Less is not more when austerity impacts public health

By Esperanza Cantu

At a keynote address called “The Body Economic and Population Health,” of the Inaugural Forum on Population Health Equity forum at the Harvard T.H. Chan School of Public Health in late 2015, Dr. David Stuckler, Professor of Political Economy and Sociology of Oxford University, made a radical proposition: Fiscal austerity is bad for your health. He chronicled the decline in health of populations by historical events, including the U.S. foreclosure crisis, the Great Depression, Sweden’s banking crisis, Greece’s financial crisis, among others. Through gathered evidence, he purported that to strengthen a community’s health, its social protection systems needed to support fairer, more equal societies.

At that same time, the largely African American community of Flint was experiencing a tragedy that affected its nearly 100,000 residents. The Flint water crisis began in April of 2014 when Flint changed its water source from the Detroit Water and Sewage Department to the Flint River. Due to a failure to apply corrosion inhibitors, the public water infrastructure was contaminated with lead, causing a widespread water contamination and public health emergency. Flint’s residents, including thousands of children, have been exposed to lead during this tragedy, which will likely have devastating long-term health and developmental effects. The Flint Water Crisis may affect much more than just the water supply; this tragedy’s effects will be felt well into the future as property values and tax revenues could decrease, and the people’s trust in structures meant to protect them have failed them. Several lawsuits against government officials, including nine criminal charges filed by Michigan Attorney General Bill Schuette, have occurred in the assignment of accountability.

Professor Peter J. Hammer of Wayne State University’s Damon J. Keith’s Center for Civil Rights, takes it a step further. Delivered as a written testimony to the Michigan Civil Rights Commission as part of the hearings related to the Flint Water Crisis, Professor Hammer released a 65-page report titled “The Flint Water Crisis, KWA and Strategic-Structural Racism.” In this report, Professor Hammer details how emergency management, fiscal austerity, and strategic racism resulted in the decisions that led to the Flint Water Crisis. He concluded by likening the Flint Water Crisis to the Tuskegee Syphilis Experience and reminding us all that nothing about the Flint Water Crisis was accidental.

From a population health perspective, the Flint Water Crisis is another example of how fiscal austerity has affected the lives of thousands, perpetuating racial injustice and health disparities. Read this story by the American Civil Liberties Union of Michigan by Curt Guyette, who provided a brief summary of the report, and Professor Hammer’s testimony here.

Professor Hammer delivered a presentation on structural racism and public health as the collaborative foundation for the next Civil Rights movement, at the 2016 Population Health Forum.  See that presentation here. He is also a member of the Population Health Council

Esperanza Cantu is manager of Health Equity and Community Engagement for Authority Health.