David Stuckler's research while affiliated with Università commerciale Luigi Bocconi and other places
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Publications (540)
People who reach old age enjoying good physical and mental health can be defined as (health) “superheroes”, given their relatively low impact on healthcare expenditure and the desirable model they represent.
To evaluate prevalence and possible determinants of being “physical superheroes” (i.e., free from the ten major chronic conditions, plus obesi...
We study the impact of public health messages on intentions to vaccinate and vaccination uptakes, especially among hesitant groups. We performed an experiment comparing the effects of egoistic and altruistic messages on COVID-19 vaccine intentions and behaviour. We administered different messages at random in a survey of 6379 adults in December 202...
Background:
Few studies have focused on changes in health and social services access due to the COVID-19 pandemic. We aimed to describe changes in the use of selected health and social home services due to the pandemic and to investigate potential associated factors, including socio-demographic characteristics, number of chronic diseases and menta...
As retirement ages increase around the world, not all workers may be equally able to extend their working lives. In this article, we examine the health and labor market effects of an Italian pension reform that suddenly increased the normal retirement age up to 7 years for women and up to 2 years for men. To do this, we use linked labor and healthc...
Background
The COVID-19 pandemic and associated lockdown measures posed an unprecedented challenge to the crucial role of grandparenting in family-oriented cultures, such as Italy. Reduced contact with grandchildren during this period potentially threatened grandparents’ mental health and well-being.
Methods
We analysed data from the LOckdown and...
Social protection can buffer the negative impacts of unemployment on health. Have stimulus packages introduced during the COVID-19 pandemic mitigated potential harms to health from unemployment? We performed a systematic review of the health effects of job loss during the first year of the pandemic. We searched three electronic databases and identi...
An unprecedented mortality crisis struck Eastern Europe during the 1990s, causing around seven million excess deaths. We enter the debate about the causes of this crisis by performing the first quantitative analysis of the association between de-industrialisation and mortality in Eastern Europe. We develop a theoretical framework identifying deindu...
Background:
Far-right politicians in several countries have been vocal opponents of COVID-19 vaccination. But can this threaten vaccine roll-out?
Methods:
We take advantage of repeated cross-sectional surveys with samples of around 3800 individuals across Spain conducted monthly from December 2020 to January 2022 (n = 51 294) to examine any asso...
Background
There is increasing recognition of including social determinants of health (SDOH) in teaching for future doctors. However, the educational methods and the extent of integration into the curriculum vary considerably—this scoping review is aimed at how SDOH has been introduced into medical schools' curricula.
Methods
A systematic search w...
Background:
We aimed to assess the prevalence of depressive and anxiety symptoms, hopelessness and insomnia in the older adults before and during the COVID-19 pandemic identifying subgroups at higher risk of mental distress.
Methods:
Within the Lost in Lombardy project, a web-based cross-sectional study was conducted on a representative sample o...
Purpose
Multiple studies have reported a positive association between missing teeth and cognitive impairment. While some authors have postulated causal mechanisms, existing designs preclude assessing this.
Methods
We sought evidence of a causal effect of missing teeth on early-onset cognitive impairment in a natural experiment, using differential...
Background
The vast investments that have been made in recent decades in new medicines, vaccines, and technologies will only lead to improvements in health if there are appropriate and well-functioning health systems to make use of them. However, despite the growing acceptance by major global donors of the importance of health systems, there is an...
Background
Health Policy and Systems Research is a neglected area in global health financing. Despite repeated calls for greater investment, it seems that there has been little growth. We analysed trends in reported funding and activity between 2015 and 2021 using a novel real-time source of global health data, the Devex.com database, the world’s l...
Objectives:
Research identifies that multinational corporations, including The Coca-Cola Company ('Coca-Cola'), seek to influence public health research and policy through scientific events, such as academic and professional conferences This study aims to understand how different forms of funding and sponsorship impact the relationship between Coc...
We rigorously investigated potential longitudinal associations of hair cortisol and cortisone with verbal memory, time orientation, and dementia, adjusting for sociodemographic and health confounders. Data from the English Longitudinal Study of Ageing wave 6–9 (6-year follow-up, covering 4399 persons aged 50+) were analysed using linear random effe...
Background
Global pandemics have occurred with increasing frequency over the past decade reflecting the sub-optimum operationalization of surveillance systems handling human health data. Despite the wide array of current surveillance methods, their effectiveness varies with multiple factors. Here, we perform a systematic review of the effectiveness...
Background
Syphilis case notifications among men-who-have-sex-with-men (MSM) have increased markedly over the past two decades in Europe. We tested several potential factors for this resurgence.
Methods
Self-reported data from two cross-sectional waves of the European MSM Internet Survey (EMIS-2010 and EMIS-2017, N = 278,256 participants living in...
Most COVID-19-related deaths occurred in older adults, however to date, evidence on determinants of SARS-CoV-2 infection in this population is limited and mostly based on case series without a comparison group. A telephone-based cross-sectional study was conducted in November 2020 on a representative sample of 4,400 people aged ≥65 years from the I...
The COVID-19 pandemic strongly impacted older people, not only in terms of clinical outcome but also in care provision. Investigating trends of changes in healthcare services access among older subjects during the pandemic, along with studying potential determinants, is of utmost interest to identify the most at-risk individuals. We used data from...
Background
Multiple studies report reductions in air pollution associated with COVID-19 lockdowns.
Methods
We performed a systematic review of the changes observed in hazardous air pollutants known or suspected to be harmful to health, including nitrogen dioxide (NO2), nitrogen oxides (NOx), carbon monoxide (CO), sulfur dioxide (SO2), ozone (O3) a...
The COVID-19 pandemic disproportionally affected older people in terms of clinical outcomes and care provision. We aimed to investigate older adults’ changes in access to care during the pandemic and their determinants. We used data from a cross-sectional study (LOST in Lombardia) conducted in autumn 2020 on a representative sample of 4400 older ad...
Healthcare delivery reorganization during the COVID-19 emergency may have had a significant impact on access to care for older adults with chronic conditions. We investigated such impact among all adults with chronic conditions aged ≥ 65 years, identified through the electronic health databases of two local health agencies—ATS Brianza and ATS Berga...
Background
Air pollution is speculated to increase the risks of COVID-19 spread, severity and mortality.
Objectives
We systematically review studies investigating the relationship between air pollution and COVID-19 cases, non-fatal severity and mortality in North America and Europe.
Methods
We searched PubMed, Web of Science, and Scopus for studi...
Aims
Restrictions imposed to prevent SARS-CoV-2 transmission should be weighed against consequences on vulnerable groups’ health. Lifestyles and disease management of older people with diabetes might have been differentially impacted compared to non-chronic individuals.
Methods
A cross-sectional study (LOST in Lombardia) was conducted on a represe...
Objectives
Given the growing interest worldwide in applying public policies to improve human health, we undertook a systematic review of studies investigating whether public policies targeting unhealthy products could reduce cardiovascular diseases.
Study design
This study was a systematic review of the literature.
Methods
We searched research st...
How can resource-deprived countries accelerate progress towards Universal Health Coverage? Here we extend the analysis of Nanini and colleagues to investigate a case-study of Uganda, where despite high-level commitments, health system priority and funding has shrunk over the past two decades. We draw on the Stuckler-McKee adapted Political Process...
Far-right politicians in several countries have been vocal opponents of COVID-19 vaccination. But does this matter? We take advantage of repeated cross-sectional surveys with samples of around 3,800 individuals across Spain conducted monthly from December 2020 to January 2022 (n = 51,294) to examine any association between far-right politics and va...
Background
Evidence showed that mental health problems have risen markedly during COVID-19. It is unclear if part of the mental sufferings relates to the climate of uncertainty and confusion originated by rough communication by health officials and politicians. Here we test the impact of unanticipated policy announcements of lockdown policies on me...
Little is known on potential socioeconomic and gender disparities in dietary changes during the COVID-19 pandemic. We conducted a telephone-based survey during fall 2020 on 4400 participants representative of the population aged 65-99 years living in Lombardy, Italy. Changes in a Mediterranean lifestyle were assessed retrospectively by scoring modi...
Background
There is increasing recognition to include social determinants of health (SDOH) teaching for future doctors. However, the educational methods and the extent of integration into the curriculum vary considerably - this scoping review is aimed at how SDOH has been introduced into medical schools' curricula.
Methods
A systematic search was...
Background:
Involuntary psychiatric admissions are a widely used practice despite ethical concerns about coercion. There are particular concerns that vulnerable groups, such as single, unemployed or racial minorities, may be more subjected to such practices.
Aim:
We aimed to investigate the social patterns of involuntary psychiatric admissions from...
Background: Involuntary psychiatric admissions are a widely used practice despite ethical concerns about coercion. There are particular concerns that vulnerable groups, such as single, unemployed or racial minorities, may be more subjected to such practices.
Aim: We aimed to investigate the social patterns of involuntary psychiatric admissions fro...
Background
There are growing concerns that the public’s trust in science is eroding, including concerns that vested interests are corrupting what we know about our food. We know the food industry funds third-party ‘front groups’ to advance its positions and profits. Here we ask whether this is the case with International Food Information Council (I...
Background:
Although a direct relationship between tinnitus or hearing difficulties and COVID-19 has been suggested, current literature provides inconsistent results, and no research has been undertaken in older adults.
Methods:
In November 2020, we conducted the LOST in Lombardia survey, a telephone-based cross-sectional study on a sample of 4,...
Most COVID-19-related fatalities occurred among older adults, however to date, evidence on determinants of SARS-CoV-2 infection in this population is limited and mostly based on case series without a comparison group. A telephone-based cross-sectional study was conducted in November 2020 on a representative sample of 4,400 Italians aged ≥65 years r...
Background
There are widespread concerns that ethnic minorities and migrants may have inadequate access to COVID-19 vaccines. . Improving vaccine uptake among these vulnerable groups is important towards controlling the spread of COVID-19 and reducing unnecessary mortality. Here we perform a systematic review of ethnic minorities’ and migrants’ acc...
Evidence linking past experiences of worsening health with support for radical political views has generated concerns about the consequences of the COVID-19 pandemic. The influenza pandemic that began in 1918 had a devastating health impact: 4.1 million Italians contracted influenza and about 500 000 died. We tested the hypothesis that deaths from...
Background & Aims
COVID-19 containment measures significantly impacted lifestyle of the general population, including physical activity. Although the older adults are particularly susceptible to the potential consequences of sedentary lifestyle and inactivity, few studies investigated pandemic effects in this segment of the population. We aimed to...
In many European countries requirements for retirement have been tightened, causing an increase in work participation of older workers, in spite their potentially poorer health may limit their work ability. This study aimed at assessing the diffusion of health problems and exposure to unfavorable working conditions among ageing workers in two Itali...
Aims
Retirement is a major life transition that may improve or worsen mental health, including depression. Existing studies provide contradictory results. We conducted a systematic review with meta-analysis to quantitatively pool available evidence on the association of retirement and depressive symptoms.
Methods
We applied PRISMA guidelines to co...
Introduction: Mental health problems increased during the coronavirus disease 2019 (COVID-19) pandemic. Knowledge that one is less at risk after being vaccinated may alleviate distress but this hypothesis remains unexplored. This study tests whether psychological distress declined in those vaccinated against COVID-19 in the U.S. and whether changes...
Background
The COVID-19 pandemic and associated policy responses, such as physical distancing interventions, pose risks to mental health that could be mitigated by social support systems. We examine associations between changes in mental health in the population aged 50 years and older in Europe and stringency of pandemic responses and social prote...
The COVID‐19 pandemic has been associated with worsening mental health but it is unclear whether this is a direct consequence of containment measures, like “Stay at Home” orders, or due to other considerations, such as fear and uncertainty about becoming infected. It is also unclear how responsive mental health is to a changing situation. Exploitin...
Are we repeating the mistakes of the human immunodeficiency virus (HIV) epidemic in our approach to combating coronavirus disease 2019 (COVID-19)? Is the world's emphasis on developing vaccines overshadowing investment in the health systems that can deliver them? We analyse a report on the politics of investing in health policy and systems research...
Background
There are widespread concerns that workers in precarious employment have suffered the most in the COVID-19 pandemic and merit special attention. The aim of this rapid scoping umbrella review was to examine what evidence exists about how COVID-19 has affected the health of this highly vulnerable group, and what gaps remain to be investiga...
Introduction
Manufacturers, such as producers of cigarettes, drugs or ultra-processed foods, influence health policy, research and practice. This influence is one of the main barriers against the implementation of public health policies around the world. Our goal was to identify existing mechanisms to limit this influence.
Methods
We conducted a s...
Informal payments are widespread in many healthcare systems and can impede access to healthcare and thwart progress to achieving universal health coverage, a major element of the health-related Sustainable Development Goals. Gender may be an important driver in determining who pays informally for care, but few studies have examined this, particular...
Background
Retirement is a life-course transition likely to affect, through different mechanisms, behavioural risk factors’ patterns and, ultimately, health outcomes. We assessed the impact of transitioning to retirement on lifestyle habits and perceived health status in a nationwide cohort of Italian adults.
Methods
We analysed data from a large...
Background
Job loss is a well-established social determinant of health. Recent research has taken an ‘institutional turn’, asking whether unemployment support could buffer the health consequences of job loss. Here, we exploit a quasi-natural experiment based on the Fornero reforms in Italy, which increased wage replacement rates from 60% to 75% on...
Background: Mental health problems increased during the COVID-19 pandemic. Knowledge that one is less at risk after being vaccinated may alleviate distress but this hypothesis remains unexplored. Here we test whether psychological distress declined in those vaccinated against COVID-19 in the US and whether changes in perceived risk mediated any ass...
Background
Drug-related mortality in the UK rose markedly after 2012. Here we test the hypothesis that cuts to disability-related spending were associated with increased drug-related mortality across local governments in Great Britain.
Methods
We regressed changes in drug-related death rates (years 2010–12 versus 2015–17) on local government disab...
Background
Food insecurity concerns have featured prominently in the UK response to the COVID-19 pandemic. We assess changes in the prevalence of food-related hardships in the UK population from April to July 2020.
Method
We analysed longitudinal data on food-related hardships for 11,104 respondents from the April-July 2020 waves of the Understand...
Objectives
The aim of the study was to test the hypothesis that worsening mortality rates in the early 1930s were associated with increasing votes for the Nazi Party.
Study design
The study consist of panel data with fixed effects.
Methods
We used district- and city-level regression models of Nazi vote shares on changes in all-cause mortality rat...
The Covid-19 pandemic has been associated with worsening mental health but it is unclear whether this is a direct consequence of containment measures, like ‘Stay at Home’ orders, or due to other considerations such as fear and uncertainty about becoming infected. It is also unclear how responsive mental health is to a changing situation. Exploiting...
An unprecedented mortality crisis struck Eastern Europe during the transition from socialism to capitalism. Working-class men without a college degree suffered the most. Some argue that economic dislocation caused stress and despair, leading to adverse health behavior and ill health (dislocation-despair approach). Others suggest that hazardous drin...
Objective
Patients with a combination of long-term physical health problems can face barriers in obtaining appropriate treatment for co-existing mental health problems. This paper evaluates the impact of integrating the improving access to psychological therapies services (IAPT) model with services addressing physical health problems. We ask whethe...
In 1935, the United States introduced the old-age assistance (OAA) program, a means-tested program to help the elderly poor. The OAA improved retirement conditions and aimed to enable older persons to live independently. We use the transition from early elderly plans to OAA and the large differences in payments and eligibility across states to show...
Do international trade rules and agreements constrain health policy space? A multitude of global actors and institutions with different interests and power can shape national health policy, and trade rules provide one means through which to exert pressure on governments. Yet, the full scope of political pressure on health policy within the global t...
The scale of the COVID-19 pandemic is a consequence of international trade and globalisation, with the virus spreading along established trade and travel routes. However, the pandemic also affects international trade through reductions in both supply and demand. In this Viewpoint we describe the many implications for health and propose ways to miti...
We study the link between fiscal austerity and Nazi electoral success. Voting data from a thousand districts and a hundred cities for four elections between 1930 and 1933 show that areas more affected by austerity (spending cuts and tax increases) had relatively higher vote shares for the Nazi Party. We also find that the localities with relatively...
The ten countries with the fastest shrinking population are all located in Eastern Europe, with low fertility as one of the leading causes. In this article, we analyze the privatization of companies as a potential but so far neglected factor behind the postsocialist fertility decline. We argue that privatization is linked to lower fertility by cata...
A growing literature on deaths of despair has argued that workers' declining life expectancy in deindustrialized rustbelt areas in the U.S. and the associated deepening of health inequalities signal the profound existential crisis of contemporary capitalism. Competing explanations downplay the negative consequences of "creative destruction" and foc...
Background: Food supply concerns have featured prominently in the UK response to the COVID-19 pandemic. We assess changes in food insecurity in the UK population from April to July 2020. Method: We analyze 11,095 respondents from the April through July waves of the Understanding Society COVID-19 longitudinal study survey linked with Wave 9 of the U...
Background
Syphilis transmission has increased markedly over the past two decades in Europe, concentrated in men who have sex with men. We test alternative potential social and behavioral individual- and population-level determinants of this resurgence.
Methods
Two rounds of the cross-sectional European Men who have sex with men Internet Survey (E...
Abstract Objectives Restricting mobility is a central aim for lowering contact rates and preventing COVID-19 transmission. Yet the impact on mobility of different non-pharmaceutical countermeasures in the earlier stages of the pandemic is not well-understood. Design Trends were evaluated using Citymapper’s mobility index covering 2nd to 26th March...
How do pension systems contribute to healthy ageing? It is widely speculated that more generous and stable pensions could promote better ageing outcomes, as well as could potentially result in lowered healthcare costs. Yet little is known about how alternative pension regimes shape health and healthcare expenditures in older persons. Here, using mu...
Objectives
Transgender-identifying sex workers (TGISWs) are among the most vulnerable groups but are rarely the focus of health research. Here we evaluated perceived barriers to healthcare access, risky sexual behaviours and exposure to violence in the United Kingdom (UK), based on a survey of all workers on BirchPlace, the main transgender sex com...
Objective
We evaluate the extent to which Coca-Cola tried to influence research in the Global Energy Balance Network, as revealed by correspondence between the company and leading public health academics obtained through Freedom-of-Information (FOI) requests.
Design
US state FOI requests were made in the years 2015–2016 by US Right to Know, a non-...
