Intended for healthcare professionals

Letters Great leap backwards

Spanish children are most affected by the economic crisis, says the Spanish Society of Public Health (SESPAS)

BMJ 2015; 350 doi: (Published 14 April 2015) Cite this as: BMJ 2015;350:h1945
  1. Luis Rajmil, senior researcher1,
  2. Lucía Artazcoz, director of health promotion2,
  3. Pilar García-Gómez, assistant professor of applied economics3,
  4. Manuel Flores, research associate4,
  5. Ildefonso Hernández-Aguado, professor5
  6. On behalf of the Spanish Society of Public Health (SESPAS)
  1. 1Agència de Qualitat i Avaluació Sanitàries de Catalunya (AQuAS) and IMIM Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona 08023, Spain
  2. 2Agència de Salut Pública de Barcelona, Barcelona
  3. 3Erasmus School of Economics, Erasmus University, Rotterdam, Netherlands
  4. 4DEGA Instituto Universitario de Estudos e Desenvolvemento de Galicia, University of Santiago de Compostela, Santiago de Compostela, Spain
  5. 5Department of Public Health, Universidad Miguel Hernández and CIBERESP, Spain
  1. lrajmil{at}

As Taylor-Robinson and colleagues show, child health and wellbeing have taken “a great leap backwards” in many countries during the current economic crisis.1 Since 2008, the risk of poverty and economic inequality has increased in Spain, and more so among children than in the general population. The proportion of children at risk of poverty increased from 28.2% to 36.3% between 2008 and 2012.2 Within Europe, Spain has one of the highest proportions of children at risk of poverty.

The proportion of children living in households in which all members are unemployed increased from 6.5% in 2008 to 13.8% in 2012. Income inequality between the upper and lower fifths has increased more than 20%.3 The number of vulnerable families with children that have asked non-governmental organisations for help to meet their basic needs has tripled since 2007. In spite of the scarcity of data on impacts on health,4 there is evidence of worse overall health and mental health in children from evicted families.5

Countries that are committed to maintaining and increasing investment in social protection of children are known to be more likely to overcome the negative effects on health. By contrast, countries with policies of budget cuts in education, health, and social protection of children have worse health outcomes. In Spain budgets for the social protection of children have declined and are among the lowest in the European Union.6

Measures proposed by the Spanish Society of Public Health (SESPAS) to remedy this situation include ensuring access to early education; keeping and funding public school canteens for the whole year; suspending evictions of families with children and ensuring basic housing for all families; increasing effective public investment for the promotion of youth and parents’ employment and socially disadvantaged families; and effective universal and equal access to healthcare services for the entire population (repealing RD Law 16/2012 of healthcare exclusion).


Cite this as: BMJ 2015;350:h1945