Do spending cuts cost lives?

Radical cuts to social welfare spending to reduce budget deficits could cause not just economic pain but cost lives, warn experts in a study published on bmj.com today. While there is a major debate under way about the potential economic impacts of radical budget cuts in Europe, David Stuckler from the University of Oxford and his colleagues dissect the effect of public spending on people's health.

Their analysis shows that levels of social spending in Europe are "strongly associated" with risks of death, especially from diseases relating to social circumstances, such as heart attacks and alcohol-induced illness.

As such, they argue that, although governments may feel they are protecting health by safeguarding healthcare budgets, social welfare spending is as important, if not moreso, for population health.

The team evaluated data on social welfare spending collected by the Organisation for Economic Cooperation and Development (OECD) from 15 European countries in the years 1980 to 2005. This includes programmes to provide support to families and children, help the unemployed obtain jobs, and support for people with disabilities, all of which could plausibly affect health.

They analysed the relationship between trends in these data and social spending. They found that when social spending was high, mortality rates fell, but when they were low, mortality rates rose substantially.

Based on their mathematical models, the researchers estimated that each £70 reduction in social welfare spending per person would increase alcohol-related deaths by about 2.8% and cardiovascular mortality by 1.2%, so that even modest budget cuts could have a significant impact on public health.

The researchers found spending on social welfare to promote health, and not simply healthcare, had the greatest impact on public health. However, they also found that reducing spending on non-welfare sources, such as military or prisons, had no such negative impact on the public's health.

"This result indicates that some aspects of population health are sensitive to spending on social support," say the authors. "Nevertheless, health and social welfare programmes appears to be a key determinant of future population health that should be taken into account in ongoing economic debates."

They add: "This report reveals that ordinary people may be paying the ultimate price for budget cuts - potentially costing them their lives. If we want to promote a sustainable recovery in Britain, we must first ensure that we have taken care of people's most basic health needs."

Source: BMJ-British Medical Journal