Some states are beginning to open after the unprecedented shutdown of our country’s economy.
We recognize that this must be done safely, but I have been amazed at the lack of urgency about striving to return to normal times in some quarters. In other quarters, people are desperate to return to work.
It is essential that we recognize that COVID-19 is not our only health threat. On April 3, when we were three weeks into the shutdown, Reuters did a story on the long-term health toll the shutdown, especially if it drags on for a long time.
“Throwing millions of people out of work,” Reuters warns, can have dire health consequences—depression, domestic violence, more suicides, bad outcomes for students who can’t go to school, and ironically, the crippling of our public health system when it comes to needs other than those caused by COVID-19.
The longer the suppression lasts, history shows, the worse such outcomes will be. A surge of unemployment in 1982 cut the life spans of Americans by a collective two to three million years, researchers found.
During the last recession, from 2007-2009, the bleak job market helped spike suicide rates in the United States and Europe, claiming the lives of 10,000 more people than prior to the downturn. This time, such effects could be even deeper in the weeks, months and years ahead if, as many business and political leaders are warning, the economy crashes and unemployment skyrockets to historic levels.
There are signs of an upswing in domestic violence:
Domestic violence programs across the country have cited increases in calls for help, news accounts reported – from Cincinnati to Nashville, Portland, Salt Lake City and statewide in Virginia and Arizona. The YWCA of Northern New Jersey, in another example, told Reuters its domestic violence calls have risen up to 24%.
“There are special populations that are going to have impacts that go way beyond COVID-19,” said Ray-Jones, citing domestic violence victims as one.
I’ll bet you didn’t think missing school can shorten the lifespan, but Reuters reports:
High school students who miss at least three days a month are seven times more likely to drop out before graduating and, as a result, live nine years less than their peers, according to a Robert Wood Johnson Foundation report.
Unemployment is a more obvious health threat:
In Europe and the United States, suicide rates rise about 1% for every one percentage point increase in unemployment, according to research published by lead author Aaron Reeves from Oxford University. During the last recession, when the unemployment in the United States peaked at 10%, the suicide rate jumped, resulting in 4,750 more deaths. If the unemployment rate increases to 20%, the toll could well rise.
“Sadly, I think there is a good chance we could see twice as many suicides over the next 24 months than we saw during the early part of the last recession,” Reeves told Reuters. That would be about 20,000 additional dead by suicide in the United States and Europe.
Reuters quotes an expert suggesting that the notion that we are rallying around to help in a national cause might prevent some suicides. However, the Air Force Academy reduced some of its shutdown restrictions after two apparent suicides in March.
Perhaps the strangest threat to our health is that, in the name of COVID-19, we may be destroying the finest health system in human history:
Local health departments run programs that treat chronic diseases such as diabetes. They also help prevent childhood lead poisoning and stem the spread of the flu, tuberculosis and rabies. A severe loss of property and sales tax revenue following a wave of business failures will likely cripple these health departments, said Adriane Casalotti, chief of government affairs with the National Association of County and City Health Officials, a nonprofit focused on public health.
After the 2008 recession, local health departments in the U.S. lost 23,000 positions as more than half experienced budget cuts. While it’s become popular to warn against placing economic concerns over health, Casalotti said that, on the front lines of public health, the two are inexorably linked. “What are you going to do when you have no tax base to pull from?” she asked.
Carol Moehrle, director of a public health department that serves five counties in northern Idaho, said her office lost about 40 of its 90 employees amid the last recession. The department had to cut a family planning program that provided birth control to women below the poverty line and a program that tested for and treated sexually transmitted diseases. She worries a depression will cause more harm.
“I honestly don’t think we could be much leaner and still be viable, which is a scary thing to think about,” Moehrle said.
We ignore these health threats at our peril.