I am curious...
where has this string gone too?

here in the us, in pittsburgh, the answers to the questions being raised are fairly clear.  those parts of the city/region that were decimated in the economic restructuring of the 1980s, when we lost our industrial base have continued to struggle with poor health and hard lives.  a massive diaspora of young folks- which is why the Pittsburgh Steelers have a fan base across the country- is all that has kept the lid on mass destitution.  

how might a "stimulus package" help protect and promote health?  how might it help those who are casualties?  

how much of what is happening is the business cycle, and how much is another part of restructuring of global productive forces?  seems to me, here in the us, that its both.  with our command and control economy, we have been pulling in profits from all over the world, and lending them out at cut rate prices to anyone who asked.  at the same time, except for the capitalists and managers, no one has been making any more money.  we financed those suvs with credit, just as we financed those inflated houses.  but without actually making more money, sooner or later, folks would not be able to pay the loans.  and we have been in free fall ever since.  without increasing the share of money going to the new "service worker", there is no way to maintain prosperity.  now the credit markets have frozen and demand is plummeting.

there has been no effective way to really organize service workers- so far. 

putting more money into their hands is a start to help increase demand. but i also think there is a clear need for service workers and the remaining industrial workers to take control of government spending and make sure it improves the common good- universal health care, increased education, improved "modernized" public services...

i am not sure we are strong enough yet to make this happen.  

last time we had a recession on top of a major structural change- the 1980s- we lost industry and we gained- "an underclass", increased violence, incarceration, crack, hiv, homelessness, unemployment, devastated communities.  cant wait.....

Ken Thompson 







________________________________________
From: The Health Equity Network (HEN) [[log in to unmask]] On Behalf Of Mike Hughes [[log in to unmask]]
Sent: Friday, January 09, 2009 5:35 PM
To: [log in to unmask]
Subject: Re: Impact of recession on health

Surely this discussion points to an interesting way equalogists could be looking at the impact of the recession?

Those of us with long memories will have little doubt that for the developed nations the impact of the recession health status will be generally worse. And any comparison of health status by social or economic disadvantage will be more pronounced. I guess someone will have to demonstrate this, and deal with the reductionist notion that the way to health equality is through our stomachs and lungs, but it won’t change the world.

However there will be some in disadvantaged groups for whom the recession will be life changing in a positively healthy way, and perhaps we should be looking at this group to learn about tackling inequality and breaking down the apparently rigid link between income and employment and health status.

In the words of graffiti that adorned a wall leading from York University in the dying days of the Callaghan government and when health economics was possibly just a twinkle in the eyes of a few welfare economists ....

“Don’t go to work ... there’s too much to do”.

Mike Hughes



From: The Health Equity Network (HEN) [mailto:[log in to unmask]] On Behalf Of Popay, Jennie
Sent: 09 January 2009 21:53
To: [log in to unmask]
Subject: FW: Impact of recession on health


Fascinating exercise in collective memory and don’t have lot of time to add relevant references but just wanted to ‘remind’ people of the LS (John Fox et al) seemingly decisive publication during the 1980’s debate – unemployment – will it won’t it have negative impacts on health (a debate that flares up every time there is a significant recession of course).  The Fox research seemed to be considered to be pretty conclusive evidence by most commentators last time around – it sure shut Maggie up but then I’m not an economist either.
Jennie Popay
Lancaster University


From: The Health Equity Network (HEN) [mailto:[log in to unmask]] On Behalf Of Joe Farrington-Douglas
Sent: 07 January 2009 12:58
To: [log in to unmask]
Subject: Re: Impact of recession on health

Interesting stuff, thanks.

In UK John Appleby’s written<http://www.bmj.com/cgi/content/full/337/oct28_2/a2259?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=appleby&searchid=1&FIRSTINDEX=0&sortspec=date&resourcetype=HWCIT> in BMJ on this from a public finances and unemployment/ mental health perspective.

Most commentators’ predictions I’ve seen – including at an NHS Confed debate in December – have tended to be gloomy – except for Andrew Lansley who made a similar point to those below (e.g. lower income = better diet) and got generally mocked for being counter to the evidence (viz obesity).

Julian Le Grand’s response to Michael Marmot at the HEN lecture raised an interesting question. He showed that relative poverty and gini inequality (which are key measure for Wilkinson’s inequality = ill health theory) counter-intuitively declined (or slowed) during the last 2 recessions as benefit and pension rates rose relative to average and top wages. This might suggests improving health in recession, subject to certain conditions, but also might question how useful relative measures are when thousands are losing jobs.

A further question for the economists on this list (not me!) is whether income elasticity of demand – rising demand for healthcare (as distinct from need) increasing more quickly than income – is symmetrical, ie does demand fall back again as incomes decline and non-health consumption becomes a higher priority?

From a healthcare system point of view the health need/ demand question maybe a relative side-show compared to the financial squeeze impact of recession/ depression.

Joe Farrington-Douglas
Senior Policy Manager
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________________________________
From: The Health Equity Network (HEN) [mailto:[log in to unmask]] On Behalf Of alex scott-samuel
Sent: 07 January 2009 11:53
To: [log in to unmask]
Subject: Impact of recession on health

interesting discussion on spirit of 1848 (US health left) group

-------- Original Message --------
Subject:

Impact of recession on health

Date:

Wed, 07 Jan 2009 11:50:37 +0000

From:

alex scott-samuel <[log in to unmask]><mailto:[log in to unmask]>

Reply-To:

[log in to unmask]<mailto:[log in to unmask]>

To:

alexss <[log in to unmask]><mailto:[log in to unmask]>



Impact of recession on health <http://groups.yahoo.com/group/spiritof1848/message/13033;_ylc=X3oDMTJxb2Vua2IwBF9TAzk3MzU5NzE1BGdycElkAzM3MTc0NQRncnBzcElkAzE3MDUwNjExNDYEbXNnSWQDMTMwMzMEc2VjA2Rtc2cEc2xrA3Ztc2cEc3RpbWUDMTIzMTI0MTY4MQ-->
Posted by: "Larry Adelman" [log in to unmask] <mailto:[log in to unmask]>
Mon Jan 5, 2009 3:01 pm (PST)
Can anyone kindly recommend articles or studies predicting the impact of
the current economic meltdown (layoffs, foreclosures, etc.) on morbidity
and mortality rates, either from a national or regional perspective?

I've seen pieces on losing health insurance coverage, and cuts in health
services, but nothing on the consequences of job loss, living with
uncertainty, downward mobility, loss of hope, etc. save for an odd piece
in the NY Times back in October called "Are Bad Times Healthy?" that
emphasized how a recession gives parents more time to spend with their
children, greater incentives to eat at home rather than out, and relief
from the stress of overwork:
www.nytimes<http://www.nytimes>.com/2008/10/07/health/07well.html?scp=72&sq=recession%20and%
20health&st=cse

Many thanks,

Larry

Larry Adelman

CALIFORNIA NEWSREEL

500 Third Street, #505

San Francisco, CA 94107

415-284-7800

[log in to unmask]<mailto:LA%40newsreel.org>

www.newsreel<http://www.newsreel>.org <http://www.newsreel.org>

www.unnaturalcauses<http://www.unnaturalcauses>.org
Re: Impact of recession on health <http://groups.yahoo.com/group/spiritof1848/message/13034;_ylc=X3oDMTJxaXFnZ2NqBF9TAzk3MzU5NzE1BGdycElkAzM3MTc0NQRncnBzcElkAzE3MDUwNjExNDYEbXNnSWQDMTMwMzQEc2VjA2Rtc2cEc2xrA3Ztc2cEc3RpbWUDMTIzMTI0MTY4MQ-->
Posted by: "David Spero RN" [log in to unmask] <mailto:[log in to unmask]>   dsperorn <http://profiles.yahoo.com/dsperorn>
Mon Jan 5, 2009 3:30 pm (PST)
Hi Larry,
I don't think much has been written about this, and it would all be guesstimates really. Nobody knows, but in my worthless opinion, as Unnatural Causes showed so well, a lot will depend on whether the recession / depression increases or decreases inequality. But the effects on community may be equally important.

If people's economic struggles continue to be seen as individual failings, then economic problems will tend to exacerbate health problems. If, OTOH, recession brings people (families, communities) together, there could be health benefits like the ones in the NYT article. Highly significant health benefits occurred in England during WW1 and WW2. Marmot and Wilkerson attribute this to the marked reduction in inequality during the war years - everyone was employed, taxes were very high, wages went up. There was also the feeling of "we're all in this together." Life expectancies (for noncombatants) soared.

Could this happen in an economic downturn? It might depend on how we as a society respond. If we turn away from consumerism and toward community, if we tax the rich to pay for jobs programs, we might see benefits. If things go on as they are, health disparities and general health are likely to worsen.

But, amazingly, the US also seems to have experienced gains in life expectancy and decreased death rates during the Bush Administration. (See this NCHS news release http://www.cdc.gov/nchs/PRESSROOM/08newsreleases/mortality2006.htm)
I am at a loss to explain this, but it could mean the effect the Times found could be more robust than we know. It could be that, if people have to cut down on driving, cut down on meat, and do more things together, health will improve for quite a way down.

What do you think?
David
Re: Impact of recession on health <http://groups.yahoo.com/group/spiritof1848/message/13035;_ylc=X3oDMTJxbmJrcTRmBF9TAzk3MzU5NzE1BGdycElkAzM3MTc0NQRncnBzcElkAzE3MDUwNjExNDYEbXNnSWQDMTMwMzUEc2VjA2Rtc2cEc2xrA3Ztc2cEc3RpbWUDMTIzMTI0MTY4MQ-->
Posted by: "Merlin Chowkwanyun" [log in to unmask] <mailto:[log in to unmask]>
Mon Jan 5, 2009 4:02 pm (PST)
Nicholas Freudenberg et. al had an AJPH piece a few years ago using a
historical example (1975 NYC):

http://www.ajph.org/cgi/content/abstract/96/3/424

The Impact of New York City.s 1975 Fiscal Crisis on the Tuberculosis, HIV,
and Homicide Syndemic
Re: Impact of recession on health <http://groups.yahoo.com/group/spiritof1848/message/13036;_ylc=X3oDMTJxYnB0ZG0zBF9TAzk3MzU5NzE1BGdycElkAzM3MTc0NQRncnBzcElkAzE3MDUwNjExNDYEbXNnSWQDMTMwMzYEc2VjA2Rtc2cEc2xrA3Ztc2cEc3RpbWUDMTIzMTI0MTY4MQ-->
Posted by: "Robert Chernomas" [log in to unmask] <mailto:[log in to unmask]>
Mon Jan 5, 2009 4:49 pm (PST)
There is an extensive literature under the heading (can be found in
Google) "The Business Cycle and Mortality." Right-wing and Left-wing
economists have argued over the stylized facts. The issue here is
whether the current event will fit into a business cycle analysis or are
we in the midst of something mush deeper and longer.

Robert Chernomas
Re: Impact of recession on health <http://groups.yahoo.com/group/spiritof1848/message/13037;_ylc=X3oDMTJxNTZpY2gxBF9TAzk3MzU5NzE1BGdycElkAzM3MTc0NQRncnBzcElkAzE3MDUwNjExNDYEbXNnSWQDMTMwMzcEc2VjA2Rtc2cEc2xrA3Ztc2cEc3RpbWUDMTIzMTI0MTY4MQ-->
Posted by: "Sam Friedman" [log in to unmask] <mailto:[log in to unmask]>
Mon Jan 5, 2009 5:24 pm (PST)
I was about to point to this literature.
I would also point to examples of larger economic meltdowns, including
the horrific one in Russia in the 1990s, as leading to very bad health
outcomes. Also, that in many parts of Africa in the last 30 years.
sam
Re: Impact of recession on health <http://groups.yahoo.com/group/spiritof1848/message/13038;_ylc=X3oDMTJxaHBvcHU0BF9TAzk3MzU5NzE1BGdycElkAzM3MTc0NQRncnBzcElkAzE3MDUwNjExNDYEbXNnSWQDMTMwMzgEc2VjA2Rtc2cEc2xrA3Ztc2cEc3RpbWUDMTIzMTI0MTY4MQ-->
Posted by: "Nicholas Freudenberg" [log in to unmask] <mailto:[log in to unmask]>
Mon Jan 5, 2009 7:23 pm (PST)
A few weeks ago I posted a short article "Can the Economic Crisis
Create New Opportunities to Advance Public Health?" at Common
Dreams http://www.commondreams.org/view/2008/11/23-1. I ask whether
a progressive public health movement could win new support for
healthier policies during the economic crisis.

Nick Freudenberg


--

****************************************************************************

Dr Alex Scott-Samuel

EQUAL (Equity in Health Research and Development Unit)

Division of Public Health

University of Liverpool

Whelan Building

Quadrangle

Liverpool

L69 3GB

UK



Tel  (+44)151-794-5569

Fax  (+44)151-794-5588



http://pcwww.liv.ac.uk/~alexss

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