Trevor Hancock: A different perspective on COVID-19

There is no question COVID-19 is a serious issue. If we did nothing, hundreds of thousands of Canadians, especially older people, might die and the health care system would be overwhelmed, jeopardizing the health of many other people with other health problems. Flattening the curve will reduce the peak of the epidemic, spreading it out over a longer period of time. This also buys us time to find treatment or a vaccine.

So around the world today and across Canada borders are closed, as are schools, universities, libraries, rec centres, cafés, pubs and many businesses, large and small. Our communities and societies have been brought to a halt, or at least to a dramatic slowdown, and our economies are in a tailspin.

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But many might be concerned that the public-health and societal effort to contain COVID-19 comes at a huge cost to society, that it is triggering a global recession, that it might even lead to a depression. Could it even be the case that the social and economic disruption we create will kill or sicken more people than does the disease?

After all, the Great Depression in North America and Europe was a time of great misery and despair. Surely that was bad for health. Surprisingly, it seems that was not the case; in fact, the opposite was true.

A 2009 paper co-authored by a leading American social epidemiologist, Ana Diez Roux at the University of Michigan, examined life and death during the Great Depression.

They found “population health did not decline and indeed improved during the Great Depression of 1930-1933” and that death rates “decreased for almost all ages, and gains of several years in life expectancy were observed for males, females, whites and non-whites — with the latter group being the group that most benefited.”

This is not to say there are no ill-effects of a recession or depression. They note that among the six main causes of death, accounting for about two-thirds of all deaths in the 1930s, “only suicides increased during the Great Depression.” Today, at a time of industrial decay in some parts of the U.S., we have seen an increase in deaths from the “diseases of despair” — alcohol and drug use (especially opioids) and suicide — among lower-middle income middle-age men.

But contrary to our expectations, they note, “years of strong economic growth are associated with either worsening health or with a slowing of secular improvements in health.” Moreover, they added, this “was first noted decades ago, but was largely ignored until recently.”

The reasons for increased deaths during economic expansions, they report, include “increases in smoking and alcohol consumption, reductions in sleep and increases in work stress” as well as increases in “traffic or industrial injuries … [and] atmospheric pollution.”

As I have noted before, there are many businesses and many ways of making a profit that can harm health. Just recently, I reported that a joint WHO-UNICEF-Lancet Commission had identified commercial activities as one of the three greatest threats to children’s health, along with climate change and poverty; all are influenced by this COVID-19 recession.

Environmental scientists have already noted a dramatic reduction in air pollution and carbon emissions in China and Italy, and this will soon become worldwide. Indeed, Stanford University environmental resource economist Marshall Burke suggested in early March that the reduction in air pollution in China might have already saved more lives than the COVID-19 epidemic had cost.

We can already see the reductions in traffic on our local roads, which will not only reduce air pollution and carbon emissions but crashes and injuries.

If this goes on for months, as it might, we will likely see increasing need for government support for laid-off workers, strengthening support for some form of guaranteed income and/or shelter — basic requirements for health — is met. Coupled with that we can expect reduced demand for more “stuff,” as people adjust to lower incomes.

It might be that with this combination of reduced consumption and reduced environmental harm, coupled with societal commitment to ensuring the meeting of basic needs for all, we will find ourselves unintentionally creating the well-being economy we need in the 21st century.

thancock@uvic.ca

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