Tuesday, April 30, 2013

Austerity is a killer disease

No one should be surprised that the financial and economic crisis is taking its toll on people’s health right across Europe and North America. What would be a surprise, however, is if policy makers and politicians responded positively to shocking research findings.

Nine physicians have produced an analysis of the impact of the economic crisis on the health of ordinary people. Published in The Lancet, they conclude that the public health effects are already visible, particularly in the countries most affected by the recession and where drastic spending cuts have been imposed.

In Greece, the European Union and the International Monetary Fund has demanded that public spending on health should not exceed 6% of GDP. It’s the first time a country has lost control of what it spends on health.

Spending on drugs has been cut sharply while physicians have seen a 25% fall in their income. In 2011 alone, 370 specialist units were eliminated and 2,000 hospital beds were lost in Greece.

The incidence of mental disorders has increased in Greece and Spain and self-reported general health and access to health-care services have worsened in Greece. The number of suicides in people younger than 65 years has grown in the EU since 2007, reversing a steady decrease in many countries. The Greek Ministry of Health reported a 40% rise in suicides between January and May, 2011.   

In the member states that joined the EU in or after 2004, suicides peaked in 2009 and remained high in 2010, whereas a further increase was noted in 2010 in the 15 pre-2004 countries of the EU. In England, the increase in suicides in 2008-10 was “significantly associated with increased unemployment”, and resulted in an estimated 1,000 excess deaths.

In Spain, between 2006 and 2010, the prevalence of mental health disorders in people attending primary care increased significantly, especially those of mood, anxiety, somatoform, and alcohol-related disorders; the rise in the prevalence of major depression was the biggest.

“It is estimated at least half the rise in attendance with mental health disorders could be attributed to the combined risks of individual or family unemployment and difficulties with mortgage payments,” say the study’s authors.

Loss of family income particularly affects the weakest and most vulnerable members of society. In Catalonia between 2005 and 2010, the proportion of children at risk of poverty increased from 20·6% to 23·7%. In 2012, the Spanish government passed by royal decree a law that ties health coverage to employment. Hundreds of thousands of immigrants without papers will only have limited access.

Political economist David Stuckler, one of the authors of The Lancet research, and Sanjay Basu, an assistant professor of medicine and an epidemiologist at Stanford University,  have just published The Body Economic: Why Austerity Kills.

They say that more than 10,000 suicides and up to a million cases of depression could be attributed to the effects of the recession across Europe and North America. In Britain, some 10,000 families have been pushed into homelessness by the government's austerity measures, they believe. The Lancet study authors conclude:  
 Finally, public health voices have been largely absent from the debate about how to respond. Many health ministries have been silent. The Directorate-General for Health and Consumer Protection of the European Commission, despite its legal obligation to assess the health effects of EU policies, has not assessed the effects of the troika's drive for austerity, and has instead limited EU commentary to advice about how health ministries can cut their budgets.
 A small source of optimism is that European civil society organisations, including professional bodies, have spoken out about the adverse health effects of cuts to health and social spending. The question is whether anyone will listen.

With governments locked into imposing the burden of the crisis of capitalism on to ordinary people, you have to say that hands over ears is the order of the day.

Paul Feldman
Communications editor

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