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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

Cross-sectional

 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

(78.75)a

 Gunnlaugsson 2015 [18]

Iceland

Governmental responses to the crisis (2004–14)

Social determinants and child health

Low

(76.25)a

 Herranz-Aguayo et al. 2016 [19]

Spain and Portugal

Government investment in family function (EU-SILC)

Child poverty rates and AROPE taxes

Intermediate

(62.5)a

 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

(87.5)a

 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

(82.5)a

 Rajmil et al. 2015 [22]

Spain

Government responses to the crisis (2005–13)

Social determinants, child health, and HCS

Intermediate

(67.5)a

 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

(83.7)a

 Toffolutti et al. 2018 [24]

Italy

Public health expenditure 2000–14

MMR coverage by health region

Low

(82.5)a

 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

(67)

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

(75)a

 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

(46.25)a

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

(82.9)

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

(47.7)

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)