Back in July a friend and I debated the “cure worse than the disease” question: does restricting economic activity to control the coronavirus pandemic produce more suffering and death than just letting the pandemic run its course?
South Dakota’s state and local governments have taken the pro side of that argument. As a result, we saw 202 deaths from coronavirus in October. How many South Dakotans would have died if we had shut down the bars, restaurants, tourist attractions, and sporting events on which our economy depends?
Fewer than my friend would expect. Research has shown that recessions produce lower mortality rates:
VEDANTAM: In some ways, David, recessions seem to change the mortality rate, and not in the direction you might expect. I was speaking with the economist Erin Strumpf at McGill University. Along with Thomas Charters, Sam Harper and Ari Nandi, she studied the effect of the Great Recession a decade ago by looking at 366 metropolitan areas in the United States, which cover about 80 percent of the U.S. population.
ERIN STRUMPF: We find that in areas where the unemployment rate is growing faster, mortality rates decline faster. So during the Great Recession in the U.S., we saw increases in the unemployment rate of about 4-5 percentage points, so that translates to about 50,000 to 60,000 fewer deaths per year, the same order of magnitude as the number of people who die from influenza and pneumonia every year.
VEDANTAM: …We’ve seen similar effects in other recessions starting in the United States in the 1970s. Strumpf told me the biggest declines in mortality were in motor vehicle accidents and in heart attacks. Now, the traffic-death decline might be attributable to fewer people driving. Strumpf thinks the decline in heart attacks might have something to do with the stresses people experience at work or other lifestyle changes.
STRUMPF: When the economy is worse, people have less money to spend. They may go out and have unhealthy meals less often. They may smoke less or drink less. They may drive less. That’s kind of what people have in mind when they’re thinking about why increases in unemployment are linked to decreases in mortality [Shankar Vedantam, “Study: Great Recession Led to Fewer Deaths,” NPR: Hidden Brain, 2018.01.09].
People do suffer during recessions—ideally, we should avoid both economic declines and pandemics—but while there is some evidence of increased suicide in times of economic distress, those deaths don’t reverse an overall decrease in mortality:
While many people experience reduced stress, less risk of accidents, and lower disease burden as a result of economic downturns, others are still hit hard. Mental health deteriorates. Binge drinking booms. For some, stress-related conditions increase, and in the US, healthcare may become impossible to access for many. Suicide rates do seem to increase as a result of recessions—although both suicides and opioid-related deaths in the US have continued to increase even as the economy has recovered, and other factors play a role.
It’s a complex picture. In some arenas, mortality rates decrease; in others, they rise. Based on historical patterns, the health benefits appear to outweigh the costs in terms of sheer numbers of deaths [Cathleen O’Grady, “How Does Economic Collapse Alter the Mortality Rate?” Ars Technica, 2020.04.28].
One Australian study finds no correlation in Australia between unemployment and suicide or any other cause of death except one: higher unemployment is associated with fewer vehicle crash deaths. The Australian researchers note that countries like their own and Canada that offer universal health care don’t see major fluctuations in mortality tied to the business cycle because their guaranteed affordable health care protects people all the time.
Brag all you want about South Dakota’s relatively low unemployment numbers amidst the pandemic. The inescapable, research-based fact is that South Dakota’s business-über-alles philosophy is not consistent with our professed “pro-life” philosophy. We would save lives if we locked down portions of our economy and supported South Dakotans with coronavirus relief funds; the inevitable immediate economic recession would lead to lower mortality overall.