Jonathan Koltai1, Martin McKee2, David Stuckler3. 1. Department of Sociology, University of New Hampshire, Durham, USA. Electronic address: jonathan.koltai@unh.edu. 2. Centre for Global Chronic Conditions, London School of Hygiene and Tropical Medicine, London, UK. 3. Dondena Centre for Research on Social Dynamics and Public Policy, Bocconi University, Milan, Italy.
Abstract
BACKGROUND: Drug-related mortality in the UK rose markedly after 2012. Here we test the hypothesis that cuts to disability-related spending were associated with increased drug-related mortality across local governments in Great Britain. METHODS: We regressed changes in drug-related death rates (years 2010-12 versus 2015-17) on local government disability-related budget reductions, adjusting for a range of regional, demographic, and economic factors. Budget reductions are captured with a combined measure of financial losses due to Incapacity Benefit and Disability Living Allowance reforms, expressed in pounds sterling per capita, per year. 364 local authorities across England, Scotland, and Wales were included in the study. FINDINGS: Greater budget reductions were associated with greater increases in drug-related death rates. In the unadjusted model, each £100 per capita budget reduction was associated with an increase in drug-related death rates of 3.30 per 100 000 population (95% CI: 2.43 to 4.17). The magnitude of the association increased after adjusting for region and demographic factors (b = 4.84; 95% CI: 3.26 to 6.43). The association remained statistically significant after adjusting for a full set of controls, including baseline and trends in unemployment rates, median hourly pay, and gross disposable household income per capita (b = 4.41; 95% CI: 2.57 to 6.24). CONCLUSION: Deeper cuts to local government spending in Great Britain in the 2010s were associated with larger increases in drug-related deaths.
BACKGROUND: Drug-related mortality in the UK rose markedly after 2012. Here we test the hypothesis that cuts to disability-related spending were associated with increased drug-related mortality across local governments in Great Britain. METHODS: We regressed changes in drug-related death rates (years 2010-12 versus 2015-17) on local government disability-related budget reductions, adjusting for a range of regional, demographic, and economic factors. Budget reductions are captured with a combined measure of financial losses due to Incapacity Benefit and Disability Living Allowance reforms, expressed in pounds sterling per capita, per year. 364 local authorities across England, Scotland, and Wales were included in the study. FINDINGS: Greater budget reductions were associated with greater increases in drug-related death rates. In the unadjusted model, each £100 per capita budget reduction was associated with an increase in drug-related death rates of 3.30 per 100 000 population (95% CI: 2.43 to 4.17). The magnitude of the association increased after adjusting for region and demographic factors (b = 4.84; 95% CI: 3.26 to 6.43). The association remained statistically significant after adjusting for a full set of controls, including baseline and trends in unemployment rates, median hourly pay, and gross disposable household income per capita (b = 4.41; 95% CI: 2.57 to 6.24). CONCLUSION: Deeper cuts to local government spending in Great Britain in the 2010s were associated with larger increases in drug-related deaths.
Authors: Jonathan Stokes; Peter Bower; Bruce Guthrie; Stewart W Mercer; Nigel Rice; Andrew M Ryan; Matt Sutton Journal: Lancet Reg Health Eur Date: 2022-06-10