The hidden costs of austerity

In making deep budget cuts, politicians are experimenting with the health of nations, not just their wealth

ECONOMIC austerity seems here to stay ? at least for the foreseeable future. Any hope that a sharp dose of belt-tightening would quickly give way to resurging prosperity has melted away. And like an impolite house guest outstaying their welcome, its demands seem ever more burdensome as time goes on.

The longer austerity lasts ? and it is only just getting under way in earnest in some countries, such as the UK ? the greater the toll on our most vulnerable citizens. It is no surprise that this will affect their health.

Eurozone countries have already provided object lessons in just how severe such effects can be: the incidence of mental illness has shot up, long-vanquished infectious diseases are making a comeback, and people have been driven to extraordinary lengths to obtain even basic medical supplies from failing healthcare systems (New Scientist, 26 May 2012, p 6).

Even in the cautiously optimistic US, researchers from the Center on Budget and Policy Priorities in Washington DC have warned that budget cuts mean up to 750,000 people living in poverty could lose access to a vital supplemental nutrition programme.

And as we report on "Cost of cuts: Austerity's toxic genetic legacy", the immediate consequences of austerity may give way to more enduring and insidious effects on health. It is plausible that protracted economic hardship will lead to increases in heart attacks, strokes and depression. Stress hormones are known to trigger or exacerbate these conditions, and it is hard to argue that those worrying about the security of their jobs, homes, families and finances are not experiencing high levels of stress.

The studies of stress conducted so far relate mostly to people who suffer from loneliness and social exclusion. They show that it causes wholesale reprogramming of genes in white blood cells, which in turn drives chronic inflammatory conditions. We also know that growing up in deprived conditions reshapes genes for life, and there is suggestive evidence that stressful events early on ? perhaps even before birth ? may become "biologically embedded" via altered gene activity.

If we can find behavioural or pharmacological ways to "switch off" the adverse gene programming, we may be able to mitigate the harm. But the research is still at an early stage, and some of the key findings so far relate to animals, not people.

We also don't know if the findings apply to the kinds of stresses we are enduring. It's conceivable that the prevailing social conditions affect people's response: the stresses of war against a common foe might be very different to those of a socially divisive financial crisis, for example. Or it might be that stress is stress, biomedically speaking.

Much ink has been spilled debating the fiscal merits of austerity. Its effects on health, on the other hand, have gone largely undiscussed, the assumption being that they will dissipate as the belt-tightening does.

But if genetic responses to stress have long-term effects, perhaps lasting for generations, politicians must reconsider solutions to what they see as a purely economic crisis. Because austerity is not just an experiment with the wealth of nations. It is an experiment with their health, too.

This article appeared in print under the headline "The true cost of cuts"

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