Is The COVID-Induced Recession Good For Our Health?
Though unintuitive, the relationship between a bad economy and a low mortality rate has largely been established in research. But does it hold in the time of COVID-19?
It is no secret that the coronavirus pandemic and the resulting recession have taken a toll on our mental health. About 9.6 million Americans lost their jobs in 2020 which is associated with increased anxiety and depression and low self-esteem. Before the pandemic, 1 in 10 adults in the U.S. reported symptoms of anxiety or depressive disorder. Now, 4 in 10 adults report these symptoms. 53% of adults in households with low incomes experienced mental health symptoms, compared to 32% of adults who did not experience job or income loss. Adults are also having trouble sleeping and eating, and they are drinking more, none of which bodes well for our physical and mental well-being. If recessions are so bad for our mental health, why are they associated with fewer deaths?
When the economy is bad, number of deaths go down due to changes in behaviour
When studying the recessions of the last 100 years, epidemiologists have found that as unemployment increases, death rates decrease. This phenomenon has been observed in several developed countries including the United States and other European nations. In Spain, the death rate was declining at a rate of 2% per year before the 2008 recession. After the recession, it started declining at a faster rate of 3%.
Scientists have several hypotheses for why fewer people die when the economy is down:
- Fewer work-related accidents. As workers are laid off, those who have more experience are left behind. These tend to be older, women, permanent employees in large companies. Thus, they are less likely to be injured at work. However, given that the current economic downturn is driven by COVID-19, the workplace has perhaps become more dangerous. In Canada’s most populous province, 25,500 workers contracted the virus on the job in Ontario as of May 2021.
- Less traffic. As people drive less, there are fewer road accidents. Fewer cars also mean less air pollution which is great for our health, contributing to fewer cardiovascular and respiratory problems. In Ontario, traffic collisions went down by 26% during the pandemic but fatality increased by 22% due to more dangerous driving.
- Increase in preventive activities. As people work less and have less money to spend, they have more time for activities which ward off disease such as getting good sleep, exercising, and spending less on alcohol and smoking. While more than 1 million in the UK quite smoking in 2020 (mostly in response to prevent COVID), it seems we are drinking more this time around. In March 2020, online sales of alcohol increased 262% in the U.S. compared to the year before.
Are these positive changes enough to offset the increase in mortality due to the coronavirus?
Unlike past recessions, the number of deaths has increased and not just due to COVID
In the U.S., there were 522,368 more deaths than expected between March 2020 and January 2021 and only 73% of them were due to COVID-19. While some of these excess deaths can be explained by undocumented COVID infections or delayed care, other causes include chronic diseases such as heart disease, diabetes, and Alzheimer’s. Another cause could be drug overdoses. 13% of American started using drugs or increased their use during the pandemic and deaths due to synthetic opioids increased by 55%. While mental health has worsened during the pandemic, a study of 21 countries found that suicide rates have remained constant and even declined in high-income and upper-middle-income countries.
What makes this recession so different from past ones? Why aren’t people engaging in activities that are good for their health and reducing harmful ones?
Here are my hypotheses:
- Lack of social safety nets. Strong social protection policies can play a role in mitigating the effect of unemployment on mortality rates. In the 1990s, Sweden spent four times as much as Spain on social protections. When the economy took a hit, the suicide rate declined in Sweden whereas Spain saw an increase in suicides. While the U.S. safety net has expanded overall, it has reduced coverage for the poorest Americans, leaving them vulnerable to the negative effects of the recession.
- Delayed treatment for other conditions. In Canada, 205,549 procedures and consultations were postponed between March and May/June 2020 because hospitals were overwhelmed with the volume of coronavirus patients. Last May, modelling suggested 33 people could die because their cardiac surgeries were delayed since March. In general, the delay in seeking treatment can lead to further deterioration of health, making health conditions more difficult to manage and treat, thus, increasing the chance of mortality.
The coronavirus pandemic has highlighted the need for investing in preventive healthcare and being ready for emergencies. By being better prepared for the next inevitable recession, we can reap the positive changes in health behaviour and minimize mortality.
