 7.1 (p = 0.002) Heavy drinking Prevalence (%), 2005–2007 vs. 2009–2011 MEN: 6.9 vs. 5.2 (p < 0.001) WOMEN: 3.3 vs. 2.8 (p = 0.013) Adjusted prevalence ratio (PR) (ref pre-crisis): MEN: 0.73 (95% CI: 0.67–0.79) WOMEN: 0.86 (95% CI: 0.75–0.99) Binge drinking Prevalence (%), 2005–2007 vs. 2009–2011 MEN: 19.3 vs. 22.0 (p < 0.001) WOMEN: 7.1 vs. 10.1 (p < 0.001) Adjusted prevalence ratio (PR) (ref pre-crisis): MEN: 1.17 (95% CI: 1.12–1.22) WOMEN: 1.62 (95% CI: 1.49–1.76) Drugs Hypnotics/sedatives sporadic users Prevalence (%), 2005–2007 vs. 2009–2011 MEN: 1.2 vs. 1.6 (p = 0.005) WOMEN: 2.1 vs. 2.4 (ns) Hypnotics/sedatives heavy users Prevalence (%), 2005–2007 vs. 2009–2011 MEN: 1.8 vs. 2.1 (p = 0.005) WOMEN: 3.7 vs. 5.4 (p < 0.001) Prevalence ratio (PR) (ref pre-crisis): MEN: 1.19 (95% CI: 0.99–1.42) WOMEN: 1.32 (95% CI: 1.17–1.49) By socioeconomic status Interaction (RRR) between activity (unemployed vs. employed) and period (2009–2011 vs. 2005–2007) MEN: 0.69 (95% CI: 0.49–0.97) Substance abuse Cannabis sporadic users Prevalence (%), 2005–2007 vs. 2009–2011 MEN: 5.6 vs. 5.2 (p ns) WOMEN: 3.1 vs. 2.4 (p < 0.001) Adjusted prevalence ratio (PR) (ref pre-crisis) MEN: 0.90 (95% CI: 0.81–1.01) WOMEN: 0.77 (95% CI: 0.64–0.91) By socioeconomic status Interaction (RRR) between activity (unemployed vs. employed) and period (2009–2011 vs. 2005–2007) MEN: 1.40 (95% CI: 1.10–1.77) WOMEN: 1.68 (95% CI: 1.17–2.41) Cannabis heavy users Prevalence (%), 2005–2007 vs. 2009–2011 MEN: 6.0 vs. 5.7 (ns) WOMEN: 2.0 vs. 1.9 (ns) | |
Diaz-Mendez 2019 [22] | Cross-sectional Adults >16 years N = 50,485 (2006: 29,478; 2011–2012: 21,007) | Frequency of consumption of food | Diet Trend 2006–2011 Fruits (daily): falling Meat (3 or more times a week): rising Eggs (3 or more times a week): falling Fish (3 or more times a week): falling Pasta-rice-potatoes (daily): falling Bread (daily): remaining within guidelines. Vegetables (daily): falling Pulses (once or twice a week): rising Processed meats (occasionally/seldom or never): continuing Dairy (daily): falling Sweets (occasionally/seldom or never): falling Soft drinks (occasionally/seldom or never): continuing | |
Garcia-Mayor 2019 [25] | Cross-sectional Spanish National Health Survey (SNHS) Adults 18–64 years N = 51,370 (2006: 28,478; 2012: 21,007; 2017: 23,089) | Alcohol use during the last 2 weeks Tobacco use Fruit vegetable, pastries and/or sweets, sweetened beverages daily intake (yes or no) | Alcohol Differences in prevalence, 2012 vs. 2006, 2017 vs. 2006 MEN: −4.7% (p < 0.001), −8.7% (p < 0.001) WOMEN: −3.3% (p < 0.001), −5.8% (p < 0.001) By socioeconomic status High (−2.8%, −4.4%) Middle (−1.2%, −4.0%) Low (−0.8%, −7.2%) Smoking Differences in prevalence, 2012 vs. 2006, 2017 vs. 2006 MEN: −3.5% (p < 0.001), −7.7% (p < 0.001) WOMEN: +0.3% (ns), −1.6% (ns) By socioeconomic status High (−3.4%, −7.0%) Middle (−0.4%, −5.2%) Low (−0.6%, −2.3%) Diet Fruit consumption Differences in prevalence, 2012 vs. 2006, 2017 vs. 2006 MEN: −3.9% (p < 0.001), −4.6% (p < 0.001) WOMEN: −7.2% (p < 0.001), −4.9% (p < 0.001) By socioeconomic status High (−5.2%, −1.2%) Middle (−5.4%, −5.3%) Low (−6.2%, −8.1%) Vegetable consumption Differences in prevalence, 2012 vs. 2006, 2017 vs. 2006 MEN: +4.8% (p < 0.001), −2.1% (p = 0.005) WOMEN: +3.5% (p < 0.001), −0.7% (ns) By socioeconomic status High (+4.6%, +2.3%) Middle (+5.2%, −1.0%) Low (+2.1%, −3.8%) Sweets consumption Differences in prevalence, 2012 vs. 2006, 2017 vs. 2006 MEN: −4.4% (p < 0.001), −8.8% (p < 0.001) WOMEN: −6.7% (p < 0.001), −9.3% (p < 0.001) By socioeconomic status High (−3.5%, −8.9%) Middle (−7.7%, −9.9%) Low (−5.4%, −9.2%) Sweetened beverages Differences in prevalence, 2012 vs. 2006, 2017 vs. 2006 MEN: −4.7% (p < 0.001), −3.5% (p < 0.001) WOMEN: −8.9% (p < 0.001), −5.0% (p < 0.001) By socioeconomic status High (−2.2%, −7.1%) Middle (−4.1%, −5.4%) Low (−5.2%, −8.1%) Physical activity Differences in prevalence, 2012 vs. 2006, 2017 vs. 2006 MEN: +0.7% (p: ns), +4.9% (p < 0.001) WOMEN: -4.7% (p < 0.001), +3.3% (p < 0.001) By socioeconomic status High (−0.1%, +7.6%) Middle (−0.3%, +6.3%) Low (−2.1%, +3.6%) | |
Marquez-Calderon 2014 [27] | Cross-sectional Enquesta Domiciliaria sobre Alcohol y Droga en Espana (EDADES) Adults 15-64 years Enquesta Nacional de Salud de Espana (ENS) | Alcohol consumption In the last month (EDADES) Habitual (ENS) Smoking habits In the last month (EDADES) Daily (ENS) Drugs use In the last month: sedatives, tranquilizer, hypnotics (EDADES) Last 2 weeks: antidepressants (ENS) | Alcohol Prevalence (%), 2005 vs. 2011 (EDADES) and 2006 vs. 2012 (ENS) EDADES: 64.6 vs. 62.3; ENS: 48.4 vs. 38.3 Smoking Prevalence (%), 2005 vs. 2011 (EDADES) and 2006 vs. 2012 (ENS) EDADES: 38.4 vs. 37.6; ENS: 26.4 vs. 24.0 Drugs Prevalence (%), 2005 vs. 2011 Sedatives (EDADES): 3.7 vs. 8.3; Tranquilizers (EDADES): 2.7 vs. 6.9; Hypnotics (EDADES): 2.0 vs. 3.4; Antidepressants (ENS): 8.5 vs. 7.0 Physical activity Sedentary lifestyle Prevalence (%), 2006 vs. 2012: 39.4% vs. 41.3% Substance abuse Prevalence (%), 2005 vs. 2011 Cannabis: 8.7 vs. 7.0 Ecstasy: 0.6 vs. 0.3 Hallucinogens: 0.2 vs. 0.2 Amphetamines: 0.4 vs. 0.3 Cocaine powder: 1.6 vs. 1.1 Cocaine base: 0.1 vs. 0.1 Heroin: 0.1 vs. 0.1 | |
Martin Bassols 2016 [28] | Cross-sectional People aged 15-64 years N = 92,102 (2005: 27,400; 2007: 23,276; 2009: 19,713; 2011: 21,713) | Alcohol consumption Smoking habits Substance abuse marijuana and hard drugs such as crack, cocaine, heroin, ecstasy, hallucinogens, inhalants, and amphetamines in the last 12 months, last 30 days, every day in last 30 days | Alcohol Mean (%) 2005, 2007, 2009, 2011 Alcohol in last 12 months: 76.63, 72.92, 79,17, 77.08 Drunk in last 12 months: 22.01, 19.60, 27.16, 22.44 Alcohol in last 30 days: 63.24, 58.98, 62.48, 60.58 Alcohol every day in last 30 days: 12.05, 9.27, 9.31, 8.68 By socioeconomic status Probability (%) of consuming alcohol given a 10% increase in the provincial unemployment rate Alcohol in the past 12 months: −3.4 (p < 0.1) Not consuming any alcohol: +3 (p < 0.05) Consuming alcohol fewer than 20 days in the last year: 1.1 (p < 0.05) Consuming alcohol between 20 and 29 days during the last year: −0.1 (p < 0.05) Consuming alcohol between 30 and 150 during the last year: −1.7 (p < 0.05) Consuming alcohol more than 150 days during the last year: −2.3 (p < 0.05) Smoking Mean (%) 2005, 2007, 2009, 2011 Smoked in last 12 months: 31.81, 29.21, 31.78, 31.19 By socioeconomic status Probability (%) of smoking tobacco given a 10% increase in the provincial unemployment rate Smoked daily during the last 12 months: +3 (p < 0.01) Substance abuse Drug consumption in last 12 months Mean (%) 2005, 2007, 2009, 2011 Marijuana: 12.79, 10.56, 13.21, 11.38 Hard drugs: 4.03, 3.73, 3.99, 3.47 Cocaine: 3.31, 2.96, 3.09, 2.81 Ecstasy: 1.46, 1.17, 1.19, 0.91 Drug consumption in last 30 days Mean (%) 2005, 2007, 2009, 2011 Marijuana: 9.79, 7.42, 9.40, 8.26 Hard drugs: 2.21, 2.00, 1.93, 1.46 Cocaine: 1.76, 1.64, 1.43, 1.33 Ecstasy: 0.62, 0.41, 0.50, 0.33 By socioeconomic status Probability of using drugs in last 12 months given a 10% increase in the provincial unemployment rate Marijuana: +3.1 (p < 0.01) Hard drugs: +0.9 (ns) Cocaine: +1.2 (p < 0.01) Ecstasy: −0.4 (ns) Probability of using drugs in last 30 days given a 10% increase in the provincial unemployment rate Marijuana: +2.4 (p < 0.01) Hard drugs: +0.7 (ns) Cocaine: +0.9 (p < 0.1) Ecstasy: −0.2 (ns) | |
Moreno Lostao 2019 [30] | Cross-sectional Spanish National Health Survey. People aged 15–74 years | Tobacco consumption daily and occasional smokers Physical inactivity no physical exercise and leisure time spent in sedentary habits | By socioeconomic status Smoking Age-adjusted percentage ratio by sex and area of residence (rural vs. large urban areas), 2006, 2011 and 2016 MEN: 0.99 (95% CI: 0.92–1.07), 0.90 (95% CI: 0.83–0.97), 0.89 (95% CI: 0.83–0.97) WOMEN: 1.09 (1.00–1.19), 0.96 (0.87–1.05), 1.03 (0.94–1.13) Physical activity Age-Adjusted percentage ratio of physical inactivity by sex and area of residence (rural vs. large urban areas), 2006, 2011 and 2016 MEN: 0.89 (95% CI: 0.86–0.92), 0.89 (95% CI: 0.83–0.95), 0.86 (95% CI: 0.79–0.92) WOMEN: 1.02 (95% CI: 0.98–1.06), 0.98 (95% CI: 0.91–1.03), 0.99 (95% CI: 0.92–1.05) | |
Perez-Romero 2016 [31] | Cross sectional Spanish National Health Survey Adults aged 18-64 years N = 30,817 (2006–2007: 18,202; 2011–2012: 12,615) | Drugs consumption hypnotics and anxiolytics in the last 2 weeks | Drugs Adjusted odds ratios (OR), 2011-2012 vs. 2006–2007 MEN: OR 2.3 (95% CI: 1.8–2.8) WOMEN: OR 1.7 (95% CI: 1.4–1.9) | |
Rajmil 2013 [33] | Cross-sectional Children <15 years old enrolled in Catalan Health Survey (ESCA) N = 4167 (2006: 2200; first wave 2010–2012: 1967) | Junk food consumption Having breakfast at home never vs. at least once per week Physical Activity Time spent on screen | Diet Junk food consumption Prevalence (%), 2006 vs. 2010–2012 50.24 (95% CI: 49.74–50.74) vs. 52.34 (95% CI: 51.92–52.76) By socioeconomic status Maternal education level: primary 47.46 vs. 50.14, secondary 50.21 vs. 52.13, university degree 52.79 vs. 53.78 Family employment status: employed 50.35 vs. 52.70, unemployed 50.25 vs. 51.04 Never having breakfast Prevalence (%), 2006 vs. 2010–2012: 4.9 (95% CI: 3.8–6.0) vs. 5.4 (4.8–6.7). By socioeconomic status Maternal education level: primary 5.9 vs. 7.7, secondary 5.1 vs. 6.4, university degree 3.5 vs. 2.7) Family employment status: employed 4.3 vs. 5.6, unemployed 8.8 vs. 4.4 Physical activity Prevalence (%), 2006 vs. 2010–2012 50.14 (95% CI: 49.52–50.76) vs. 48.23 (95% CI: 47.59–48.87) By socioeconomic status Maternal education level: primary 47.46 vs. 50.14, secondary 50.21 vs. 52.13, university degree 52.79 vs. 53.86 Family employment status: employed 50.35 vs. 52.70, unemployed 50.25 vs. 51.04 Time (hours/day) spent on screen Mean, 2006 vs. 2010–2012 2.03 (95% CI: 1.98–2.07) vs. 1.41 (95% CI: 1.35–1.47) By socioeconomic status Maternal education level: primary 2.16 vs. 1.73, secondary 2.08 vs. 1.53, university degree 1.77 vs. 1.07 Family employment status: employed 4.3 vs. 5.6, unemployed 8.8 vs. 4.4 | |
Regidor 2019 [35] | Cross-sectional Data taken from different sources | Alcohol consumption Tobacco consumption number of cigarettes sold per inhabitant aged ≥15 years; Fruit and vegetable intake measured by purchase Physical activity gone to a gym in the last 30 days, in population aged ≥15 years | Alcohol Annual percentage change (APC) in different time intervals: −0.1 (2004–2006) (ns) –2.3 (2008–2010) (p = 0.024) −0.2 (2011–2013) (ns) +2.1 (2014–2016) (p = 0.059) Smoking Tobacco smoking Annual percentage change (APC) in different time intervals: −1.9 (2004–2006) (ns) −8.3 (2008–2010) (p < 0.001) −13.5 (2011–2013) (p < 0.001) −1.1 (2014–2016) (ns) Diet Fruit and vegetable consumption: Annual percentage change (APC) in different time intervals: −0.1 (2004–2006) (ns) 2.1 (2008–2010) (p < 0.001) 1.2 (2011–2013) (p = 0.026) −1.9 (2014–2016) (p = 0.003) Away-from-home dinners Annual percentage change (APC) in different time intervals: −0.2 (2004–2006) (ns) –3.3 (2008–2010) (p < 0.001) −1.6 (2011–2013) (p = 0.009) 3.2 (2014–2016) (p < 0.001) Physical activity Going to a gym Annual percentage change (APC) in different time intervals: 0.2 (2004–2006) (ns) 4.4 (2008–2010) (p = 0.001) 1.6 (2011–2013) (ns) 7.1 (2014–2016) (p < 0.001) | |
Spijker 2018 [39] | Cross-sectional Catalan Health Survey (ESCA) Adults aged >50 years N = 16,593 (2006: 6667; 2010–2012: 4458; 2013–2015: 5469) | Sedentary life | Physical activity Sedentary life Prevalence (%), 2006, 2010–2012, 2013–2015 MEN: 50–64 years old: 20.8, 18.3, 24.4 65+: 37.4, 28.0, 34.6 WOMEN: 50-64 years old: 18.9, 16.0, 22.5 65+: 41.7, 33.4, 41.9 By socioeconomic status Occupational status (employed, unemployed) Prevalence (%) 2006: 0.26, 0.31 2010–2012: 0.23, 0.26 2013–2015: 0.28, 0.34 | |
Trujillo-Aleman 2019 [40] | Cross-sectional N = 5919 mothers (2003–2004: 2951; 2011–2012: 2698) | Smoking habits daily and not daily smokers | Smoking Prevalence (%), 2003–2004 vs. 2011–2012 Couple mothers: 35.4 vs. 29.5 Lone mothers household heads: 42.7 vs. 39.1 Lone mothers-non household heads: 78.1 vs. 42.3 By socioeconomic status Social class (non-manual, manual) Lone mothers household heads vs. couple mothers Adjusted prevalence ratios, 2003-2004 2011-2012 Non-manual: 1.26 (95% CI: 1.00–1.59) 1.23 (95% CI: 0.95–1.58) p interaction ns Manual: 1.30 (95% CI: 1.08–1.57) 1.34 (95% CI: 1.08–1.66) p interaction ns | |
Zapata Moya 2020 [42] | Cross-sectional People aged > = 18 N = 5679 | Anxiolytics and/or antidepressant consumption before 2008 and in the last two weeks before the interview (2015) | Drugs Adjusted OR: 2015 vs. 2008 1.51 (95% CI: 1.05–2.42) By socioeconomic status Interaction between crisis impact on family SES and period (2015 vs. 2008) Adjusted OR: 2.18 (95% CI: 1.48–3.16) | |
Zozaya 2020 [43] | Cross sectional Health Behavior in School-Aged Children (2002, 2006, 2010, 2014) Children and adolescents aged 9-21 years N = 77,651 | Alcohol consumption drinking any alcoholic beverage at least every week Smoking habit frequent or occasional smoking during the last year | Alcohol Prevalence (%), 2002, 2006, 2010, 2014 17.57, 18.29, 16.09, 7.11 Smoking Prevalence (%) 2002, 2006, 2010, 2014 24.92, 16.10, 17.00, 10.00 | |
COUNTRY: ITALY | ||||
Bonaccio 2014 [18] | Cross-sectional Moli-sani study Adults aged > 35 years N = 21,001 | Alcohol intake Adherence to Mediterranean diet (MD) measured through the Italian Mediterranean Index score | Alcohol Mean grams/day of alcohol intake, 2005–2006 vs. 2007–2010 16.0 (SD: 21.8) vs. 16.9 (SD: 23.2) (p < 0.01) Diet % of high adherence to MD, 2005–2006 vs. 2007–2010 31.3 vs. 18.3 (p < 0.01) By socioeconomic status Prevalence ratios (PR), 2005–2006 and 2007–2010 High Wealth Index score vs. Low Wealth Index score: 1.05 (95% CI: 0.94–1.16) 1.31 (95% CI: 1.18–1.46) >13 years of education vs. < = 8 years of education: 1.16 (95% CI: 1.04–1.31) 1.32 (95% CI: 1.17–1.50) Manual non-manual job vs: 0.97 (95% CI: 0.82–1.15) 0.67 (95% CI: 0.57–0.79) | |
Mattei 2017 [29] | Time trend analysis People aged > = 15 years | Alcohol consumption Smoking habit | Alcohol Overall rate of people aged 15 or more who consume alcohol more than once per week Regression coefficient (beta), 2008–2015 vs. 2000–2007 −0.60 (95% CI: −0.96–−0.24) Smoking Number of smokers Regression coefficient (beta), 2008–2015 vs. 2000–2007 1.68 (95% CI: 0.17–3.20) People who smoke more than 20 cigarettes per day Regression coefficient (beta), 2008–2015 vs. 2000–2007 1.04 (95% CI: 0.45–1.62) | |
Petrelli 2017 [32] | Cross-sectional Istat National Health Interview Survey 2005 and 2013 Adults aged 18–64 years N = 153,137 (2005: 80,661; 2013: 72,476) | Smoking habits | Smoking Current smokers Prevalence (%), 2005–2013 Men: Italians 32.1–31.6, immigrants 33.7–32.5 Women: Italians 20.4–20.0, immigrants 17.5–16.2 | |
Sarti 2018 [37] | Time-trend analysis Multipurpose surveys on aspects on daily life (2005–2013) Adults aged 30–64 years N = 187,731 | Alcohol consumption at least 1/2 L per day of alcoholic drinks Unbalanced diet meat every day or fruit/vegetable consumption less than once a week or no vegetable oil use Smoking habit —current smokers —heavy smokers: > 20 cigarettes per day Physical activity Physical inactivity: no activity in the workplace, at home, or voluntary | Alcohol Alcohol consumption Prevalence (%), –2013 6.6, 6.4, 6.4, 5.7, 5.2, 4.9, 4.5, 3.9, 3.5 Smoking Current smokers Prevalence (%), –2013 25.9, 27.2, 26.6, 26.7, 27.5, 27.2, 26.6, 26.2, 25.2 Heavy smokers Prevalence (%), 2005–2013 8.6, 9.2, 8.8, 9.0, 8.8, 8.5, 8.1, 7.9, 7.0 Diet Unbalanced diet Prevalence (%), –2013 27.0, 26.6, 27.4, 27.5, 27.3, 26.8, 27.0, 26.0, 26.7 Physical activity Physical inactivity Prevalence (%), 2005–2013 13.3, 14.2, 13.7, 14.0, 14.1, 15.8, 14.5, 14.7, 14.5 | |
COUNTRY: PORTUGAL | ||||
Alves 2019 [14] | Cross-sectional National Health Interview Surveys Adults aged 25–79 years N = 43,273 (2005–2006: 41,193; 2014: 18,204) | Diet consumption of food groups in the day before the interview Fruits or vegetables: the number of days in the last week (2014) | Diet Prevalence (%) of consumption, 2005/2006 vs. 2014 fish 52 vs. 49 (p < 0.01) soup 68 vs. 64 (p < 0.01) fruit 82 vs. 73 (p < 0.01) vegetables 78 vs. 52 (p < 0.01) legumes 27 vs. 32 (p < 0.01) sweets/desserts 26 vs. 37 (p < 0.01) | |
de Matos 2015 [21] | Time-trend analysis Young people attending 6°, 8° and 10° year of school N = 15,953 (2014: 6026; 2010: 5050; 2006: 4877) | Smoking habit Tobacco consumption: —never —every day Fruit or vegetable consumption rarely or never; more than once per week Physical activity more than 3 times per week Substance abuse never, more than once in a month, hashish more than once. | Smoking Prevalence (%), 2006, 2010, 2014 never: 87.8, 88.1, 92.5 every day: 5.0, 4.5, 2.6 Diet Rarely or never eats fruit Prevalence (%), 2006, 2010, 2014 8.7, 7.7, 9.0 Fruits more than once per week Prevalence (%), 2006, 2010, 2014 22.2, 22.1, 21.2 Rarely or never eats vegetables Prevalence (%), 2006, 2010, 2014 12.2, 11.8, 14.6 Vegetables more than once per week Prevalence (%), 2006, 2010, 2014 11.7, 12.2, 13,3 Physical activity (%) Prevalence (%), 2006, 2010, 2014 46.7, 48.2, 51.0 Substance abuse Prevalence (%) of consumption, 2006, 2010, 2014 never: 95.5, 93.9, 96.7 more than once in one month: 2.6, 3.4, 2.1 hashish more than once: 8.2, 8.8, 8.8 | |
Silva 2020 [38] | Cross-sectional World Mental Health Survey Initiative Portugal (2008/09) and the National Mental Health Survey Follow-Up (2015/16) Adults aged 18+ N = 911 | Drugs use of psychotropic drugs in the previous 12 months | Drugs Any psychotropic drug Adjusted OR, 2015-16 vs. 2008-09 1.50 (95% CI:1.13–2.01) Interaction age*year: 18–49*2015–2016 1.95 (95% CI: 1.32–2.90) Interaction gender*year: men*2015–2016 1.85 (95% CI: 1.08–3.17) Antidepressant Interaction age*year: 18–49*2015–2016 1.68 (95% CI: 1.05–2.68) Hypnotics/sedatives 1.60 (95% CI: 1.14–2.25) Interaction age*year: 18–49*2015–2016 2.16 (95% CI: 1.34–3.47) Interaction gender*year: men*2015–2016 2.60 (95% CI: 1.36–4.98) | |
COUNTRY: GREECE | ||||
Filippidis 2014 [23] | Cross-sectional Hellas Health I, II and IV Adults aged 18+ N = 3503 (2006: 1005; 2008: 1490; 2011: 1008) | Current smokers those who smoke every day or occasionally Fruit and vegetable consumption daily number of portions Physical activity high, moderate, or low | Smoking Daily or occasional smokers Difference 2011–2008–2006 (%): −11.56, p for linear trend: 0.014 By socioeconomic status Higher: −18.62, ns Middle: −1.06, ns Lower: −24.35, p = 0.023 Diet At least 5 daily portions of fruit and vegetables Difference 2011–2008–2006 (%): −66.27, p for linear trend: 0.001 By socioeconomic status Higher: −68.79, p < 0.001 Middle: −50.89, p < 0.001 Lower: −81.76, p < 0.001 Physical activity High or moderate level of physical activity Difference 2011–2008–2006 (%): +20.49 p for linear trend: 0.001 By socioeconomic status Higher: +10.66, ns Middle: +22.44, p = 0.001 Lower: +23.02, p < 0.001 | |
Filippidis 2017 [24] | Cross-sectional Hellas Health I, II, III, IV, and V Adults aged 18+ N = 5504 (2006: 1005; 2008: 1490; 2010: 1000; 2011: 1008; 2015: 1001) | Smoking habit every day or occasionally Fruit and vegetable consumption daily number of portions Physical activity high, moderate, or low | Smoking Current smokers Prevalence (%), 2008 and 2015 42.6 (95% CI: 40.0−45.1) 36.5 (95% CI: 33.3−39.7) Adjusted risk ratio (RR) 2015 vs. 2008: 0.86 (95% CI: 0.77−0.95) Diet Low fruit/vegetable consumption Prevalence (%), 2008 and 2015 52.1 (95% CI: 49.6−54.7) 51.2 (95% CI: 47.9−54.6) Adjusted risk ratio (RR) 2015 vs. 2008: 1.00 (95% CI: 0.92−1.09) Physical activity Sedentary lifestyle Prevalence (%), 2006 and 2015 43.4 (95% CI: 40.2−46.6) 29.0 (95% CI: 26.0−32.0) Adjusted risk ratio (RR), 2015 vs. 2006: 0.69 (95% CI: 0.61−0.79) | |
Madianos 2014 [26] | Time-trend analysis Greek Population at census N = 10,387,000 (1991), 10,964,000 (2001), 10,939,000 (2011) | Alcohol per capita consumption (liters) Antidepressant consumption (daily unit) | Alcohol Per capita consumption (liters), 2005 and 2011: 9.24 and 8.80 Drugs Daily unit consumption of antidepressants, 2005 and 2011: 215.40, 284.85 | |
Sanidas 2018 [36] | Retrospective study Hospitalized patients subjected to cardiac catheterization N = 3895 (2006-07: 1228; 2011-15: 2667) | Current smokers at least 1 cigarette per day | Smoking Prevalence (%) of smokers, 2006–2007 vs. 2011–2015: 45.4 vs. 36.9, p = < 0.001 | |
Venetsanou 2020 [41] | Cross-sectional Children attending childcare centers (mean age: 52.72 ± 3.55 months) N = 652 (2009: 182; 2012: 161; 2015: 165; 2018: 144) | Physical activity measured with Omron Walking style pro HJ-720IT-E2 pedometer | Physical activity Step counts, 2009, 2012, 2015, 2018 Weekly: 8032 ± 2026, 7816 ± 2087, 6708 ± 2739, 6943 ± 2729 School-time: 3646 ± 1372, 3459 ± 1175, 3233 ± 1590, 2991 ± 1433 Leisure-time 4906 ± 1300, 4899 ± 1321, 4026 ± 1531, 4312 ± 1466 Weekend 6700 ± 2914, 7112 ± 2802, 5676 ± 3321, 6031 ± 3412 Statistically significant differences between cohort School-time: 2009 vs. 2018 Leisure-time: 2009 vs. 2015, 2009 vs. 2018, 2012 vs. 2015 Weekend: 2009 vs. 2015, 2012 vs. 2015 | |
Country: Multicenter | ||||
Bosque-Prous 2017 [19] | Cross-sectional Economically active adults: 50–64 years N = 25,479 (2006: 8016; 2013: 17463) | Hazardous drinking average daily consumption of >2 and >3 alcoholic drinks in the previous 3 months Abstention not drinking any alcoholic beverage during the 3 months prior to the interview | Alcohol Hazardous drinking Changes in the prevalence (%), 2006–2007 vs. 2013 SPAIN MEN: −5.4 (95% CI: −8.8–−2.0) WOMEN: −1.9 (95% CI: −5.7–−1.8) ITALY MEN: −5.6 (95% CI: −9.1–−2.2) WOMEN: −1.4 (95% CI: −4.7–−1.9) Adjusted prevalence ratio (PR), 2013 vs. 2006–2007 SPAIN MEN: PR = 0.42 (95% CI: 0.23–0.81) WOMEN: PR = 0.67 (95% CI: 0.24–1.97) ITALY MEN: PR = 0.44 (95% CI: 0.27–0.79) WOMEN: PR = 0.63 (95% CI: 0.21–1.70) Abstention Changes in the prevalence (%), 2006–2007 vs. 2013 SPAIN MEN: 3.3 (95% CI: −1.9–8.4) WOMEN: 3.5 (95% CI: −4.7–11.7) ITALY MEN: 6.8 (95% CI: 1.1–12.4) WOMEN: 5.2 (95% CI: −3.0–13.4) Number of drinks per drinker per week Crude relative risks (RR), 2013 vs. 2006–2007 SPAIN MEN: RR 0.59 (95% CI: 0.43–0.82) WOMEN: RR 0.63 (95% CI: 0.35–1.14) ITALY MEN: RR 0.65 (95% CI: 0.52–0.81) WOMEN: RR 0.60 (95% CI: 0.38–0.93) | |
Rathmann 2017 [34] | Cross-sectional Adolescents aged 15 Health Behaviour in School-aged Children (HBSC) study 2009–2010 N = 6554 (Greece n = 1606, Italy n = 1495, Portugal n = 1511, Spain n = 1942) | Smoking habit regular smokers: adolescents who smoke at least weekly | Smoking Regular smokers Prevalence (%) 2005–2006 vs. 2009–2010 Greece (16.2 vs. 15.2; −6.1%), Italy (19.8 vs. 22.3; +12.6%), Portugal (10.5 vs. 10.8; +3.1%), Spain (17.7 vs. 18.5; +4.6%) |
First Author | Country | Alcohol | Smoking | Healthy Diet | Physical Activity | Drugs | Substance Abuse |
---|---|---|---|---|---|---|---|
Aguilar-Palacio 2015 [13] | Spain | − | − | ||||
Arroyo 2018 [15] | Spain | − | |||||
Bartoll 2015 [16] | Spain | − | + | − | + | − | |
Blázquez-Fernández 2019 [17] | Spain | = | |||||
Bosque-Prous 2017 [19] | Spain | − | |||||
Colell 2015 [20] | Spain | − | + | − | |||
Diaz-Mendez 2019 [22] | Spain | − | |||||
Garcia Mayor 2020 [25] | Spain | − | − | − | + | ||
Marquez-Calderon 2014 [27] | Spain | − | − | − | + | − | |
Martin Bassols 2016 [28] | Spain | − | = | − | |||
Moreno Lostao 2019 [30] | Spain | N/A | N/A | ||||
Perez-Romero 2016 [31] | Spain | + | |||||
Rajmil 2013 [33] | Spain | − | − | ||||
Rathmann 2017 [34] | Spain | + | |||||
Regidor 2019 [35] | Spain | − | − | + | + | ||
Spijker 2018 [39] | Spain | − | |||||
Trujillo-Aleman 2019 [40] | Spain | − | |||||
Zapata Moya 2020 [42] | Spain | + | |||||
Zozaya 2020 [43] | Spain | − | − | ||||
Bonaccio 2014 [18] | Italy | + | − | ||||
Bosque-Prous 2017 [19] | Italy | − | |||||
Mattei 2017 [29] | Italy | − | + | ||||
Petrelli 2017 [32] | Italy | − | |||||
Rathmann 2017 [34] | Italy | + | |||||
Sarti 2018 [37] | Italy | − | − | = | − | ||
Alves 2019 [14] | Portugal | − | |||||
de Matos 2015 [21] | Portugal | − | − | + | − | ||
Rathmann 2017 [34] | Portugal | + | |||||
Silva 2020 [38] | Portugal | + | |||||
Filippidis 2014 [23] | Greece | − | − | + | |||
Filippidis 2017 [24] | Greece | − | = | + | |||
Madianos 2014 [26] | Greece | − | + | ||||
Sanidas 2018 [36] | Greece | − | |||||
Venetsanou 2020 [41] | Greece | − | |||||
Rathmann 2017 [34] | Greece | − |
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Sane Schepisi, M.; Di Napoli, A.; Asciutto, R.; Vecchi, S.; Mirisola, C.; Petrelli, A. The 2008 Financial Crisis and Changes in Lifestyle-Related Behaviors in Italy, Greece, Spain, and Portugal: A Systematic Review. Int. J. Environ. Res. Public Health 2021, 18, 8734. https://doi.org/10.3390/ijerph18168734
Sane Schepisi M, Di Napoli A, Asciutto R, Vecchi S, Mirisola C, Petrelli A. The 2008 Financial Crisis and Changes in Lifestyle-Related Behaviors in Italy, Greece, Spain, and Portugal: A Systematic Review. International Journal of Environmental Research and Public Health. 2021; 18(16):8734. https://doi.org/10.3390/ijerph18168734
Chicago/Turabian StyleSane Schepisi, Monica, Anteo Di Napoli, Rosario Asciutto, Simona Vecchi, Concetta Mirisola, and Alessio Petrelli. 2021. "The 2008 Financial Crisis and Changes in Lifestyle-Related Behaviors in Italy, Greece, Spain, and Portugal: A Systematic Review" International Journal of Environmental Research and Public Health 18, no. 16: 8734. https://doi.org/10.3390/ijerph18168734