Austerity and suicide: are we placing health before wealth?

Protesters clash with policemen during riots at a May Day rally in Athens May 1, 2010. Angry protesters set fire to garbage cans and two TV outside broadcast vans in Athens as thousands of Greeks marched through the capital on May Day to protest against austerity measures they say only hurt the poor.  REUTERS/Icon/Panagiotis Tzamaros  (GREECE - Tags: POLITICS BUSINESS CIVIL UNREST EMPLOYMENT IMAGES OF THE DAY) GREECE OUT. NO COMMERCIAL OR EDITORIAL SALES IN GREECE

In April 2012, Greece was shocked by the suicide of a 77 year old pensioner, a retired pharmacist who shot himself outside the parliament building in Athens. In a note, he stated that he had decided to end his life as he did not want to be reduced to foraging in bins for food. The suicide encapsulated the despair of many of the older generation in Greece. In this period, pensions and other benefits were cut by up to 25% as part of the conditions of the loans that the government received to tackle the sovereign debt crisis. Prior to the economic crisis Greece had one of the lowest suicide rates in the EU.

As the authors of an important recent paper note, austerity has been discussed in terms of broader economic and social policy (Antonakakis et al, 2016). There has been little specific consideration of its impact on suicide mortality. The paper examines trends across five countries in the “Eurozone periphery”: Greece, Italy, Ireland, Portugal and Spain.

In 2008, following the global financial crisis, many countries experienced an increase in government debt and budget deficits. This led to interventions by both individual governments and the so- called “Troika”; the European Commission (EC), the European Central Bank (ECB) and the International Monetary Fund (IMF). In return for bailout packages to tackle the crisis, the Troika imposed draconian monetary policies. These included large cuts in public and welfare spending, tax increases, privatisation of services and changes to labour laws. This package of policies has become known as fiscal austerity. The introduction of fiscal austerity was controversial as it was argued that it would prolong the recession rather than shortened it.

As the paper notes, in the period 2009-2013, the unemployment rate in these five countries increased by 186.5%. Youth unemployment increased by 126.8% (in Spain it was over 50%). These figures are well above the rates in other Eurozone countries. The suicide mortality rate tends to increase in periods of high unemployment particularly if there are also reductions in the provision of welfare.

This paper sets out to investigate:

the effects of fiscal austerity, among other socio-economic control variables, on suicide rates in all Eurozone peripheral countries over the period 1968-2012.

This new study seeks to shed some light on the relationship between fiscal austerity and suicide.

This new study seeks to shed some light on the relationship between fiscal austerity and suicide.

Methods

The researchers collected annual statistics for suicide for the five countries in the period. A suicide rate per 100,000 of the population was produced. This overall figure was then broken down by age and gender.

The study methodology sought to control for various economic and socio-demographic differences.

For the purposes of this study, the principal measure for fiscal austerity was government expenditure, although the study does include some alternative proxies of fiscal austerity in their “robustness analysis”.

Results

The major finding from the study is that fiscal austerity has had an impact on the suicide rate in these countries. The authors conclude that these policies of retrenchment have short-, medium- and long-term impacts on the suicide rates of males aged 65-89. A 1% reduction in government spending is associated with increases of 1.38%, 2.42% and 3.32% in the short, medium and long-term male suicide rates.

Implications

Suicide is a very complex and multifactorial event, which needs to be examined in its societal context. Clearly, this study does not prove a causal link between fiscal austerity and a rise in suicide rates, but these results should be added to the wider pool of evidence that is considered by Governments, policy makers and citizens.

Other studies do provide some evidence on a single-country level (again looking at Greece) of the relationship between economic austerity and suicidal behaviour (Antonakakis et al, 2014; Branas et al, 2015). However, much more detailed work needs to be done to rule out potential confounders.

The debates about economic policy can often be dry and arid. For non-specialists, like myself, the sovereign debt and Eurozone crises are presented in very technocratic language. This research goes behind these debates to examine the reality of what happens when the social welfare programmes are cut so severely in such a short period.

This paper can be read alongside the work of Marmot and Pickett and Wilkinson, which show that policy making has to have health and social justice at its heart.

Further evidence is needed before we can be sure of the link between fiscal austerity and suicidal behaviour.

Further evidence is needed before we can be sure of the link between fiscal austerity and suicidal behaviour.

If you need help

If you need help and support now and you live in the UK or the Republic of Ireland, please call the Samaritans on 116 123.

If you live elsewhere, we recommend finding a local Crisis Centre on the IASP website.

We also highly recommend that you visit the Connecting with People: Staying Safe resource.

Links

Primary paper

Antonakakis N, Collins A. (2016) The impact of fiscal austerity on suicide mortality: Evidence across the ‘Eurozone periphery’, Social Science & Medicine, Volume 145, November 2015, Pages 63-78, ISSN 0277-9536. http://dx.doi.org/10.1016/j.socscimed.2015.09.033

Other references

Antonakakis N, Collins A. (2014) The impact of fiscal austerity on suicide: on the empirics of a modern greek tragedy. Soc. Sci. Med. 112, 39e50. http://dx.doi.org/10.1016/j.socscimed.2014.04.019

Branas CC, Kastanaki AE, Michalodimitrakis M, Tzougas J, Kranioti EF, Theodorakis PN, Carr BG, Wiebe DJ. (2015) The impact of economic austerity and prosperity events on suicide in Greece: a 30-year interrupted time-series analysis. BMJ Open 1, 1e11.

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Ian Cummins

Ian Cummins

Ian is Senior Lecturer in Social Work at the University of Salford. Before taking up an academic post, Ian Cummins worked as a probation officer and subsequently an approved social worker in Manchester for over ten years and is a registered social worker. He has acted as a reviewer for the Routledge Criminology, British Journal of Social Work, Journal of Social Work Education, International Journal of Social Work, Journal of Forensic Psychiatry and Psychology, Journal of Academy of Social Science and the Journal of Adult Protection and Transgressive Culture. He has acted as a reviewer of research bids for the National Institute for Health Research Central Commissioning Facility and is a member of the editorial board of the Journal of Adult Protection. The main themes of his research are policing and mental illness in the era of mass incarceration and the cultural representation of policing.

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