Though I’m really a biologist, I have been nurturing an interest in medicine for a while now, especially public health and epidemiology, more as a social concern than an academic interest. I am also a socialist and a Labour Party member (though through gritted teeth at the moment). Therefore, Stuckler and Basu’s book on the public health consequences of austerity appealed to me from its place on a shelf in my public library both on political and medical grounds, and they fuse these disciplines well to formulate the rarest of things, an evidence based economic argument.
My government has been pursuing austerity measures since 2010 (though God knows how long this will continue with Brexit-related chaos). This means that the government’s spending in areas such as social security payments and public services have been reduced, with particular severe reductions in the number of disabled people receiving government welfare payments. The government claims that this was done in order to reduce the government’s deficit, so that foreign investors gain confidence in the British economy and invest in it, growing the economy. So, it is argued, for the good of the future economy, citizens must be inconvenienced in the present. However, things are not so simple as this. Stuckler and Basu present data supporting the economic arguments against austerity; that as government spending creates economic growth principally by paying people so they have more money to buy things, cutting government spending reduces growth. This line of argument is nothing new, but Stuckler and Basu go beyond this line of argument by calling into question the idea that economic growth should be the supreme value of a government, for which everything else must be sacrificed. Rather, we say “We’ll always have our health” for a reason.
Many on the left have an instinctual repulsion against austerity measures, not because they know the consequences to be detrimental, but rather because allocating resources towards rebuilding the economic system rather than helping people is seen as inherently inhumane. “People Before Profit” has been written on a thousand placards across the land. This argument can be criticized by conservatives as over-emotional and unrealistically short-term, the state must be cut back to ensure future prosperity. Aye, there’s the rub.
Basu and Stuckler summarise studies (many of which they have been involved with) suggesting that, whilst economic recession often leads to better health outcomes for a population (largely due to lack of money leading to lower cigarette and alcohol consumption in most cases), a government responding to a recession of a similar magnitude in a similar situation with austerity (for example, in the US states which eschewed Roosevelt’s New Deal Policy) will have a lower life expectancy and a greater burden of disease than populations whose government responded to recession by stimulating the economy by spending more on public projects as seen in the comparable US states which embraced the New Deal. They detail many different examples of this situation occuring, from the high suicide rates in Russia following the collapse of communism and the adoption of radical austerity measures, or “Shock Treatment”, leaving whole villages and towns depleted of men compared to the “unshocked” Belarus. As a biologist interested in the ecology of disease, the fact of the book had to be the tracing of an unusually high number of West Nile Virus cases in Bakersfield, California in 2007 to the subprime mortgage crisis. This is because West Nile Virus is transmitted to human by the Culex mosquito, which lays its eggs in water. 2007 was a drought in Bakersfield, so there shouldn’t have been a low incidence of West Nile Virus, as the Culex population would be lower. However, as many homes were abandoned due to foreclosure after the homeowners could not keep up with their mortgage payments, the swimming pools of these houses were given over to nature, and to the mosquitos. The mosquito population boomed using the foreclosured swimming pools as nurseries, and more people got sick. From an epidemiological standpoint I find it fascinating that disease outbreaks can be traced to such unconventional sources as abandoned swimming pools. It shows how all environments are on a knife edge, and if altered due to ecological or economic reasons, disease can proliferate.
Therefore, Basu and Stuckler show simultaneously that austerity is bad for the economy and bad for health, but by doing so they turn on its head the principle behind austerity. I take from this book that governments proposing austerity as a way of economic recovery irregardless of the evidence provided by economists such as Basu and Stuckler are pursuing a harmful neoliberal ideology rather than good policy to the benefit of the citizens. I am lead to ask, what is a government for? My government seems to acting for what it thinks is the good of the economy, so places the well-being of its citizens in jeopardy by cutting welfare payments and chipping away at the NHS. This is utterly perverse, as to value the economy over the health of citizens is fundamentally undemocratic. A government that acts for the good of the people should do all it can it maximise their health and wellbeing in a financial, social and psychological sense based on sound evidence. A government that ignores such evidence in pursuit of ideology is fundamentally inhumane.