How to protect people in response to COVID-19 economic downturns: Insights from past economic crises

We welcome the study by Thor Norström and Iman Dadgar which adds to the growing body of evidence that recessions do not inevitably cause mortality to rise and may actually reduce it. By looking at total, infant and 65+ all-cause mortality across 21 OECD countries from 1960 to 2016, they find that higher unemployment rates are associated with lower all-cause mortality in the short term, whereas higher GDP is associated with lower all-cause mortality in both the short and long term. All these findings are intuitive and plausible. In the long term, it is well established that higher GDP is correlated with many improvements in the many social determinants of health, such as education and income, as well as health systems development [4]. In the short term, while the inverse association of all-cause mortality with unemployment rates may seem counterintuitive, it has been attributed to short-term reductions in alcohol consumption and road traffic deaths – both major causes of premature mortality. The key question remains: what do these findings means for policy and practice? And what do they mean now at a time of COVID-19 and its economic aftermath?