Market crashes could lead to rises in homicides and suicides, unless governments invest in labour market protections, according to a study published in The Lancet.
Researchers at London School of Hygiene & Tropical Medicine and Oxford University estimated that soaring stress brought on by job losses could prompt a 2.4% rise in suicide rates in people under-64 years of age, a 2.7% rise in heart attack deaths in men between 30 and 44 years, and a 2.4% rise in homicides rates, corresponding to thousands of deaths in European Union countries, such as the UK.
Government spending to keep people in employment and quickly get them back to work when they lose jobs could prevent these rises in deaths from occurring, the study says. When spending on such "active labour market programmes" is above US $190 (£115; €135) per person, financial crisis would not be a major killer.
The report also suggests that in poor countries, where investments in active labour market programmes are much lower or virtually non-existent, the death toll brought on by the financial meltdown would be much worse.
The study, entitled The public health effect of economic crisis and alternative government policy responses in Europe: an empirical analysis was written in the wake of concerns that health might suffer as a result of the financial crisis. It is thought to be the most comprehensive evaluation of the relationship between economic crises, unemployment and mortality in Europe and the first to consider the role of specific government responses.
"Financial crisis causes hardship for many ordinary people, but it does not have to cost them their lives", social epidemiologist David Stuckler, who led the research said. He continued, "Our findings show that investing in active labour market programmes can both help the economy and save lives."
The researchers studied mortality rates for over 30 causes of death from the World Health Organisation's Health for All Database between the years 1970 and 2007. They then compared the results to unemployment data from the International Labour Organisation, and data from the Organisation for Economic Co-operation and Development describing different types of government social programme expenditures during the same period. Models were used to control variables such as past employment and mortality trends, differing degrees to which countries monitor suicides and unemployment, and population ageing.
Previous studies in individual countries had found mixed results – in Sweden, finding no effect of financial crises on health, but in Spain and the US, finding some negative effects and in some cases improved health. The researchers found that whether more people died depended on how much countries spent on social protections, including active labour market programmes.
In the UK, where currently about US$150 (£91; €107) per head per year is spent on active labour market programmes, the researchers estimated that at least 25 to 290 suicides would occur as a direct result of the financial crisis.
Professor Martin McKee at the London School of Hygiene & Tropical Medicine and one of the report's authors, noted that "Suicides are just the tip of the iceberg – rising suicide rates are a sign of many failed suicide attempts and high levels of mental distress among workers and families."
As with any ecological study, the analysis had several limitations. The analysis focused on the experience of entire populations, and vulnerable groups, such as migrants or refugees, could suffer disproportionately even when social spending was high. Data on social protections were also missing for many countries, in particular for most central and eastern European countries, where unemployment rates tended to be higher than the west EU and social spending was much lower.
The researchers estimated that rising unemployment rates by 3% could prompt a 2.4% rise in suicide rates in people under-64 years of age and a 2.4% rise in homicides rates, but a drop in traffic fatalities by 4.2% in European Union countries, such as the UK. The study's findings were consistent with recent reports in the UK of rising suicides and falling traffic volume. Unemployed persons have two times the risk of death as employed persons due to suicides, and during recession people walk instead of drive or use public transit, reducing risks of road injury and death.
Sanjay Basu, at University of California at San Francisco pointed out that, "The analysis suggests that governments may be able to do something to protect their populations, specifically by budgeting for measures that help people get back into work." He continued, "This report shows that government spending programmes designed to stimulate the economy could also be used to prevent potentially thousands of deaths."
- The public health effect of economic crises and alternative policy responses in Europe: an empirical analysis. The Lancet, July 8, 2009
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