HSPop assistant professor Stipica Mudrazija applies a “concentric circles of well-being” lens to examine the close relationship between health and a strong social safety net
While attending college in Croatia, Stipica Mudrazija became interested in a pressing issue across European countries: the looming retirement crisis, fueled by dwindling pensions. The U.S. faces its own “silver tsunami” of aging Baby Boomers who will need increased health care and retirement benefits. When he moved to the U.S., his focus shifted to health care, a comparatively larger issue for Americans than Europeans. His research interests in demography and healthy aging led him to research and teaching positions at the Croatian Central Bank, Georgetown University, and the Urban Institute, among other institutions.
Mudrazija joined the department as an assistant professor in 2023, drawn to UW’s highly-ranked public health school and opportunities to surround himself with other health-focused scholars. Mudrazija has been focusing on research, guest lectures, and overseeing student theses, all while settling into his new life in Seattle with two young kids. He will begin teaching undergraduates the next academic year.
What drew him to study health care? Mudrazija explains, “There’s a saying that the healthy person has 1,000 wishes, and the sick person has only one…health is not the be-all and end-all, but you cannot do anything without having health. So it is just one of the aspects of the well-being of people, but it’s a critical aspect. [I’m] interested in studying the well-being of older adults in concentric circles. You have that individual embedded within a family, you have those families embedded within communities, you have those communities making up a country, and countries making up part of the world,” he explained.
Being Sick in Europe vs. the U.S.
With a foothold in both Europe and the U.S., Stipica offers a comparative analysis of health care and social safety nets. He taxonomizes European systems into four types: Southern European/Mediterranean (emphasizes the role of the family in caregiving); Continental (combines family responsibility with government benefits); Nordic/Northern European (government takes on almost all responsibility), and Eastern European/post-communist. Yet even with those key differences, European systems are still, on the whole, far more generous than our American one. When something goes wrong for an American–whether it’s a sudden illness or a lost job– it can be a catastrophe.
“There are externalities to every decision that you make, and we do not live in isolation; things that we do don’t impact just us.”
-Stipica Mudrazija
“Reasonable people can differ in terms of the answers they give of how to strike the right balance: what is the personal responsibility, what is the social responsibility, how much of the tab should be picked up by society, how much of the tab should be picked up by individuals,” said Mudrazija. “There’s not a universal answer in Europe, either. But comparatively speaking, Europe leans more on the side of joint responsibility, spreading risk at the population level, whereas the U.S. leans more on the individual side, even when it’s very hard to make the argument that the situation in which one found him or herself is that person’s responsibility.”
This generous European welfare state is paid for through higher taxes, which may burden individuals. Mudrazija cautions that we should always consider an individual’s overall expenses, though, rather than looking at taxes in a vacuum. In Europe, the government pays for many services (retirement, health care, etc.) that often fall on individuals in the U.S.
Certain investments can pay dividends down the road, too. Take public school funding: taxes that go towards education create a higher-skilled populace, which will eventually pay for the retirement accounts of current tax-payers. With his background in economics, Mudrazija terms this virtuous cycle a “positive externality.”
“There are externalities to every decision that you make, and we do not live in isolation; things that we do don’t impact just us,” he explains.
Safety Nets and Social Determinants of Health
Mudrazija examines how a weak social safety net impacts health at all levels. He has published numerous studies on mobility in relation to caregiving, how debt shapes health outcomes, Social Security aid to tribal communities, and other topics.
In recent papers, he’s examined “brain health equity” among older adults. His study “Preclinical Dementia and Economic Well-being Trajectories of Racially Diverse Older Adults” found that older adults with dementia “were more likely to drop out of the labor force and become poor than similar older adults without dementia. Racial/ethnic disparities in poverty persisted during the preclinical period, with non-Hispanic Black older adults more likely to leave the labor force and Hispanic older adults more likely to have unsecured debt.”
Mudrazija’s research weaves together economics and health, revealing how macro economic systems trickle down to an individual’s health.
“Even though I may be studying some very discrete issues, at the end of the day, they’re motivated by this larger issue of the well-being of people over their life course,” he said.