By: |
Robert Shelburne (United Nations Economic Commission for Europe);
Claudia Trentini (United Nations Economic Commission for Europe) |
Abstract: |
The economic and financial crisis of 2007-2009 had a serious impact on the
larger European region. For western Europe this was the deepest economic
downturn since the Second World War. Given the well-developed safety nets for
this region the immediate impact on health is likely to be minor. However the
crisis will negatively affect the long-run level of per capita income and has
left government fiscal positions’ in a poor state; both of these developments
will likely have some minor impact on health outcomes for years to come. The
deterioration of government finances also raises a concern that the region’s
contribution to global public health through its assistance programs may be
negatively impacted. In the coming years, pollution control, including of
green house gas emissions, is a major challenge for the region. Providing
health care for an aging population is also a fundamental challenge for
economies with problematic public finances. Eastern Europe and the European
CIS were the most severely affected regions of the world. Despite the large
economic downturns in these economies, this crisis was still not as great as
that that occurred during the 1990s with their transition from planned
economies to market economies. Although significant progress has been made in
establishing social safety nets and public health programs in these countries
over the last decade, these remain inadequate and as a result this economic
crisis is likely to have a noticeable negative impact on public health
throughout eastern Europe and the CIS. Even before the current economic
downturn, there were a number of significant health concerns for eastern
Europe and the CIS that were continuing to deteriorate which could have been
significantly improved with realistic levels of public expenditures and the
implementation of proper policies. The health care systems (often
enterprise-based) and institutions collapsed during the transition due to the
breakup of the economic and political systems and even the countries
themselves (i.e., the Soviet Union and Yugoslavia). The poor health outcomes
for the region are due to the fact that a number of diseases and social
behaviors became established during the turmoil of the 1990s transition and
did not recede as prosperity retuned after 2000. The increase in inequality
that developed during the transition is reflected in growing inequalities for
access to health care and in health care outcomes. Today, the region is
characterized (relative to other regions with similar levels of income) by its
high death rates from noncommunicable diseases. The issues of alcoholism and
traffic fatalities are highlighted in this paper. For communicable diseases,
the European CIS are central in the global fight against TB and HIV/AIDS. |
Keywords: |
health systems, economic crisis, transition economies, CIS, Russia, HIV, AIDS, Tuberculosis, road safety, pollution |
JEL: |
I10 I12 I18 P20 P27 P29 |
Date: |
2009–11 |
URL: |
http://d.repec.org/n?u=RePEc:ece:dispap:2009_2&r=cis |