Authors suggest that uncertainty and negative expectations generated by the recession rather than unemployment might explain the changes seen.

Published (Updated )

The 2008 Great Recession resulted in changes to individuals’ health behaviour, with a significant increase in the likelihood of obesity, diabetes and mental health problems, according to a new study from City, University of London and King’s College London.

In particular, the researchers discovered that the probability of being obese and severely obese increased by 4.1 and 2.4 percentage points respectively. Similarly, the probability of having diabetes was 1.5 percentage points higher after 2008, with the prevalence of mental health problems increasing by 4 percentage points.

It was also found that there was a decrease in smoking and drinking, as well as fruit intake. These changes were also seen to impact particularly on women and those less educated, with the authors suggesting that uncertainty and negative expectations generated by the recession rather than unemployment might explain the changes seen.

Healthcare implications

The findings are also relevant for policymakers and clinicians, as universal health coverage and free provision of healthcare - and prescriptions in some cases - via the NHS might have worked as a protective factor during economic hardship.

However, the authors point out that as some health outcomes deteriorate during recessions, demand for health services might increase, leading to longer waiting times that can further worsen any negative effects. An increase in welfare benefits is another factor that may have protected people during the recession.

The reductions in smoking and drinking are also relevant given that lifestyle-related health problems cost the NHS £11 billion a year, but the authors emphasise that the right level of support from health specialists needs to be delivered if these positive behavioural changes are to be preserved beyond the duration of economic downturns. The research is published in the journal Social Science & Medicine.

The Great Recession

As the second largest economy in the EU and one of the largest financial hubs in the world, the UK was one of the countries hit the hardest by the Great Recession in 2008. The UK shrunk by 4.3% in 2009 alone and the government had to bail out and nationalise large domestic banks, leading to increased government debt and deficit.

To explore this issue and its impact on health, the researchers looked at data from the Health Survey for England (HSE), a cross-sectional survey taken yearly from a representative sample of about 9,000 English households. They specifically used data on respondents above 16 years of age for the period 2001–2013. In addition to socio-economic characteristics, the HSE includes information on a wide range of health lifestyles and health conditions.

The results of the study suggest that the start of the recession was associated with worse dietary habits and increased BMI and obesity. It was also associated with a shift away from risky behaviours, as a decrease in smoking and alcohol consumption was seen. In addition, there was an increase in the use of medicines and a higher likelihood of suffering diabetes and mental health problems, all of which were generally experienced more acutely by those with less education and by women.

Professor Mireia Jofre-Bonet from the Department of Economics at City, University of London and lead author of the study, said:

"Our study confirms the close relationship between health and the economic environment as we found that the 2008 Great Recession led to a decrease in risky behaviour, such as smoking and drinking, but also an increase in the likelihood of obesity, diabetes and mental health problems.

With the NHS and health-related services under increasing pressure – and with another recession becoming increasingly likely - our findings have a number of important policy considerations. In particular, the fact that those less educated were more vulnerable to the health effects of the recession highlights the need for an urgent policy response as it is clear that this population need to receive information on health behaviours and risk factors to avoid the negative consequences and also the potential future impacts."

Mireia Jofre-Bonet, Victoria Serra-Sastre, Sotiris Vandoros (2018). The impact of the Great Recession on health-related risk factors, behaviour and outcomes in England. Social Science & Medicine

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