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The Lancet. Financial crisis, austerity, and health in Europe
[Source: The Lancet, full text: (LINK). Abstract, edited.]
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The Lancet, Early Online Publication, 27 March 2013
doi:10.1016/S0140-6736(13)60102-6
Financial crisis, austerity, and health in Europe
Original Text
Marina Karanikolos MSc a b, Philipa Mladovsky MSc c, Jonathan Cylus MSc a c, Sarah Thomson PhD c, Sanjay Basu PhD d, David Stuckler PhD e, Prof Johan P Mackenbach PhD f, Prof Martin McKee MD a b
Summary
The financial crisis in Europe has posed major threats and opportunities to health. We trace the origins of the economic crisis in Europe and the responses of governments, examine the effect on health systems, and review the effects of previous economic downturns on health to predict the likely consequences for the present. We then compare our predictions with available evidence for the effects of the crisis on health. Whereas immediate rises in suicides and falls in road traffic deaths were anticipated, other consequences, such as HIV outbreaks, were not, and are better understood as products of state retrenchment. Greece, Spain, and Portugal adopted strict fiscal austerity; their economies continue to recede and strain on their health-care systems is growing. Suicides and outbreaks of infectious diseases are becoming more common in these countries, and budget cuts have restricted access to health care. By contrast, Iceland rejected austerity through a popular vote, and the financial crisis seems to have had few or no discernible effects on health. Although there are many potentially confounding differences between countries, our analysis suggests that, although recessions pose risks to health, the interaction of fiscal austerity with economic shocks and weak social protection is what ultimately seems to escalate health and social crises in Europe. Policy decisions about how to respond to economic crises have pronounced and unintended effects on public health, yet public health voices have remained largely silent during the economic crisis.
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a European Observatory on Health Systems and Policies, London School of Hygiene & Tropical Medicine, London, UK; b European Centre on Health of Societies in Transition, London School of Hygiene & Tropical Medicine, London, UK; c European Observatory on Health Systems and Policies, London School of Economics and Political Science, London, UK; d Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, CA, USA; e Department of Sociology, University of Cambridge, Cambridge, UK; f Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
Correspondence to: Prof Martin McKee, London School of Hygiene & Tropical Medicine, 15?17 Tavistock Place, London WC1H 9SH, UK
-doi:10.1016/S0140-6736(13)60102-6
Financial crisis, austerity, and health in Europe
Original Text
Marina Karanikolos MSc a b, Philipa Mladovsky MSc c, Jonathan Cylus MSc a c, Sarah Thomson PhD c, Sanjay Basu PhD d, David Stuckler PhD e, Prof Johan P Mackenbach PhD f, Prof Martin McKee MD a b
Summary
The financial crisis in Europe has posed major threats and opportunities to health. We trace the origins of the economic crisis in Europe and the responses of governments, examine the effect on health systems, and review the effects of previous economic downturns on health to predict the likely consequences for the present. We then compare our predictions with available evidence for the effects of the crisis on health. Whereas immediate rises in suicides and falls in road traffic deaths were anticipated, other consequences, such as HIV outbreaks, were not, and are better understood as products of state retrenchment. Greece, Spain, and Portugal adopted strict fiscal austerity; their economies continue to recede and strain on their health-care systems is growing. Suicides and outbreaks of infectious diseases are becoming more common in these countries, and budget cuts have restricted access to health care. By contrast, Iceland rejected austerity through a popular vote, and the financial crisis seems to have had few or no discernible effects on health. Although there are many potentially confounding differences between countries, our analysis suggests that, although recessions pose risks to health, the interaction of fiscal austerity with economic shocks and weak social protection is what ultimately seems to escalate health and social crises in Europe. Policy decisions about how to respond to economic crises have pronounced and unintended effects on public health, yet public health voices have remained largely silent during the economic crisis.
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a European Observatory on Health Systems and Policies, London School of Hygiene & Tropical Medicine, London, UK; b European Centre on Health of Societies in Transition, London School of Hygiene & Tropical Medicine, London, UK; c European Observatory on Health Systems and Policies, London School of Economics and Political Science, London, UK; d Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, CA, USA; e Department of Sociology, University of Cambridge, Cambridge, UK; f Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
Correspondence to: Prof Martin McKee, London School of Hygiene & Tropical Medicine, 15?17 Tavistock Place, London WC1H 9SH, UK
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