Austerity

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Austerity is not necessarily bad for health as prosperity can lead to unhealthy lifestyles. While such may partially explain why not all economic recessions lead to increased population mortality[1][2], austerity affecting social networks appears to be more predictive of mortality[3][4] [5]. In England and Wales data analysed until July 2015 have been postulated to be consistent with change in government policy with regard to social and health funding due to austerity impacting particularly on the elderly and mentally infirm and not necessarily the strain of influenza circulating in winter 2015[6]. The mortality rate improvements that had been characteristic of that society for decades appeared to change about 2011 and by 2015 mortality rates were close to those of 2008[7]. Interpreting quickly if this is a true data trend due to particular causes will be difficult due to regression to the mean, year to year variation, and changes in coding and even relevant statistics not being available as promptly but the fact of the change in previous trend that has been sustained for over 4 years is very unlikely to be a statistical artefact. It has been observed that historic composite health indices can be correlated with election results many years later[8] but given that mortality is just one component of such composite health indices and little geographic variation has been observed in mortality trend across counties in England and Wales[7] it is difficult to predict all the consequences of such data. However once the cause is understood it may be open to intervention, as was the case with air pollution with the London smogs of the 1950s.

References

  1. Avendano M1, Moustgaard H, Martikainen P. Are some populations resilient to recessions? Economic fluctuations and mortality during a period of economic decline and recovery in Finland. Eur J Epidemiol. 2016 Oct 11
  2. Regidor E, Vallejo F, Granados JA, Viciana-Fernández FJ, de la Fuente L, Barrio G. Mortality decrease according to socioeconomic groups during the economic crisis in Spain: a cohort study of 36 million people. Lancet. 2016 Oct 13. pii: S0140-6736(16)30446-9. doi: 10.1016/S0140-6736(16)30446-9.
  3. Ghobarah HA1, Huth P, Russett B. The post-war public health effects of civil conflict. Soc Sci Med. 2004 Aug;59(4):869-84.
  4. Notzon FC1, Komarov YM, Ermakov SP, Sempos CT, Marks JS, Sempos EV. Causes of declining life expectancy in Russia. JAMA. 1998 Mar 11;279(10):793-800.
  5. Loopstra R, McKee M, Katikireddi SV, Taylor-Robinson D, Barr B, Stuckler D. Austerity and old-age mortality in England: a longitudinal cross-local area analysis, 2007-2013. J R Soc Med. 2016 Mar;109(3):109-16. doi: 10.1177/0141076816632215.
  6. Green M, Dorling D, Minton J. The Geography of a rapid rise in elderly mortality in England and Wales, 2014-15. Health & place. 2017 Feb; 44:77-85.(Print-Electronic)
  7. a b Hiam L, Dorling D, Harrison D, McKee M. Why has mortality in England and Wales been increasing? An iterative demographic analysis Journal of the Royal Society of Medicine 16 February accessed 18 February
  8. The Economist. Illness as Indicator (2016, last checked 17 February 2017)