The global economic downturn of 2008-2010, accompanied by a sharp rise in unemployment, is associated with more than 260 000 excess deaths due to cancer, many of which are considered treatable. The excess of deaths from cancer was lessened in countries with universal health care (UHC) and in countries in which public spending on health care increased during the study period.1
“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, MD, MBA, professor of global health systems at Harvard T.H. Chan School of Public Health, Boston, Massachusetts, and senior author of the study.
Increased unemployment during the economic crisis could have limited access to health care, resulting in late-stage diagnoses and poor or postponed treatment.
Researchers used data from 1990 to 2010 of more than 70 high-income and middle-income countries to assess the connections between unemployment, public health care spending, and cancer mortality rates. For the study, a cancer was considered treatable if survival rates exceed 50%, such as breast cancer in women, prostate cancer in men, and colorectal cancer in men and women. Untreatable cancers were those with 5-year survival rates below 5%, such as lung and pancreatic cancers in both men and women.
Increased joblessness was associated with increased mortality from all types of cancer examined in the study. This correlation was strongest for treatable cancers.
When researchers estimated expected deaths due to cancer and actual deaths due to cancer in 2008-2010, they revealed that the global economic crisis resulted in more than 260 000 excess cancer deaths.
In countries in which legislation mandated UHC and in which there was more than 90% health care coverage and more than 90% skilled birth attendance, the association between unemployment and excess cancer deaths vanished.
Increased health spending in the public sector also weakened the correlation between increased joblessness and negative health consequences.
Limitations of this study include that it was not truly global because of the paucity of data from China, India, and low-income countries. In addition, these results are correlative and cannot draw conclusions about causality.
1. Economic downturns, universal health coverage, and cancer mortality in high-income and middle-income countries, 1990-2010: a longitudinal analysis [published online May 25, 2016]. Lancet. doi:10.1016/S0140-6736(16)00577-8.