Will the recession be bad for the health of occupational health?

There have been five recessions over the past 60 years. The prevailing view is that they are bad for health – principally because of the strong association between unemployment and serious illnesses.

But are they really bad for public health, workers’ health, and the speciality of occupational health?

Good grief

Not all commentators believe recessions are bad for public health. For example, an American economist has demonstrated improvements in physical health during economic downturns that are “especially pronounced for individuals of prime working age, employed persons, and males.” However, the opposite may be true for mental health.

There are a number of mechanisms by which recession might improve workers’ health: less overtime and shiftwork less smoking and alcohol improved diet and, less driving and fewer accidents. Evidence from factory closures suggests that even the short-term adverse health effects of unemployment might be followed by a greater health gain if staff move to ‘good work’.

So recession may not be bad for workers’ health, or even public health. It may not even be bad for the NHS. But is it bad for occupational health?

A look back at what was happening during the past three recessions provides some insight.

Recessions and OH

On 31 July 1974, right in the middle of the 1973-75 recession, the Health and Safety at Work Act received Royal Assent. A couple of articles in the speciality press at the time tackled the hot topics of mental health at work and the success of collaborative work between OH nurses and doctors.

As the UK entered recession 30 years ago, an editorial tackled the thorny issue of how to get benefits recipients back into the workforce. “An extension of the DHSS system for permitting work trial while on sickness benefit might be valuable as one way out of the all-or-nothing ‘fit or unfit for work’ certification.”

Other articles in 1979 addressed the hot topics of OH provision in the NHS and sickness absence in nurses.

As the UK entered recession, we were advised: “We need to convince management and government that… we advocate only those measures which have been rigorously evaluated and will be of real benefit in relation to their cost and inconvenience.”

Hot topics during the last recession included TB screening, the provision of OH in primary care, and the need for “specific central funding for… a dedicated research unit”.

Lessons from the past

As we look to identify the OH challenges of the current recession, we need look no further than the archives. Many of the challenges we faced in the previous three still remain high on our agenda. The only possible conclusion is that the speciality of OH has not moved on since past recessions, even though they provided an impetus to identify and tackle important issues.

As an editorial cautioned in 1989: “Raising the profile of the speciality is a heavy responsibility, but without it [we have] a bleak future.” And before that, in 1979: “unrealistic advice can only create a credibility gap… and threaten the many valuable and necessary aspects of occupational health we would wish to preserve”.

For once, I have nothing to add.

The articles quoted in this piece are from the archives of Occupational Medicine.

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