Table 1 The health effects of the financial crisis

The health effects of the global financial crisis have been complex. Some causes of death have declined, in particular road traffic injuries, as the volume of heavy traffic on the roads diminished. But others increased, such as suicides [72–74]. Yet this was not inevitable. The historical record reveals that there was a clear link between job losses and suicides in some countries, such as Spain. Yet in others, such as Sweden, there was no such link. The difference was the strength of the welfare state, and specifically investment in what are called active labour market programmes [75, 76]. These are programs that help people get back into work, providing information and retraining and support for people with disabilities. But more fundamentally, they are a means by which the state can say that it cares about its people.

The situation with infectious disease was especially complex [77]. First, the circumstances had to exist to rely a particular infection to emerge or re-emerge. It was not plausible that malaria would emerge in Norway. Second, there had to be a breakdown in those processes that had kept it under control. Thus, cutbacks in vector control allowed malaria to reappear in Greece. Cuts to a needle exchange program in Athens contributed to an epidemic of HIV [78]. Abandoned swimming pools following mortgage foreclosures in California provided breeding grounds for the mosquitoes transmitting West Nile virus.