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The impact of economic crises on communicable disease transmission and control: a systematic review of the evidence.

Suhrcke, M; Stuckler, D; Suk, JE; Desai, M; Senek, M; McKee, M; Tsolova, S; ... Semenza, JC; + view all (2011) The impact of economic crises on communicable disease transmission and control: a systematic review of the evidence. PLoS One , 6 (6) , Article e20724. 10.1371/journal.pone.0020724. Green open access

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Abstract

There is concern among public health professionals that the current economic downturn, initiated by the financial crisis that started in 2007, could precipitate the transmission of infectious diseases while also limiting capacity for control. Although studies have reviewed the potential effects of economic downturns on overall health, to our knowledge such an analysis has yet to be done focusing on infectious diseases. We performed a systematic literature review of studies examining changes in infectious disease burden subsequent to periods of crisis. The review identified 230 studies of which 37 met our inclusion criteria. Of these, 30 found evidence of worse infectious disease outcomes during recession, often resulting from higher rates of infectious contact under poorer living circumstances, worsened access to therapy, or poorer retention in treatment. The remaining studies found either reductions in infectious disease or no significant effect. Using the paradigm of the "SIR" (susceptible-infected-recovered) model of infectious disease transmission, we examined the implications of these findings for infectious disease transmission and control. Key susceptible groups include infants and the elderly. We identified certain high-risk groups, including migrants, homeless persons, and prison populations, as particularly vulnerable conduits of epidemics during situations of economic duress. We also observed that the long-term impacts of crises on infectious disease are not inevitable: considerable evidence suggests that the magnitude of effect depends critically on budgetary responses by governments. Like other emergencies and natural disasters, preparedness for financial crises should include consideration of consequences for communicable disease control.

Type: Article
Title: The impact of economic crises on communicable disease transmission and control: a systematic review of the evidence.
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1371/journal.pone.0020724
Publisher version: http://dx.doi.org/10.1371/journal.pone.0020724
Language: English
Additional information: © 2011 Suhrcke et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. PMCID: PMC3112201 This work was conducted by the European Centre for Disease Prevention and Control and contractors hired to support data collection and analysis. ECDC is an international public health agency, similar to CDC in Atlanta, and the authors have no financial interests in the outcome of the studies. No funding bodies had any role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Keywords: Communicable Disease Control, Communicable Diseases, Humans, Models, Biological, Politics
UCL classification: UCL
URI: https://discovery.ucl.ac.uk/id/eprint/1354059
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