Simon Wren Lewis looks at a recent research paper in the BMJ conjecturing that the Coalition ‘austerity’ program led to a flattening off of the previous downward trend in mortality (and upward trend in life-expectancy), and thus induced deaths that would counter-factually have been avoided with more spending on local authority social care.
This seems a highly plausible thesis. Large high frequency changes in life expectancy around prevailing trends – in the absence of major disease outbreaks – ought not to be expected. Reduced public spending is unlikely to be substituted for quickly, if at all, for those at the bottom of the income and wealth distribution by private spending. Those anyway at the end of their working lives are likely not to be able to change their plans and work longer to make up for a withdrawal of provision by the government. Even within stable life expectancy figures, we know that there are large inequalities, and these are associated with income. A sudden change in policy reducing the ‘social income’ of the poor – ie their access to health preserving social care – could individuals through a health distribution that is already laid bare by the past experience of the population even in more stable periods of government funding.
Simon is rightly perplexed, in my opinion, that the BBC chose not to cover and debate the report. The reason given was that the analysis was considered ‘highly speculative’.
The decision is odd, in retrospect, because the BBC website had already run a story on the end of the life-expectancy reductions, combining charts of the data with comments from Professor Sir Michael Marmot from University College London. This coincided with the release of the ‘Marmot Indicators 2017‘, a collection of charts on life expectancy, inequality, and development. In that story, the BBC report the fall in life expectancy, and Marmot making the conjectural link with spending on social care. The text of the BBC article reads:
“[Marmot] said it was “entirely possible” austerity was to blame and said the issue needed looking at urgently” the story argues, making no bones of quoting a speculation, even if it was a reasonable one.
Later on, when researchers make a decent econometric fist of testing the hypothesis, the BBC decide to back off. It seems that a paper trying to put the causal connection between life expectancy and austerity on firmer foundations, rather than just speculating about one, was a step too far.
To provide some context, recall the decision to cover analysis by Economists for Free Trade – analysis that would be rejected by an overwhelming majority of economists not just as ‘speculative’ but in fact wrong, and this looks like a regrettable decision.