Literature DB >> 19589588

The public health effect of economic crises and alternative policy responses in Europe: an empirical analysis.

David Stuckler1, Sanjay Basu, Marc Suhrcke, Adam Coutts, Martin McKee.   

Abstract

BACKGROUND: There is widespread concern that the present economic crisis, particularly its effect on unemployment, will adversely affect population health. We investigated how economic changes have affected mortality rates over the past three decades and identified how governments might reduce adverse effects.
METHODS: We used multivariate regression, correcting for population ageing, past mortality and employment trends, and country-specific differences in health-care infrastructure, to examine associations between changes in employment and mortality, and how associations were modified by different types of government expenditure for 26 European Union (EU) countries between 1970 and 2007.
FINDINGS: We noted that every 1% increase in unemployment was associated with a 0.79% rise in suicides at ages younger than 65 years (95% CI 0.16-1.42; 60-550 potential excess deaths [mean 310] EU-wide), although the effect size was non-significant at all ages (0.49%, -0.04 to 1.02), and with a 0.79% rise in homicides (95% CI 0.06-1.52; 3-80 potential excess deaths [mean 40] EU-wide). By contrast, road-traffic deaths decreased by 1.39% (0.64-2.14; 290-980 potential fewer deaths [mean 630] EU-wide). A more than 3% increase in unemployment had a greater effect on suicides at ages younger than 65 years (4.45%, 95% CI 0.65-8.24; 250-3220 potential excess deaths [mean 1740] EU-wide) and deaths from alcohol abuse (28.0%, 12.30-43.70; 1550-5490 potential excess deaths [mean 3500] EU-wide). We noted no consistent evidence across the EU that all-cause mortality rates increased when unemployment rose, although populations varied substantially in how sensitive mortality was to economic crises, depending partly on differences in social protection. Every US$10 per person increased investment in active labour market programmes reduced the effect of unemployment on suicides by 0.038% (95% CI -0.004 to -0.071).
INTERPRETATION: Rises in unemployment are associated with significant short-term increases in premature deaths from intentional violence, while reducing traffic fatalities. Active labour market programmes that keep and reintegrate workers in jobs could mitigate some adverse health effects of economic downturns. FUNDING: Centre for Crime and Justice Studies, King's College, London, UK; and Wates Foundation (UK).

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Mesh:

Year:  2009        PMID: 19589588     DOI: 10.1016/S0140-6736(09)61124-7

Source DB:  PubMed          Journal:  Lancet        ISSN: 0140-6736            Impact factor:   79.321


  314 in total

1.  The differential impact of the financial crisis on health in Ireland and Greece: a quasi-experimental approach.

Authors:  P Hessel; S Vandoros; M Avendano
Journal:  Public Health       Date:  2014-10-18       Impact factor: 2.427

2.  Is there a statistical relationship between economic crises and changes in government health expenditure growth? an analysis of twenty-four European countries.

Authors:  Jonathan Cylus; Philipa Mladovsky; Martin McKee
Journal:  Health Serv Res       Date:  2012-06-07       Impact factor: 3.402

3.  How government spending cuts put lives at risk.

Authors:  David Stuckler; Sanjay Basu; Martin McKee
Journal:  Nature       Date:  2010-05-20       Impact factor: 49.962

4.  The use of a surveillance system to measure changes in mental health in Australian adults during the global financial crisis.

Authors:  Zumin Shi; Anne W Taylor; Robert Goldney; Helen Winefield; Tiffany K Gill; Jane Tuckerman; Gary Wittert
Journal:  Int J Public Health       Date:  2010-10-21       Impact factor: 3.380

5.  Hard times or good times? Inequalities in the health effects of economic change.

Authors:  Mylène Riva; Clare Bambra; Susan Easton; Sarah Curtis
Journal:  Int J Public Health       Date:  2011-02       Impact factor: 3.380

6.  The impact of the 2008 financial crisis on psychological work stress among financial workers and lawyers.

Authors:  Feng-Jen Tsai; Chang-Chuan Chan
Journal:  Int Arch Occup Environ Health       Date:  2010-12-29       Impact factor: 3.015

7.  Association Between Social Integration and Suicide Among Women in the United States.

Authors:  Alexander C Tsai; Michel Lucas; Ichiro Kawachi
Journal:  JAMA Psychiatry       Date:  2015-10       Impact factor: 21.596

8.  Is It More Important to Address the Issue of Patient Mobility or to Guarantee Universal Health Coverage in Europe?: Comment on "Regional Incentives and Patient Cross-Border Mobility: Evidence From the Italian Experience".

Authors:  Helena Legido-Quigley
Journal:  Int J Health Policy Manag       Date:  2015-09-02

Review 9.  EPA guidance on mental health and economic crises in Europe.

Authors:  M Martin-Carrasco; S Evans-Lacko; G Dom; N G Christodoulou; J Samochowiec; E González-Fraile; P Bienkowski; M Gómez-Beneyto; M J H Dos Santos; D Wasserman
Journal:  Eur Arch Psychiatry Clin Neurosci       Date:  2016-02-13       Impact factor: 5.270

Review 10.  [Suicidal behavior: a psychiatric emergency situation, suicide prevention: a psychiatric obligation].

Authors:  M Wolfersdorf; B Schneider; A Schmidtke
Journal:  Nervenarzt       Date:  2015-09       Impact factor: 1.214

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