Global economic downturn linked with at least 260,000 excess cancer deaths

http://www.eurekalert.org/pub_releases/2016-05/htcs-ged052416.php

Public Release: 25-May-2016
Global economic downturn linked with at least 260,000 excess cancer deaths
Harvard T.H. Chan School of Public Health

The economic crisis of 2008-10, and the rise in unemployment that accompanied it, was associated with more than 260,000 excess cancer-related deaths--including many considered treatable--within the Organization for Economic Development (OECD), according to a study from Harvard T.H. Chan School of Public Health, Imperial College London, and Oxford University. The researchers found that excess cancer burden was mitigated in countries that had universal health coverage (UHC) and in those that increased public spending on health care during the study period.

•••••

"Higher unemployment due to economic crisis and austerity measures is associated with higher number of cancer deaths. Universal health coverage protects against these deaths. That there are needless deaths is a major societal concern," said Rifat Atun, professor of global health systems at Harvard Chan School and senior author of the study. He added that increased joblessness during the economic crisis may have limited people's access to health care, leading to late-stage diagnoses and poor or delayed treatment.

"Cancer is a leading cause of death worldwide so understanding how economic changes affect cancer survival is crucial," says lead author Mahiben Maruthappu from Imperial College London, UK. "We also found that public healthcare spending was tightly associated with cancer mortality--suggesting healthcare cuts could cost lives."

Although previous studies have shown connections between economic changes and rates of suicides, cardiovascular disease, and overall mortality, only a few had examined the relationship between economic downturns and cancer outcomes, especially in countries with underdeveloped social security and health care systems.

•••••

The researchers found that increases in unemployment were associated with increased mortality from all the cancer types included in the study. The association was strongest for treatable cancers, suggesting that lack of access to care may have been a factor in these excess deaths. Also, comparing estimates of expected cancer deaths with actual deaths from 2008-10, they found that the recent global economic crisis was linked with more than 260,000 excess cancer deaths among the 35 member states of the OECD alone.

Adverse health effects persisted for several years after initial increases in unemployment, the study found. In addition, excess cancer deaths were a more significant problem in middle-income countries than in high-income countries.

In countries with UHC--defined in the study as countries that have legislation mandating UHC, more than 90% health care coverage, and more than 90% skilled birth attendance--the link between unemployment and excess cancer deaths disappeared, suggesting that greater access to health care played a key role in mitigating the problem. Twenty-six OECD countries were listed in the study as having UHC, while nine--Barbados, Latvia, Lithuania, Malta, Mexico, Poland, Russia, the U.S., and Uruguay--did not have it.

Researchers also found that increases in public sector health spending helped blunt the negative health impact of unemployment increases.

•••••