Just this month we have seen the release of two major studies that showed a strong correlation between suicides and unemployment. The first study steps through 30 years of Greece’s economic rises and falls and the rate of suicide. It found statistically significant increases of suicides for both men and women after austerity-related events. The second reviewed 63 countries from 2000 to 2011 and found that about 20% of all suicides were associated with unemployment. Thus, while there was “only” about 5000 more suicides in 2009 than in pre-crisis 2007, a total of about 46,000 suicides in 2009 were associated with unemployment.
This raises the question of what is a State’s right to health obligation when implementing macroeconomic policy. Notably, the first study shows that while there was a 13.1% (p<0.01) increase in male suicides per month when the Greek recession began in October 2008, there was a much larger increase of 35.7% (p<0.001) when new austerity measures were implemented in June 2011. This dramatic rise in suicides after the implementation of austerity measures implicates the Greek government’s role in increasing suicides. There would be no question that a country violated its obligations under the right to health if it passed legislation that directly caused the deaths of thousands of people. Austerity measures aren’t so clear cut. Austerity measures are more complex as they have two components: 1) increasing unemployment, which is linked to mental health concerns and suicides and 2) slashing funding for mental health services. The latter component can be criticized as a retrogression in violation of the right to health (See General Comment 14, paras. 32, 48). For the former, it’s not clear what the State’s actual obligation is. If a state imposed severe austerity measures that increased unemployment but didn’t decrease, or even increased, mental health services, would that State be in full compliance with the right to health? What does the right to health require when a policy choice does no direct harm but indirect deaths are a statistical certainty?
Fortunately, a book edited by Aoife Nolan came out at the end of last year to start answering these questions. It’s called Economic and Social Rights after the Global Financial Crisis and it’s the first book to show the interrelations between financial crises, policy responses and resulting impact on the realization of economic, social and cultural rights. Hopefully this book sparks further discussion clarifying what the right to health requires from States during times of economic crisis.