The health consequences of economic crises

This journal is dedicated to researching and publishing on emerging threats to human health. The subject areas vary from the threats to a small group, such as Iranian veterans exposed to sulphur mustard, through to threats on a regional or global basis. One of the key evolving threats is the current global economic crisis. In October 2008, the world finally realised that the credit crisis, which arose from the United States sub-prime housing collapse, was the harbinger of the most significant international recession since the 1930s. 1 Although the economic and political consequences of the recession are being studied in exhaustive detail, the potential health consequences have received much less attention. The effects on health are likely to be manifold. At a global level, health care, already precarious in many developing countries, is likely to decline further as aid dries up and government expenditure falls, with millions more forced into poverty and malnutrition, particularly women and children. 2 This is likely to be further exacerbated by the collapse of business and banking institutions as world trade declines, on a background of raised food and fuel costs. 3 The consequences have been seen before. After the Asian crisis in 1997, women and girls generally suffered disproportionately as the industries that employed them were the first to be hit, and as spending on women's health care, including antenatal and maternity services, was cut. 4 Excess deaths can also be expected, particularly in developing countries, as poorer patients defer medical treatment and health services deteriorate, with the greatest impact likely to be on the most vulnerable patients including children, the disabled, and the elderly. 5 After the Mexican financial crisis in 1995, over 27,000 excess deaths were estimated to have occurred in these vulnerable groups. 6 In more developed countries, mortality rates may actually fall as a result of reduced alcohol and tobacco use, and less road travel. 7 Disease control is also expected to suffer during the current crisis. There is growing concern that funding for treatment, research, and global control of malaria, tuberculosis, and HIV/AIDS is being cut back, and that other currently underfunded programs for serious infectious diseases would not get the investment they require. 8 Resources for disease surveillance and laboratory capacity are also often cut back at these times, which may seriously impact on the timely identification and mitigation of emerging epidemics and pandemics. 9 Even in more …