Global Economic Downturn Linked To Increase in Cancer Deaths Interview with:
Dr Mahiben Maruthappu MD
Senior Fellow to the CEO,NHS England
Imperial College
London, UK What is the background for this study? What are the main findings?

Dr. Maruthappu: There are over 8 million deaths due to cancer every year.
At the same time, there are around 40 million unemployed people across the OECD, 7
million more than before the recent economic crisis. As a result,
understanding how economic changes affect cancer survival, given the
economic climate, is crucial. What should readers take away from your report?

Dr. Maruthappu: We sought to characterize these relationships at a global level for
the first time – looking at data between 1990-2010, from over 70
countries, covering a population of over 2 billion people. From our
analyses we estimate that between 2008-2010 there were 260,000
additional cancer deaths in the OECD alone. We also found that rises
in unemployment were associated with significant increases in cancer
mortality up to 5 years after the unemployment change, – so these were
long-lasting effects – particularly and unfortunately for cancers that
are potentially treatable, such as breast, prostate and colorectal
cancer Importantly we found that universal health coverage protected
against some of the effects on unemployment, making the case for
health systems such as the NHS which actually performed very well
between 2008-2010, in contrast to the United States which relies on
employer based health insurance and saw up to 18,000 additional cancer
deaths during this period.

Finally, we found that public spending on healthcare was directly linked to cancer outcomes – suggesting that healthcare cuts could cost lives – due to increased cancer mortality. What recommendations do you have for future research as a result of this study?

Dr. Maruthappu: Collectively our findings make the case for: implementation of
universal health coverage to protect the health of populations, and
also investment in health systems during times of economic hardship –
which otherwise could be fatal, potentially costing lives
unnecessarily Is there anything else you would like to add?

Dr. Maruthappu: Further work is required to characterise the mechanisms linking
economic changes to cancer outcomes at the local, regional and
national levels. Thank you for your contribution to the community.

Economic downturns, universal health coverage, and cancer mortality in high-income and middle-income countries, 1990–2010: a longitudinal analysis Mahiben Maruthappu*, Johnathan Watkins*, Aisyah Mohd Noor, Callum Williams, Raghib Ali, Richard Sullivan, Thomas Zeltner, Rifat Atun The Lancet
Published Online May 25, 2016 S0140-6736(16)00577-8 S

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Last Updated on May 26, 2016 by Marie Benz MD FAAD