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Austerity hits the very heart of our health, warns expert

Austerity policies directly affect public health, according to one of the UK's leading academics, driving up mortality rates and risking a long legacy of social problems.

Dr David Stuckler, a senior research leader at Oxford University, will tell an audience in Glasgow next week that austerity measures designed to tackle the global economic crisis are having a devastating impact across Europe and North America.

His book, The Body Economic: Why Austerity Kills, was published earlier this year and catalogues a host of health costs attached to policies brought in after the credit crunch.

Based on research into previous major economic downturns around the world, he and his co-author Sanjay Basu, of California's Stanford University, estimate there have been 10,000 extra suicides and a million additional cases of depression in Europe and America, as a result of the financial crisis.

Greece in particular is in the middle of a public health disaster, they argue, with soaring rates of HIV and malaria outbreaks while 35,000 health staff have lost their jobs.

Dr Stuckler is a key speaker at City Health 2013, a two-day conference at Glasgow's Science Centre, which is being organised by The Scottish Council for Voluntary Organisations (SCVO) and the social care charity Turning Point Scotland.

Running Monday and Tuesday, this is the second year the conference has been held after the inaugural event in London in 2012. It aims to cover a wide range of urban health issues, including sexual health, club drugs, alcohol policy, policing, sex work and harm reduction.

The conference will have a particular focus on the social factors affecting health, and aims to explore the future challenges for creating healthy cities.

Dr Stuckler's message directly contradicts the austerity policies pursued by the Chancellor George Osborne and the strategy of deep cuts to counter national debts in countries such as Greece.

He argues that recessions need not necessarily lead to a rise in mortality and other negative health outcomes. However, the policies pursued in response are critical. "Fiscal policy is a matter of life and death," he says.

In some cases, reduced incomes can cause people to be more healthy - walking instead of driving to save money, for example. Meanwhile, the evidence from previous recessions shows that investing in health, or in fiscal stimuli can help economies recover faster, he claims.

The book frames economic policy in public health terms. Indiscriminate cuts can turn hardship into an epidemic, Dr Stuckler says, while had austerity been assessed in the same way as a drug trial, the experiment would have been stopped due to the lethal side effects. Unemployment, he adds, should be treated like a pandemic. "It is a leading cause of suicide, alcoholism and heart attacks," he explains.

Even the International Monetary Fund, he points out, gave up its initial advocacy of austerity for economic recovery. "We underestimated the negative effect of austerity on employment and spending power," the IMF said following a policy review in 2012.

Previous downturns have been successfully followed by investment - the New Deal instituted by Franklin Roosevelt after the Great Depression, or the creation of the Welfare State and the NHS in the UK, Dr Stuckler points out. "Collectively, we seem to be losing sight of our history."

Dr Stuckler's talk comes after Sir Michael Marmot, warned this week that long-term youth unemployment was "storing up a public health timebomb waiting to explode".

Sir Michael, a University of London professor and chairman of the World Health Organisation's Commission on Social Determinants of Health, said too many children and young people were being failed on a grand scale.

"I would say to any government that cares about the health of its population: look at the impact of their policies on the lives people are able to lead and, more importantly, at the impact on inequality," he said.

"Health inequality is socially unjust, unnecessary and avoidable, and it offends against the human right to health."

The City Health conference will also hear from Professor Michel Kazatchkine, UN Special Envoy for HIV/Aids.

He will warn that increasing urbanisation is concentrating HIV infection in key population groups in the developing world.

He will say that, despite huge advances made in the fight against the epidemic over the past 30 years, policy makers have failed to make a difference among the worst affected populations, including sex workers, men who have sex with men, intravenous drug users and transgender people.

Dr Ingrid van Beek is director of Australia's Kirketon Centre, which provides services to drug users in Sydney. The centre was the first medically supervised injecting centre in the English speaking world.

Dr van Beek will talk at the conference about public health and public order, a week after the UK Government ruled out the establishment of so called "shooting galleries" in Britain.

City Health 2013 is at Glasgow Science Centre, November 4 and 5. See www.cityhealthinternational.org/2013 for details.

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