“The relationship between unemployment and poor health has been well documented. The unemployed tend to have higher levels of impaired mental health including depression, anxiety, and stress, as well as higher levels of mental health hospital admissions, chronic disease (cardiovascular disease, hypertension, and musculoskeletal disorders), and premature mortality.”
- Jennifer R. Pharr, Sheniz Moonie, and Timothy J. Bungum, “The Impact of Unemployment on Mental and Physical Health, Access to Health Care and Health Risk Behaviors,” International Scholarly Research Notices, 2011
The decision of whether states should reopen their economies has been described as a choice between economics and public health — between dollars and lives. Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, made this distinction in his recent testimony before the U.S. Senate Committee on Health, Education, Labor and Pensions. Responding to a question from Sen. Rand Paul, R-Kentucky, Fauci declared:
“I have never made myself out to be the end-all and only voice in this. I’m a scientist, a physician, and a public health official. I give advice, according to the best scientific evidence. There are a number of other people who come into that and give advice that are more related to the things that you spoke about, about the need to get the country back open again, and economically. I don’t give advice about economic things. I don’t get advice about anything other than public health.”
As James Freeman of the Wall Street Journal pointed out, Fauci’s dismissal of economic concerns demonstrates his myopic vision of public health. He doesn’t appear to recognize that, in the real world, public health and economics are inseparable.
Instead, Fauci and others, including secretary of the N.C. Department of Health and Human Services Dr. Mandy Cohen and Gov. Roy Cooper, create a false dichotomy. Public health and economic well-being are closely linked and move in opposite directions. There is a sizable academic literature on this subject, all coming to the same basic conclusion. Economic growth and employment improve physical health. Economic decline and unemployment can be deadly.
University of Pittsburgh statistician Bernard Cohen concluded in the Journal of American Physicians and Surgeons, that being in poverty can lower life expectancy by as much as 3,500 days or 9.5 years. In an earlier study published in the Journal of Risk and Uncertainty, Cohen and co-author Randall Lutter estimated that there is one death for every $15.5-million reduction in gross domestic product (in current dollars). And, again, in the Journal of Health and Physics, Cohen calculates that being unemployed increases one’s risk of death by 4% and reduces life expectancy by 1.4 years. He notes, “This is roughly … equal to smoking 10 packs [of cigarettes] per day while unemployed.” These conclusions stem from some very real facts: Unemployed people are more likely to have heart attacks, strokes, alcohol-related problems, are more likely to commit suicide, or be the victim of a homicide.
Forced business closings, statewide stay-at-home orders, and restrictions on access to medical providers have consequences. Medical experts expect to encounter an increase in cancer deaths over the coming year due to a reduction of cancer-related screenings, such as mammograms, pap smears, and certain blood tests. The BBC recently reported that in Great Britain, a drop off in cancer screenings has led to roughly 2,700 fewer people per week receiving timely diagnoses. “Most modellers in the UK estimate excess of deaths [from these late diagnosed cancers] is going to be way greater than we are going to see with COVID-19,” they noted.
In the United States, there are typically about 150,000 new cases of cancer diagnosed each month. And according to Dr. Scott Atlas, former head of neuroradiology at Stanford University Medical Center and senior fellow at the Hoover Institution, “most of them are not getting diagnosed.” He continued, “Half of people on chemotherapy are not going in for their chemo … two-thirds of women are not getting the pap smears for cervix cancer … two-thirds of vaccinations for California’s children are not getting done.”
Fauci and others who are narrowly focused on COVID-19 deaths persistently remind the public of the dangers of reopening the economy “too soon.” The decision to remain on lockdown could be even more deadly. Estimates of the mortality costs associated with reopening “too soon” tell us little if they do not consider the mortality costs of not reopening “soon enough.” Unfortunately, public health professionals and the elected officials that defer to them show little awareness of this tradeoff. And if they acknowledge it, they demonstrate no willingness to take it seriously.
In North Carolina, Cooper’s insistence on shuttering most of the state’s economy may actually be costing more lives than it is saving. In a free society, the burden of proof always lies with those who wish to restrict our liberties in the name of the “common good.” Before continuing his very stringent lockdown policies one more day, it is incumbent upon the governor to demonstrate that those policies, at the very least, are saving more lives than they are taking. The residents of North Carolina deserve to have such an accounting.
Dr. Roy Cordato is senior economist emeritus at the John Locke Foundation.