The article, written by Professor Tony Blakely and Dr Melissa McLeod, of the University of Otago, Wellington, bases its predictions on both international studies and research on the impacts of structural reforms in New Zealand during the late 1980s and early 1990s.
The article warns that the current global economic crisis will have health consequences for the New Zealand population.
“As in the 1980s and 1990s, the distribution of health impacts is likely to be concentrated in those who are already socio-economically deprived, and in ethnic minority groups,” says Professor Blakely.
“The unemployment rate is projected to reach levels two thirds of those in the early 1990s, and there is already evidence that the burden is again likely to be unevenly distributed across ethnic groups.
“As of September 2009, the overall unemployment rate sits at 6.5%, but is 14.2% and 12.3% for Māori and Pacific people, compared to 4.5% for European New Zealanders.
“However, as long as we do not allow our social and health system policies to regress to the neoliberal policies of the 1980s and 1990s, we are much better positioned to weather the deleterious impacts of the recession on the health of New Zealanders,” says Professor Blakely.
Ways the current recession might impact on health include through unemployment, lowered incomes, and reorganisation of health and social policies in the face of funding constraints.
He says Māori life expectancy stagnated in the 1980s and early 1990s, while non-Māori life expectancy showed strong increases.
The structural reforms of the 1980s and early 1990s, and in particular the high unemployment rates that peaked in 1991-92 at 25% for Māori compared to 8% for European, almost certainly contributed to the divergence of Māori and non-Māori life expectancy trends in the 1980s and 1990s.
In times of high unemployment, ethnic minority groups and low socio-economic groups are inevitably most at risk of losing employment. These groups, and those unemployed before the recession, are also less likely to gain employment when the job market is flooded with relatively more educated potential employees.
Lower incomes are also likely to result in a reduction in the ability of households to afford healthy food. Lower incomes could also lead to accommodation overcrowding, particularly among Māori/Pacific Island and lower socio-economic households, and a reduction in the affordability of healthcare, such as doctor’s visits and prescriptions.
The article also discusses concerns about the impact of possible health system reorganisation and funding cuts, and cuts affecting housing, education and social services, as a result of reductions in Government spending.
“We are currently restructuring our health system. Many of the proposed changes are sensible and welcomed. But we must be very careful to not unwind the gains of the last ten years, and in particular make sure that a renewed Government emphasis on efficiency does not cause health inequities to widen again,” Professor Blakely says.
An example of health system changes includes the establishment of a National Health Board that well attempt to co-ordinate nationally even provision of public health and health cares services.
Professor Blakely says rigorous and fair allocation and decision-making will be essential. For example, as cardiovascular disease mortality continues to fall, access to expensive cancer treatments will come under increasing focus.
“In light of international evidence, and the New Zealand case study of the 1980s and 1990s, it is also critical that we keep our social welfare system strong, to buffer the impacts of unemployment and income loss,” says Professor Blakely.
Professor Tony Blakely
University of Otago, Wellington
Senior Communications Advisor
University of Otago
Tel 64 3 479 8263