What happens to people’s health and well-being when whole continents suffer economic decline, and millions of people become exposed to the strains of poverty? For nearly a decade, the Great Recession has presented researchers with a disturbing natural experiment in public health, and emerging data shows that cancer’s death toll rose along with social hardship.
Yet the groundbreaking study, just published in The Lancet, also suggests the health impacts of a financial collapse can be offset by healthcare policies that protect against the economic assault.
The analysis of disease trends in more than 70 nations shows cancer mortality rose by more than 263,000 deaths specifically in the wealthy countries of the Organisation for Economic Co-operation and Development, following the recession from 2008–10. Focusing on “treatable” varieties, like breast and prostate cancer, and less treatable cancers, researchers linked excess cancer deaths to rising, recession-induced unemployment.
But despite elevated cancer mortality, in countries with universal healthcare systems, the trend was much diminished or negligible. Most excess deaths for treatable cancers were concentrated in countries without universal healthcare coverage. In countries with guaranteed coverage, however, “access to health care is less problematic than in non-[universal healthcare] countries, where access is often provided by means of an employment package.” That finding may seem obvious, but it’s a lesson US policymakers keep ignoring.
A more specific, yet-unpublished dataset, co-author Mahiben Maruthappu tells The Nation, reveals that the United States “saw about 18,000 [excess cancer] deaths during that time, whereas the United Kingdom saw zero [excess] deaths…which we believe is likely or possibly due to the fact that in the US, there isn’t universal health coverage.” Similarly, higher public healthcare investment helped mitigate the negative effect of the recession on cancer death rates, regardless of unemployment trends.
The study did not explicitly compare different healthcare policies across countries, and so did not weigh relative benefits of a single-payer system, such as the United Kingdom’s National Health Service, or universal insurance, like Switzerland’s nationwide private-insurance system. Universality of services was the key. The findings demonstrate the obvious: Even amid economic disaster, even for deadly diseases like cancer, your medical fate improves significantly when access to care does not hinge on whether you happen to be gainfully employed at a business that provides a health plan. (The two-year research period also does not capture the more recent implementation of the Affordable Care Act, so coverage was significantly lower then in the United States.)