Flashcards in Austerity and health Deck (27):
What is austerity?
- Official actions taken by the government, during a period of adverse economic conditions, to reduce its budget deficit using a combination of spending cuts or tax rises
Why is austerity a danger to public health?
- Reduces the social safety net
Which areas saw the biggest cuts to their healthcare budgets after the 2008 crisis?
- The poorest were hit hardest
- Manchester- 1 in the health deprivation and disability rankings- lost £320 per head, Liverpool (number 2) lost £391 per head
- Elmbridge (number 321) gained £8 per head and South Bucks (number 322) lost £2 per head
What are the 4 ways in which austerity impacts health?
1. Suicide and self harm
2. Mental health
3. Maternal mortality and mortality in older adulthood
4. Access to healthcare and use of foodbanks
What has been the trend in suicide for economic reasons? (4 countries)
- In 2007/8 in Greece huge increase in men and women of working ages suicide rate- has continued increasing
- In Italy prior to the crisis suicide was increasing at a rate of 10.2 per year, jumped to 53.9 per year in 2008 (De Vogli et al, 2013)
- UK significant upward trend in suicide rate among men aged 45-59 since 2008- highest rates in north east
- In the US suicide rates mirrored unemployment rates
How can recession lead to suicide? (8)
(Haw et al, 2015)
- Threat of job loss
- Bankruptcy/ financial difficulties
- Loss of home
- Loss of savings
- Cuts in healthcare
- These can cause debt, strain on relationships and social isolation
- Possible predisposition to mental illness
What is the trend in self reported mental health problems?
- Slow increase between 2004 and 2008
- From 2009 the rate of increase of self reported mental health problem increased much faster
- Employed people much less likely to report mental health problems
(Barr et al, 2015)
Give qualitative evidence on the impact of austerity on self harm?
(Barnes et al, 2016)
- 19 people who had attended hospital for self harm in the UK who specifically cited economic hardship, job loss or austerity as reasons
- Economic hardships often the last straw
- Bedroom tax especially or benefit cuts particularly harmful
How did the UK governments cut in housing benefit impact health?
(Reeves et al, 2016)
- April 2011
- Cuts to financial support for those renting in the private sector
- among those receiving housing benefit the numbers reporting symptoms of depression increased by c. 26,000.
- Especially in London because rents are so high
- Also likely to have increased homelessness- physical and mental health consequences
What is the link between homelessness and health?
(Homeless Link, 2010)
- 41% of homeless people reported long term physical health problems (28% gen. population)
- 45% have been diagnosed with a mental health problem (25% gen pop.)
- 36% had taken drugs in past 6 months (5% of gen pop.)
How did austerity impact maternal health?
- After cuts in gov. healthcare funding risks in maternal healthcare
- Maternal mortality rates in the EU (1981-2010) were significantly elevated up to 1 year after reductions in government healthcare spending
How did austerity impact pensioner mortality rates?
(Loopstra et al, 2016)
- Each 1% reduction in pension credit spending is associated with a 0.68% increase in mortality
- Increase in mortatlity rate in 2011 after long term reduction after pensioner credit fell
How does healthcare access differ between the rich and poor and what is the trend in this?
- rich more likely to have their healthcare needs met than the poor
- difference increased between 2008 and 2009
- Richest quintile had fairly steady line of needs being met but poorest quintile increased rapidly between 2008 and 2013 (7.0 -> 13.9)
What happened to the percentage of patients seen in four hours or less?
- Between 2005 and 2010- 96%
- Started falling in 2011 and in first quarter of 2019 was 76.8%
How has austerity impacted healthcare in Greece?
- Low on basic supplies - i.e. gloves, syringes, gauze, cotton wool and paper supplies
- Numbers of doctors and nurses is critically low
- Free healthcare is only available for one year after losing a job so 2.5 million Greeks are unable to access healthcare
- Screening for diseases is down
- Patients are arriving at the doctors in the later stages of diseases after being unable to access primary care
- Has been an increase in TB and Malaria since 2008
- Relying on volunteer doctors
What cuts did the torys make during austerity?
- lowered social welfare budgets
- Reassess for disability benefits
- Welfare reform act
- Overall £85bn in cuts
Why did mental health issues increase in women more than men?
- precarious work disproportionately impacts women
How do we know that it's austerity that caused mental health problems not just the recession?
- when the recession ended mental health problems kept rising
How have GPs seen austerity impact health?
- 63% of GPs saw patients health be affected by a decrease in benefits
- 94% saw their workload increase due to patients financial hardship
What is food poverty?
- 10% or more of income is spent on food
- 4.7million people in the UK live in food poverty (Garthwaite, 2015)
- 500,000 ppl food insecured
How has malnutrition increased?
- In 2013 there was a 19% increase in hospitalisation for malnutrition
What are the 2 usual triggers for foodbank use?
- people with precarious housing circumstances
- people experiencing financial difficulties due to social security benefit changes
How are foodbank users criticised?
- Seen as undeserving
- Seen as choosing unhealthy foods- but healthy and fresh foods too expensive (wastage)
How is foodbank usage caused by health issues in some cases?
- Some people have mental health issues or health appointments which mean they miss benefit appointments and then get sanctioned
How can foodbank use cause health problems?
- You don't necessarily get the foods you need at a foodbank- e.g. gluten free
- food banks are also on a budget so struggle to buy healthy foods
- people get all their food at once so often run out by the end of the week
How many people used foodbanks in 2013?
- Almost 1 million people got food from Trussel trust
- Triple the amount of people than in 2012