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The Body Economic: Why Austerity Kills

The Body Economic: Why Austerity Kills

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by David Stuckler, Sanjay Basu

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Politicians have talked endlessly about the seismic economic and social impacts of the recent financial crisis, but many continue to ignore its disastrous effects on human health—and have even exacerbated them, by adopting harsh austerity measures and cutting key social programs at a time when constituents need them most. The result, as pioneering public health


Politicians have talked endlessly about the seismic economic and social impacts of the recent financial crisis, but many continue to ignore its disastrous effects on human health—and have even exacerbated them, by adopting harsh austerity measures and cutting key social programs at a time when constituents need them most. The result, as pioneering public health experts David Stuckler and Sanjay Basu reveal in this provocative book, is that many countries have turned their recessions into veritable epidemics, ruining or extinguishing thousands of lives in a misguided attempt to balance budgets and shore up financial markets. Yet sound alternative policies could instead help improve economies and protect public health at the same time.

In The Body Economic, Stuckler and Basu mine data from around the globe and throughout history to show how government policy becomes a matter of life and death during financial crises. In a series of historical case studies stretching from 1930s America, to Russia and Indonesia in the 1990s, to present-day Greece, Britain, Spain, and the U.S., Stuckler and Basu reveal that governmental mismanagement of financial strife has resulted in a grim array of human tragedies, from suicides to HIV infections. Yet people can and do stay healthy, and even get healthier, during downturns. During the Great Depression, U.S. deaths actually plummeted, and today Iceland, Norway, and Japan are happier and healthier than ever, proof that public wellbeing need not be sacrificed for fiscal health.

Full of shocking and counterintuitive revelations and bold policy recommendations, The Body Economic offers an alternative to austerity—one that will prevent widespread suffering, both now and in the future.

Editorial Reviews

Publishers Weekly
Can the economic crisis have an effect on our health? Oxford Senior Research leader Stuckler and Stanford epidemiologist Basu offer insight into the economic crisis—including the Great Recession—and its effect on public health, arguing that countries attempt to fix recessions by balancing budgets, but have failed to protect public well-being. They demonstrate how maintaining a healthy populace is intimately entwined with the health of the social environment. Filled with graphs and charts, the book shows how government's investment in social welfare improves the public's health, due to the creation of unemployment programs, pensions, and housing support. Each chapter offers historical facts from the 1930s in United States, to Russia and Indonesia in the 1990s, to present-day Greece, Britain, Spain, and the U.S., revealing how the government's mismanagement of the economic crisis has resulted in the public's poor health and an epidemic of diseases. The authors argue that it is the politicians' job to ensure that people's health needs are met, rather than their ability to pay. Societies will prosper when they invest in people's health both in good times and in bad. The question remains: what steps need to be taken to prevent widespread suffering both now and in the future? (June)
From the Publisher

Boston Globe
“Meticulously researched and richly annotated, The Body Economic is nonetheless a very accessible and engaging book. The authors succeed admirably in making the case that downsizing (or dismantling) the social safety nets that exist to protect those in need directly leads to increased sickness and death within the general population.... The lessons contained within The Body Economic should be carefully considered by both policy makers and constituents.”

Financial Times
“Austerity kills — and on a grand scale. So argue David Stuckler and Sanjay Basu in The Body Economic, a powerful attack on efforts to curb public spending since the financial crisis, which holds belt-tightening politicians responsible for a health catastrophe.... By telling the stories of individual victims of austerity as well as analyzing its impact at the population level, Stuckler and Basu provide a wealth of evidence that it is bad for our health. That is a valuable contribution to the current debate.”

“This book is timely, very readable, well written, and informative, and should be read by those interested in the health of the economy and citizens. Highly recommended.”

Financial Times
“[Stuckler and Basu] gathered and analyzed huge sets of data on the effects that economic stringency has had on public health in recent history. They published their findings in their 2013 book The Body Economic: Why Austerity Kills. If you think the book’s title is a tad dramatic, think again. Looking at cases such as European Union-backed budget cuts in Greece and the Great Recession in the United States, Basu and Stuckler conclude, as they wrote in a New York Times op-ed, that ‘austerity — severe, immediate, indiscriminate cuts to social and health spending — is not only self-defeating, but fatal.’”

The New Republic
“Stuckler and Basu provide a capable summary of the basic problems with austerity economics as economics, but their signal contribution in this book is to focus on the health effects of austerity.... They find that, the more austerity was practiced in a state or country, the more people got sick and the more people died. In short, ‘Austerity Kills’ is more than just a slogan. Austerity doesn’t work as economics, and it kills people in the bargain.”

Foreign Affairs
“Stuckler and Basu approach austerity policies from a medical perspective, producing an extensive array of evidence to show that austerity — especially cuts to spending on public health — increases illness and death. Most compelling is their finding that countries that have suffered through recessions have avoided deterioration in their citizens’ well-being by maintaining government spending on public health.”

“[Stuckler and Basu] wear their expertise and statistical knowledge lightly, opting to deliver their research findings in a jazzy, casual tone.... The real power of the book lies in the epidemiological insight that it’s possible to think about medicine not in the exclusive terms of the individual patient’s life, but by tracking the conditions that affect health throughout society.”

The Guardian
“[This] message...is explosive, backed by a decade of research, and based on reams of publicly available data.... In a powerful new book, The Body Economic, Stuckler and his colleague Sanjay Basu...show that austerity is now having a ‘devastating effect’ on public health in Europe and North America.”

Times Higher Education
“This book deserves to be widely read and widely influential. It brings crucial arguments, set out and tested in academic papers, to a larger audience. It lays bare the madness of the conventional wisdom that the answer to the current crisis is to cut public spending, and it explains clearly why the social policy response to economic events matters. It reminds us that politicians have a devastating tendency to listen to ideology rather than history — and that the cost of this approach can be counted not just in lost economic output but in human lives.”

Shelf Awareness for Readers
“Throughout the book, Stuckler and Basu rely on economic studies, most of them subjected to peer review, to underline a critical point: public health is economic health. Far from being the ‘luxury’ the IMF categorizes it as, public health spending is in fact necessary to the economic recovery of a country in recession. The Body Economic makes the point in stark and accessible terms..... [A] thoroughly researched look into the effects of austerity policies on public health.”

“What price a healthy stock market? In this stringent economic analysis, sociologist David Stuckler and epidemiologist Sanjay Basu argue that during a recession, austerity-based cuts to social spending erode public health.... A sobering call for democratic, informed choices in response to recession.”

“Today’s politicians know very well that some of their policies kill people. But they go ahead and carry out those policies anyway. How they have done it recently is brilliantly documented in this book.... The authors make a powerful case that the austerity measures adopted in some countries – and imposed on some others — had a direct and fatal impact on those countries’ public health. ”

The Progressive
"An admirable work, eminently readable and yet without skimping on rigorous analysis.”

In These Times
“Stuckler and Basu show distressingly consistent increases in such key public-health indicators as suicides, heart disease, alcoholism and HIV infection in societies embarking on steep reductions in social spending. Correspondingly, societies (such as Iceland, Sweden and Finland) that have refused to pare back their welfare states in hard times exhibit steady — and, in some cases, increasing — signs of public health.”

The Observer, UK
“Global austerity has a rarely discussed death toll, and David Stuckler and Sanjay Basu’s The Body Economic: Why Austerity Kills breaks the silence.”

Publishers Weekly
“Oxford Senior Research leader Stuckler and Stanford epidemiologist Basu offer insight into the economic crisis — including the Great Recession — and its effect on public health, arguing that countries attempt to fix recessions by balancing budgets, but have failed to protect public well-being.”

Kirkus Reviews
“A dramatic study emphasizing some of the combined consequences of ideological obsessions and bureaucratic thoughtlessness.”

“This informative book will add important perspective to the ongoing debate on the consequences of economic policies.”

Paul Farmer, MD, PhD, Kolokotrones University Professor, Harvard Medical School, and Founding Director, Partners in Health
The Body Economic is a bold synthesis of quantitative data, historical cases, personal narratives, and sociological and clinically informed analyses about the effects of investing, or failing to invest, in public health safety nets. In investigating the causes of adverse health outcomes in populations from the United States to the Soviet Union to Greece, Iceland, and the UK, David Stuckler and Sanjay Basu expose many of the myths and mystifications that prop up the regnant ideologies of fiscal austerity. Stuckler and Basu revive the great, progressive tradition of social medicine. Their work is important not just for all those who deliver health care services, but also for anyone who might, just might, one day be a patient.”

Ha-Joon Chang, PhD, Faculty of Economics, Cambridge University, and author of 23 Things They Don’t Tell You About Capitalism
“A powerful and important contribution to our future. Stuckler and Basu use statistics not to dehumanize people, but to bring them to life.”

Richard Parker, Lecturer in Public Policy and Senior Fellow, Shorenstein Center at Harvard Kennedy School, and author of John Kenneth Galbraith: His Life, His Politics, His Economics
“The Great Recession’s visible costs — bankruptcies, foreclosures, unemployment, government deficits — and their still-lingering effects are chillingly well-known. Less understood are the health consequences — the suicides, epidemics, and soaring mortality rates — that represent the most intimate human effects not just of our global financial collapse but also of the mistaken austerity programs that have followed. The Body Economic is required reading for anyone who wants to see how bad politics and worse policies have worsened suffering around the world when, by any democratic measure, our common obligation is to end suffering.”

Darrell J. Bricker, CEO, Ipsos Public Affairs, and author of The Big Shift: The Seismic Change in Canadian Politics, Business, and Culture and What It Means for Our Future
The Body Economic is must reading for anyone who wants to understand the real life consequences of governments making the wrong policy decisions in response to the worst economic disruption since the Great Depression. In a debate too often dominated by ideology, Stuckler and Basu bring a refreshing, evidence-based perspective to the table. And, they present their case—that an obsession with austerity hurts both economies and people—in an accessible, personal way. This isn’t a story about spreadsheets and algorithms—it’s about the ordinary people who pay the ultimate price for their government’s cavalier ideological obsessions.”

Kirkus Reviews
How budget-cutting responses to recession produce increases in death rates and epidemiclike breakdowns in public health. Stuckler (Senior Research Leader/Oxford Univ.; co-author: Sick Societies: Responding to the Global Challenge of Chronic Disease, 2011) and Basu (Medicine/Prevention Research Center, Stanford Univ.) contrast the "large and long-lasting public health improvements" brought about by Franklin Roosevelt's New Deal with the documented effects of the austerity created by the Great Depression. They show how reversing what was well-established and returning to a one-size-fits-all austerity--whether in the form of the shock-therapy privatizations applied in the former Soviet Union or the IMF austerity imposed on the countries of Southeast Asia and the Republic of Korea in 1998--has led to poorer health conditions and an increase in death rates. The life expectancy of working-age males in Russia was reduced from 64 to 57 between 1991 and 1994, and the number of deaths in that age group set the country back demographically at least 20 years. In other areas, the authors examine deaths by suicide and from alcoholism, as well as the spreading of sexually transmitted diseases, which often accompany forced reductions in health programs. Stuckler and Basu also review austerity's effects on the British National Health Service and the effects of the housing crisis on America's health profile. Foreclosures and homelessness also contribute to the spreading of disease--for example, unmaintained, stagnant swimming pools in California have provided a breeding ground for the mosquito-borne West Nile Virus. A dramatic study emphasizing some of the combined consequences of ideological obsessions and bureaucratic thoughtlessness.

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Basic Books
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13 - 18 Years

Meet the Author

Dr. David Stuckler is a Senior Research Leader at Oxford University and Honorary Research Fellow at the London School of Hygiene&Tropical Medicine. He lives in Oxford, England.

Dr. Sanjay Basu is an Assistant Professor of Medicine and an epidemiologist at the Prevention Research Center of Stanford University. A former Rhodes Scholar, he lives in San Francisco.

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The Body Economic: Why Austerity Kills 5 out of 5 based on 0 ratings. 3 reviews.
Holiday1 More than 1 year ago
This book has the most insightful detail of current and historic results of austerity. This book is a must read.
davekDK More than 1 year ago
This is a wonderful book that shows the deleterious effects on health and wellbeing that fiscal austerity produces. In country after country, the weakening of the social safety net during periods of economic decline leads to increases in suicides and illness. People needlessly suffer as a result of a misguided ideological agenda.
Mybookreview More than 1 year ago
The book "The Body Economic" contrasts the contemporary health and social consequences of policies in countries that have in recent decades implemented austerity policies with those countries that increased funding and quality of health and social programs during recessions and depressions. The contrasting results are shown for countries such as the U.S., Russia, Malaysia, Indonesia, Thailand, Spain, Italy, Greece, Sweden, Iceland, Finland and in the UK. The austerity economic policy approach (i.e., cutting budget for health and social programs) resulted in increases in health and social problems such as suicide, TB, HIV, alcohol abuse, and homelessness. Austerity policies also led to worsened economic results (e.g., unemployment, lower GDP). The contrasts presented in the book are well-supported by published research studies but the authors also show the human effects of economic policy on individuals. Drawing upon the facts presented the authors make several policy recommendations. Considering the continuing problems resulting from the financial crisis that hit the world beginning in 2007, the book is timely. It should be required reading for all elected government officials and their staff, and decision makers of multinational financial institutions. Although drawing upon statistics, the writing and clear illustrations in the book make the information easy to understand. The authors acknowledge that ideology often drives decisions about economic policies but they rely too much on the premise that political policy makers will choose more wisely if they have facts such as those presented in the book. Perhaps beyond the scope of this book or outside the authors’ expertise, analyses of the reasons that elected officials form policies on ideology rather than facts, and recommendations for addressing those causes would strengthen the argument and recommendations presented in the book. Disclosure: I am acquainted with the authors.