The article’s authors look at social spending in the OECD and find changes in social spending directly related to changes in mortality. Even more, they find the impact of social spending on health to be much greater than simple increases in the gross domestic product of a country. The article finds:
This means that the potential health benefits of increased wealth crucially depend not just on increasing income but on what fraction goes into social welfare spending from governments.
The authors cite a recent report to the British government on health inequalities that found:
Children who receive better education, have safe environments in which to play, and who live in good quality housing are more likely to grow up healthy than those who do not. Adults in secure and safe employment, receiving wages above the level of need merely to survive, are less likely to adopt hazardous lifestyles (such as smoking, drinking, or unhealthy diets) and can expect to live longer.
The BMJ’s editorial points out:
That fair employment practices – freedom from coercion, job security, a fair income, job protection, respect and dignity – are not “nice to haves” in hard economic times. They have been shown to narrow the gap in health inequalities and to improve a nation’s overall health.
In British Columbia our government has adopted a policy that sees social programs cut back first in both good times and bad. The BMJ might help us to count the cost.