An article published Online First and in a future edition of The Lancet reports that the rising rates of suicide and murders in the population are directly associated to the growing unemployment rates originated by the economic downturn. Another effect is the decline in road-traffic accidents. Active labor market programs aiming to maintain and reintegrate workers in jobs could tone down some of these unfavorable effects. The article is the work of Dr David Stuckler, of the University of Oxford, UK, and Professor Martin McKee, of the London School of Hygiene and Tropical Medicine, UK, and their team.
It is acknowledged that economic trouble can lead to adverse effects in health because of its impact on mental health, addiction problems, increased stress and suicides. On the other hand, some people argue that recessions can lead people to be healthier, because they engage in more healthy behavior, such as for instance walking instead of driving, and less over-consumption of food and alcohol. In order to find out more about the effects of economic downturns on public health, the authors evaluated how economic changes have affected mortality rates in twenty six European Union (EU) countries in the last thirty years. They identified how governments might reduce adverse effects.
They established that for every 1 percent increase in unemployment, there was a 0.8 percent rise in suicide rates in people younger than 65 years. This translated in 60 to 550 additional suicides per year across the EU. Murder rates also rose 0.8 percent. On the other hand, road traffic accidents decreased by 1.4 percent. When there was an increase of more than 3 percent in unemployment, suicide rates for individuals under 65 years rose by 4.5 percent, and deaths from alcohol abuse by 28 percent. There was no evidence throughout the EU that all-cause mortality rates increased when unemployment rose. However different populations had diverse responses. They depended in part on the social protection mechanisms in place that could ease the damage caused by unemployment, such as active labor market programs. The authors observed in the central and eastern European countries that populations are very exposed to the potential for negative health effects when unemployment rates rise sharply. This is the result of weaker labor market protections. There is no clear effect on a particular country because the health of the population is variable. However research suggests that individuals who lose their jobs are most at risk, as well the ones with lower education levels. Moreover, the authors point out that their research only focused on mortality. The effects of recession on risk factors and disease were not considered.
The authors explain: “Some negative health effects of the Great Depression seem to have been manifested only 5-7 years after the bank crises of the late 1920s and early 1930s. A related concern is that fear and anxiety in the present crisis could be particularly long-lasting; even when the market recovers, people’s worries and associated behaviours (such as health-care seeking, or alterations to health-system budgets) might not.”
They point out that the consequences of the current economic crisis may be weaker than had been forecasted. There were 25 to 290 additional suicides in Britain attributable to unemployment rises. But, they carry on by saying: “Nevertheless, although the financial sector of an economy may be principally responsible for risk-taking related to the present economic crisis, the true costs of this risk-taking behaviour are to society as a whole.”
They write in conclusion: “The analysis also suggests that governments might be able to protect their populations, specifically by budgeting for measures that keep people employed, helping those who lose their jobs cope with the negative effects of unemployment, and enabling unemployed people to regain work quickly. We observed that social spending on active labour market programmes greater than $190 per head purchasing power parity mitigated the effect of unemployment on death rates from suicides, creating a specific opportunity for stimulus packages to align labour market investments with health promotion.”
In an associated note, Dr Andreas Lundin and Dr Tomas Hemmingsson, of the Karolinska Institutet, Stockholm, Sweden, comment: “When the social security system is less extensive, unemployment is a more probable mediator between mental illness and suicide. Without a moderating effect of unemployment benefits, an increase in suicide rates following increased unemployment rates is, as suggested by Stuckler and colleagues, more plausible.”
“The public health effect of economic crises and alternative policy responses in Europe: an empirical analysis”
David Stuckler, Sanjay Basu, Marc Suhrcke, Adam Coutts, Martin McKee
DOI: 10.1016/S0140-6736(09)61124-7
thelancet
Written by Stephanie Brunner (B.A.)