Mon, May 20, 2013 - Page 9 News List

Austerity measures take their toll on public health

There’s a simple way to demonstrate that the way governments deal with the economic crisis has a direct effect on public health: Examine fluctuations in suicide rates. Economist and public health expert David Stuckler believes the facts speak for themselves

By Jon Henley  /  The Guardian, LONDON

Illustration: Yusha

The austerity programs administered by Western governments in the wake of the 2008 global financial crisis were, of course, intended as a remedy, a tough, but necessary course of treatment to relieve the symptoms of debts and deficits and to cure recession.

However, if austerity had been run like a clinical trial, “it would have been discontinued. The evidence of its deadly side-effects — of the profound effects of economic choices on health — is overwhelming,” David Stuckler says.

Stuckler speaks softly, in the measured tones and carefully weighed terms of the academic, which is what he is: A leading expert on the economics of health, masters in public health degree from Yale, doctorate from Cambridge, senior research leader at Oxford, 100-odd peer-reviewed papers to his name.

However, his message — especially in the UK, as even the IMF starts to question British Chancellor of Exchequer George Osborne’s enthusiasm for ever-deeper budget cuts — is explosive, backed by a decade of research, and based on reams of publicly available data.

“Recessions can hurt. But austerity kills,” Stuckler says bluntly.

In a powerful new book, The Body Economic, Stuckler and his colleague Sanjay Basu, an assistant professor of medicine and epidemiologist at Stanford University, show that austerity is now having a “devastating effect” on public health in Europe and North America.

The mass of data they have mined reveals that more than 10,000 additional suicides and up to a million extra cases of depression have been recorded across the two continents since governments started introducing austerity programs in the aftermath of the crisis.

In the US, more than 5 million Americans have lost access to healthcare since the recession began, essentially because when they lost their jobs, they also lost their health insurance.

In the UK, 10,000 families have been pushed into homelessness following housing benefit cuts, the authors say.

The most extreme case, says Stuckler, reeling off numbers he knows now by heart, is Greece.

“There, austerity to meet targets set by the troika is leading to a public-health disaster,” he says. “Greece has cut its health system by more than 40 percent. As the health minister said: ‘These aren’t cuts with a scalpel, they’re cuts with a butcher’s knife.’”

Worse, those cuts have been decided “not by doctors and healthcare professionals, but by economists and financial managers. The plan was simply to get health spending down to 6 percent of GDP. Where did that number come from? It’s less than the UK, less than Germany, way less than the US,” he says.

The consequences have been dramatic. Cuts in HIV-prevention budgets have coincided with a 200 percent increase in the virus in Greece, driven by a sharp rise in intravenous drug use against the background of a youth unemployment rate now running at more than 50 percent and a spike in homelessness of about a quarter.

The WHO recommends a supply of 200 clean needles a year for each intravenous drug user; groups that work with users in Athens estimate the current number available is about three, Stuckler says.

In terms of “economic” suicides, “Greece has gone from one extreme to the other. It used to have one of Europe’s lowest suicide rates; it has seen a more than 60 percent rise,” he says.

In general, each suicide corresponds to about 10 suicide attempts and — it varies from country to country — between 100 and 1,000 new cases of depression.

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