Skip to main content

Table 1 Type of studies and risk of bias

From: Austerity policy and child health in European countries: a systematic literature review

Type of study (first author, year) Country/−ies Exposure measure (year/s of study, source of data) Outcome measure Risk of bias
(% of the total score-STROBE)
     Average score = 72.1
 Horridge et al. 2019 [16] 32 EU countries Survey to professionals and families/children. Countries classified according to the level of austerity following the European Union’s Maastricht criteria (2016–17) Healthcare services to disabled children. Requests on changes in the quality and characteristics of services in the last years Intermediate (70.4)
Trends over time - Repeated cross-sectional analysis
 Chzhen et al. 2017 [17] 30 EU countries (27 EU plus Iceland, Norway, Switzerland) Spending on Social protection as a share of GDP (EU-SILC) (2008–13) Relative and anchored (2008) child poverty rates Low
 Gunnlaugsson 2015 [18] Iceland Governmental responses to the crisis (2004–14) Social determinants and child health Low
 Herranz-Aguayo et al. 2016 [19] Spain and Portugal Government investment in family function (EU-SILC) Child poverty rates and AROPE taxes Intermediate
 Nygard et al. 2019 [20] 22 EU countries Public expenditure on family cash benefits and in-kind transfer benefits (OECD) (2006–15) Child poverty rates (EU-SILC) Low
 Rajmil et al. 2018 [21] 16 EU countries Countries stratified in 3 austerity groups according to the CAPB (IMF) (2005–15) Material deprivation, child poverty, perinatal outcomes (EU-SILC), (OECD) Low
 Rajmil et al. 2015 [22] Spain Government responses to the crisis (2005–13) Social determinants, child health, and HCS Intermediate
 Robinson et al. 2019 [23] England Effects during and after the English inequality strategy (1998–2010 / 2011–17) IM according to the Towsend index of deprivation area in quintiles Low
 Toffolutti et al. 2018 [24] Italy Public health expenditure 2000–14 MMR coverage by health region Low
 Zografaki et al. 2018 [25] Greece Changes in perinatal outcomes centered on the long term trends (1980–2004 and 2004–14) Perinatal outcomes at early (2008–10) and “established crisis” (2011–14) Intermediate
Before-after approach
 D’Agostino et al.2019 [26] Italy, Greece, France, United Kingdom Changes in social protection benefits (EU-SILC) (2009/14) Monetary and non-monetary indicators of well-being Intermediate
 Stefansson et al. 2018 [27] Iceland People own assessment of their ability to make ends meet (EU-SILC) (2009/14) Material deprivation by dimensions, vulnerability High
Cohort study
 Reinhard et al. 2018 [28] Ireland Cohort GUI; 3 waves included a question on reduction in social welfare benefits (2009/11/13) Family living conditions; child health, etc Low
Qualitative study
 Stalker et al. 2015 [29] Scotland Survey to providers for disabled children, and focus groups with carers and children (2011–13) Changes in access and quality of services after budget cuts STROBE: High
EPICURE (intermediate risk)
  1. aTwenty was considered as the maximum score for STROBE given that a couple of items were not applicable. AROPE At risk of poverty and social exclusion, CAPB Cyclically Adjusted Primary Balance, EU-SILC European Union Survey on Income and Living Conditions, GDP Gross Domestic Product, GUI Growing Up in Ireland, IMF International Monetary Fund, OECD Organisation for Economic Cooperation and Development, HCS Healthcare services, MMR Measles, mumps, rubella immunisation, STROBE STrengthening the Reporting of OBservational studies in Epidemiology (score = 0 to 22)