The Body Economic
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A. Vinokur, R. Price, and Y. Schul. 1995. “Impact of the JOBS Intervention on Unemployed Workers Varying in Risk for Depression,” American Journal of Community Psychology v23(1): 39–74; A. Vinokur, et al. 2000. “Two Years After a Job Loss: Long-term Impact of the JOBS Program on Reemployment and Mental Health,” J Occup Health Psychol v5(1): 32–47. ALMP strategies were tested at Michigan’s Prevention Research Center. The Michigan researchers introduced a JOBS workshop program in which 1,801 participants were randomly assigned to a job-search intervention or to a control group. This was the equivalent of a laboratory study, but done in the real world. It found that within two years, those who received job-search support were more likely to be working again, had higher monthly earnings, and lower risks of depression. Further research found that these persons were not simply jumping the queue to find jobs; ALMPs were helping to increase overall employment rates across countries.
17. Another way was that ALMPs help promote full employment. Some ALMPs had a component to work with firms to help them retain workers instead of making them redundant. This would help prevent a recession from leading firms to shed more jobs, so that fewer people were put in the risky situation of unemployment in the first place. As the World Bank defines them, “ALMPs have two basic objectives: (i) economic, by increasing the probability of the unemployed finding jobs, productivity and earnings; and (ii) social, by improving inclusion and participation associated with productive employment. As a consequence, they can contribute to increased employment opportunities and address the social problems that often accompany high unemployment.”
18. OECD Database on Social Expenditure. Available at: http://www.google.co.uk/url?sa=t&rct=j&q=&esrc=s&source=web&cd=2&cad=rja&ved=0CDoQFjAB&url=http%3A%2F%2Fstats.oecd.org%2Ffileview2.aspx%3FIDFile%3D91c26892-ed0b-41f6-bf61-fd46e39a40e8&ei=gZMOUc2JJqnD0QX75oCgDA&usg=AFQjCNG–faugVqOyVi1uaA1OX_9ZlYwMQ&sig2= qOCNRgH_F7x2unphGfzd8w&bvm=bv.41867550,d.d2k; http://www.oecd.org/els/employmentpoliciesanddata/36780874.pdf
19. L. Jonung and T. Hagberg, “How Costly Was the Crisis of the 1990s? A Comparative Analysis of the Deepest Crises in Finland and Sweden over the Last 130 Years,” European Commission. Economic Papers, 2005. Available at: http://ec.europa.eu/economy_finance/publications/publication692_en.pdf
See also L. Jonung, “The Swedish Model for Resolving the Banking Crisis of 1991–93. Seven Reasons Why It Was Successful.” Available at: http://ec.europa.eu/economy_finance/publications/publication14098_en.pdf
20. OECD Social Expenditure Database 2008 edition.
21. Source for Figure 7.3: D. Stuckler S. Basu M. Suhrcke, A. Coutts, M. McKee. 2009. “The Public Health Impact of Economic Crises and Alternative Policy Responses in Europe,” The Lancet v374:315–23.
22. Source for Figure 7.4: Stuckler, et al. “The Public Health Impact of Economic Crises and Alternative Policy Responses in Europe.”
23. Jonung and Haberg, “How Costly Was the Crisis of the 1990s?
24. Our colleague, the medical doctor Sir Michael Marmot, had already warned UK policymakers in 2011 that the “scale of youth unemployment was a public health emergency.” See Michael Marmot. 2011. “Scale of Youth Unemployment Is a Public Health Emergency, Marmot Says,” British Medical Journal. Available at: http://www.bmj.com/content/343/bmj.d7608?tab=related
25. For a version that is at the time of this writing available online, see “Recession and Unemployment Could Be Blamed for 1,000 More Suicides,” London Evening Standard, 2012. Available at: http://www.standard.co.uk/news/health/recession-and-unemployment-could-be-blamed-for-1000-more-suicides-8049459.html
26. Cited in B. Barr, D. Taylor-Robinson, A. Scott-Samuel, M. McKee, D. Stuckler. 2012. “Suicides Associated With the 2008–10 Economic Recession in En gland: A Time-Trend Analysis,” British Medical Journal v345:e5142. Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3419273/
27. H. Stewart, “Osborne’s Austerity Drive Cut 270,000 Public Sector Jobs Last Year,” The Guardian, March 14, 2012. Available at: http://www.guardian.co.uk/business/2012/mar/14/osborne-austerity-270000-public-sector-jobs
In Europe, policy discussions took a similar denialist tone. Nine times during sessions of EU Parliament, members of that parliament raised concerns about rising suicides. John Dalli, the EU Health Commissioner, said, “The Commission is aware of the article by David Stuckler et al [but] it needs to be taken into account that there is a range of different economic, social and health factors and causes involved.” In other words, the government was going to claim that the problem was so “multi-factorial” that there was nothing to do about it; the problem would just be buried in bureaucratic language. Another response by Mr. Andor, representing work initiatives, also noted that very little was being done. “The Commission is not aware of mental health support structures in Member States to address mental health problems arising specifically from unemployment. Public employment services can offer personalised support, which the Commission encourages.”
28. There was one further test to assess whether the relationship between ALMPs and suicidality was causal: whether a correlation from the past can predict what happens in the future. While we found that UK, US, and Spain were experiencing significant rises in economic suicides, we saw the mental health of Sweden’s population was protected from the Great Recession. During Sweden’s recession, GDP in the country fell by as much as in the US, but thanks to the ALMPs, unemployment rose to a lesser degree during the recession, from 6.1 percent in 2007 to 9.1 percent at the peak in 2010. Meanwhile there was no obvious impact on suicides. In 2007, Sweden’s suicide rates were 11.4 per 100,000 people under age sixty-five. In 2010, these rates had actually dropped, to 11.1 per 100,000 under age sixty-five.
29. D. Wasserman. Mental Health and Suicidal Behaviour in Times of Economic Crisis: Impact and Prevention. Mental Health and Suicidal Behaviour in Times of Economic Crisis: Impact and Prevention, Stockholm, Sweden, 2009.
Chapter 8: A Plague on All Your Houses
1. The bird deaths were “signaling the Apocalypse,” one resident proclaimed after the Sunday sermon at the Valley Baptist Church. “Local Men Suffer State’s First West Nile Deaths,” Bakersfield Californian, Oct 3, 2011. Available at: http://www.bakersfieldcalifornian.com/local/x651158822/Two-local-men-suffer-states-first-West-Nile-deaths
2. CDC. Symptoms of West Nile Virus. Available at: http://www.cdc.gov/ncidod/dvbid/westnile/qa/symptoms.htm
3. “Heat Death in Kern Country,” Bakersfield Californian, June 21, 2007. Available at: http://www.bakersfieldcalifornian.com/local/x1756813242/Heat-death-in-Kern-County
4. M. Engel, “Virus Linked to Foreclosures,” Los Angeles Times, Oct 31, 2008. Available at: http://articles.latimes.com/2008/oct/31/science/sci-westnile31
5. “Governor Declares State of Emergency for Kern County over West Nile,” Bakersfield Californian, Aug 2, 2007. Available at: http://www.bakersfieldcalifornian.com/local/x1018063026/Governor-declares-state-of-emergency-for-Kern-County-over-West-Nile-virus
W. K. Reisen, R. M. Takahashi, B. D. Carroll, R. Quiring. 2008. “Delinquent Mortgages, Neglected Swimming Pools, and West Nile Virus, California,” Emerging Infectious Diseases v14(11): 1747–49. Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2630753/
6. “Fight the Bite! City Gets Sprayed for West Nile Virus.” Available at: http://fightthebite.blogspot.com/2007/08/bakersfield-prepare-to-be-sprayed.html
7. S. Russell, “West Nile Virus Upturn Traced to Dry Climate,” SFGate, July 21, 2007. Available at: http://www.sfgate.com/health/article/CALIFORNIA-West-Nile-virus-upturn-traced-to-dry-2551675.php
8. RealtyTrac Staffforeclosure activity increases 81 percent in 2008. 2009. Available at: http://www.realtytrac.com/ContentManagement/pressrelease.aspx?ChannelID=9&ItemID=5681. Accessed May 5, 2009.
“Foreclosure Statistics for US, Mass., During Recession,” Boston Globe, Dec 2, 2012. Available at: http://www.bostonglobe.com/business/2012/12/02/foreclosure-statistics-for-mass-during-recession/GUf8zjEWw0xM3DQjhuY
arN/story.html
L. Christie, “California Cities Fill Top 10 Foreclosure List,” CNN Money, July 14, 2007. Available at: http://money.cnn.com/2007/08/14/real_estate/California_cities_ lead_foreclosure/index.htm; Reisen, Takashi, Carroll, Quiring, “Delinquent Mortgages, Neglected Swimming Pools, and West Nile Virus.”
One of the victims was ninety-six-year-old Marguerite Wilson. She didn’t have any standing water around her northeast Bakersfield home for mosquitoes to breed in, but must have been bitten around town. Her obituary described, “a college graduate in her 40s. A congressional intern in her 70s. A world traveller in her 90s.” Senator Roy Ash-burn, whose campaign she had supported, said “she defied age.” “It is hard to believe that a woman can make it through 96 years and then die from a bite from a mosquito,” her granddaughter said. Her traveling partner Diane Flynn reflected that “I really and truly wanted her death to spark an interest in mosquito abatement.”
9. Mosquitoes weren’t the only threat. In July 2008, Sheyenne Jenkins, a five-year-old girl, went out to play in the backyard of home in Avon, Indiana, while her grandparents were babysitting her. She wandered into the neighbors’ yard—a foreclosed home that had been abandoned with a backyard pool full of water. The pool’s cover, without anyone to tend to it, had begun to sag beneath the surface. Somehow, Sheyenne fell in. By the time that she was found, it was too late. “I’m angry that nothing was done. I’m angry that my daughter was taken away because nothing was done,” Sheyenne’s mother said. Repossessed homes were left by banks to fall into disrepair. As NBC News reporter Kerry Sanders put it, “Sheyenne’s tragedy is a worst-case example of the unintended consequences of foreclosure.” M. Celizic, “Foreclosed Homes’ Pools Can Be Death Traps,” NBC News, 2009. Available at: http://today.msnbc.msn.com/id/31795988/ns/today-money/t/foreclosed-homes-pools-can-be-death-traps/
10. Not just having a home, but the quality of the house and neighborhood impacts health. Damp, mold, and cold in substandard housing create the toxic living conditions that exacerbate childhood asthma and winter deaths. When people live in poorly ventilated, close quarters, it’s easier to spread airborne diseases such as tuberculosis. One RAND study in the 1990s compared neighborhoods that were equally deprived but found that those with substandard housing had a dramatic effect on increased risk of dying prematurely. Substandard housing and deprived neighborhoods have further been found to be linked to greater rates of child mortality, HIV and sexually transmitted diseases, diabetes, cardiovascular disease, violent deaths, among many other health threats. As one systematic review concluded, “Investment in housing can be more than an investment in bricks and mortar: It can also form a foundation for the future health and well-being of the population.” For more details see p. 11, Department of Health, 2010. Available at: http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/ @ps/documents/digitalasset/dh_114369.pdf
11. G. G. Bennett, M. Scharoun-Lee, R. Tucker-Seeley, “Will the Public’s Health Fall Victim to the Home Foreclosure Epidemic?” PLoS Medicine, 2009. Available at: http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1000087; D. Alley, et al. 2011. “Mortgage Delinquency and Changes in Access to Health Resources and Depressive Symptoms in a Nationally Representative Cohort of Americans Older Than 50 Years,” American Journal of Public Health v101(12): 2293–98. Available at: http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2011.300245
The researchers also controlled for pre-existing symptoms and behaviors (implying that these effects were truly related to the mortgage payment difficulties themselves, rather than being a mere correlation).
12. C. E. Pollack, et al. 2011. “A Case-Control Study of Home Foreclosure, Health Conditions, and Health Care Utilization,” Journal of Urban Health v88(3): 469–78. Available at: http://link.springer.com/article/10.1007%2Fs11524-011-9564-7?LI=true
13. J. Currie and E. Tekin, “Is There a Link Between Foreclosure and Health?” NBER Working Paper No. 17310, 2012. Available at: http://www.nber.org/papers/w17310.pdf; S. M. Kalita, “Tying Health Problems to Rise in Home Foreclosures,” Wall Street Journal, 2011. Available at: http://online.wsj.com/article/SB10001424053111904199404576538293771870006.html
Similarly, in the UK, emergency room visits rose but to a lesser degree, from 12.3 million emergency room visits to 13.8 million: http://www.hesonline.nhs.uk/Ease/servlet/ContentServer?siteID=1937&categoryID=1834
14. J. Nye, “How Foreclosures Ate America,” Daily Mail, Oct 2, 2012. Available at: http://www.dailymail.co.uk/news/article-2212071/How-foreclosures-ate-America-Incredible-interactive-map-shows-wave-property-repossession-past-years.html#axzz2KA5qnpGS. In January 2009, the month Obama came into office, there were 274,399 foreclosures nationwide, a figure which continued to its upward march to 341,180 in March 2010.
15. US Conference of Mayors, A Hunger and Homelessness Survey, 2007. Available at: http://usmayors.org/uscm/home.asp; see also http://www.nationalhomeless.org/factsheets/How_Many.html; quoted in P. Markee, “The Unfathomable Cuts in Housing Aid,” The Nation, Dec 4, 2011. Available at: http://www.thenation.com/article/165161/unfathomable-cuts-housing-aid
16. Unemployment, poverty, and foreclosure are three main risk factors for homelessness associated with the recession. Other factors include alcohol and drug use, mental health problems, and domestic violence. See National Alliance to End Homelessness. Foreclosure and Homelessness, 2013. Available at: http://www.endhomelessness.org/pages/foreclosure. A 2009 survey of homeless support organizations found that between 5 percent (the estimate of those working at homeless shelters) and 20 percent (the figure given by service-only providers) of their clients were homeless due to foreclosure. Foreclosures and Homelessness: Understanding the Connection. Institute for Children, Poverty, and Homelessness, 2013. Available at: http://www.icphusa.org/filelibrary/ICPH_policybrief_ForeclosuresandHomelessness.pdf
“Hunger and Homelessness Survey: A Status Report on Hunger and Homelessness in America’s Cities: A 25- City Survey,” The United States Conference of Mayors, 2008, p. 22.
US Department of Housing and Urban Development. The Third Annual Homeless Assessment Report to Congress (Washington, DC: US Department of Housing and Urban Development, 2007). Between 2006 and 2007, homelessness had dropped by 11 percent but with rising foreclosures in subsequent years, homelessness rates increased, reaching a new peak in 2009. A survey of twenty-five city mayors asked if they had adopted a policy to prevent homelessness among families whose homes were foreclosed; thirteen cities replied that they had but ten cities had not and two did not know.
M. W. Sermons and P. Witte, “State of Homelessness in America,” National Alliance to End Homelessness. Available at: http://b.3cdn.net/naeh/4813d7680e4580020f_ky2m6ocx1.pdf. The homelessness numbers are estimated slightly differently in this report for unsheltered homeless persons to account for a change in the classification of homeless persons that took effect with the implementation of HPRP. Two main homelessness estimates exist: point-in-time and prevalence. Point-in-time tends to understate the “transitional homeless,” persons who rapidly find shelter. To obtain a complete view of homelessness, it is also necessary to examine data on the number of persons who experience homelessness in a given year. Here we present both data sources. For prevalence estimates see HUD, The Annual Homeless Assessment Report to Congress. Available at: http://www.huduser.org/Publications/pdf/ahar.pdf
P. S. Goodman, “Foreclosures Force Ex-Homeowners to Turn to Shelters,” New York Times, 2009. Available at: http://www.nytimes.com/2009/10/19/business/economy/19foreclosed.html?pagewanted=all&_r=0
17. “Homeless Children: The Hard Times Generation,” CBS News, March 6, 2011. Available at: http://www.cbsnews.com/8301-18560_162-20038927.html
18. J. J. O’Connell, Premature Mortality in Homeless Populations: A Review of the Literature (Nashville, 2005). Similar risks were observed in the UK. One group studying single homeless people carefully sifted through the Coroner’s Courts records to obtain data from the inner-city ar
eas of London, Manchester, and Bristol from September 1995 to August 1996. From the courts’ detailed records, it was possible to obtain age, gender, place of death, causes of death, and events that led to death among 365 homeless persons. They were also able to link that data to hospital records, which had allocated people who were NFA (not fixed abode) without a postcode to a special code: “ZZ99 3VZ.”
A national UK audit of the homeless also found that four-fifths had a physical health problem, and about three-quarters had mental health issues, with similar patterns found in the US.
19. “Hunger and Homelessness Survey,” p. 45; Institute for Children, Poverty and Homelessness, “Foreclosures and Homelessness: Understanding the Connection,” 2013. Available at: http://www.icphusa.org/filelibrary/ICPH_policybrief_Foreclosuresand-Homelessness.pdf. We estimated that across the country there were about twenty-five homeless persons for each 1,000 foreclosures.