The short and medium term effects of the health crisis may seem contradictory, especially if only mortality is measured. For example, a last study of the recession that began in 2008 relates it to a decline in the death rate in Europe. The work, which is published today in Nature Communications, It was directed by Joan Ballester, from ISGlobal, a center run by La Caixa, and analyzes the mortality data between 2000 and 2010, a period in which the rate in Europe was generally down.
Although there is unanimity in that worse economic conditions are associated with worse health data, Joan Ramon Villalbí, from the Public Health Agency of Barcelona, warns that this is in the medium and long term. With the recent crisis, "we do not know what will happen in 10 years," he says, but it does confirm that in other situations of economic deterioration, the recession has had a first effect of reducing mortality, Villalbí explains. displacements are reduced and there is more youth unemployment, so young people do not have money to buy motorcycles or cars and hand fewer traffic accidents. Also, having less money reduces the consumption of alcohol and tobacco. And unemployment is focused on construction, which is the labor sector that suffers the most sinister, and in generaland fewer work accidents.
To these factors, Ballester adds the decrease in pollution due to the fall of industrial activity and the transport of goods. And also that, as unemployment increases, obesity and sedentary lifestyle decrease. "If you have a very absorbing job, you do not have time to exercise and eat anything," he says as an example. If you are unoccupied, you are more likely to go to the gym and prepare your food at home, for example.
Laura Vallejo-Torres, president of the Association of Health Economics (AES), agrees on the evaluation of the results of the work. "It is not an isolated finding to observe that mortality decreases in times of economic recession," he says, and also shares the reasons for this behavior: "The decrease in mortality due to traffic accidents and cardiovascular diseases" and that "in periods with high rates of unemployment people improve their habits of life – they reduce tobacco consumption and excess weight and perform more physical exercise – and also reduce the use of private transport ".
The first signatory of the paper points out that the relationship between a decrease in GDP (the indicator that measures the length of the recession) and the fall in mortality adjusted to aging is so clear that in countries where the recession was felt most intensely , the deaths also decreased more. In Spain, for example, that rate was falling to 2% year-on-year, but went to 3% from 2008, picks up the work. "The effect is almost immediate," says Ballester. "This is general throughout Europe, although some country reflects that relationship worse, such as the United Kingdom and the Netherlands," he says. In fact, even in the Spanish data taken raw (number of deaths and rate per 100,000 inhabitants), the trend is the same: low until 2010.
Although the work only lasts until that year, the researcher has made a quick calculation about the data of the following years, in which the crisis began to be overcome. And the relationship is confirmed, but the other way around. As GDP begins to rise, the decline in mortality slows down and even some increases occur, according to this shallow projection.
Regarding the possible consequences of the crisis, the president of the AES says that "although mortality may have decreased in the short term, the results in the long term unknown." "Many previous studies and those related to this economic crisis do not cover the period of time necessary to be able to observe the effects that will be derived from the social repercussions of the crisis, such as the increase in poverty rates and the risk of social exclusion. Furthermore, a reduction in mortality may be accompanied by an increase in socioeconomic inequalities, and is not, of course, incompatible with a worsening for certain more vulnerable sectors of the population, an example of this being the immigrant population in an irregular situation, it suffered an increase in its mortality rate of 15% due to the measures implemented during the economic recession, which included the withdrawal of the health card of this group ".
This last measure was decided in 2012, outside of the period covered by the work, but its main author believes that in general mortality had very little impact because "immigrants are not many and are mostly young."
The exception to this relationship between variations in GDP and mortality seems to be suicide deaths. "People with a depression or that they are not well can react worse "to the crisis, says Ballester, although his team has not gone into detail in this chapter and talks about what has been published about other similar situations. 0.1% of annual deaths, a proportion that hardly varies from a decade ago.