Yonatan Berman, Tora Hovland – The cost of austerity: How UK public spending cuts led to 190,000 excess deaths

When will politicians learn that austerity kills?

Yonatan Berman is a Lecturer in Economics in the Department of Political Economy at King’s College London. He is also a Visiting Fellow at the International Inequalities Institute at LSE and a Research Affiliate at IZA. Tora Hovland is a student and research assistant in the Department of Political Economy at King’s College London.

Cross-posted from LSE blog

Picture by Cory Doctorow

In 2010, the new UK coalition government introduced a series of austerity policies in response to the global financial crisis and the dire state of public finances. Our latest research reveals the profound impact these measures have had on mortality rates and life expectancy.

The austerity measures involved significant reductions in public spending (see left-hand panel of Figure 1). The 2012 Welfare Reform Act led to cuts in multiple welfare benefits, including child benefits, housing benefits and disability living allowance. As a result, working-age adults faced an average annual financial loss ranging from £914 in Blackpool to £177 in the City of London. Spending on education was also cut drastically. While healthcare spending per capita was not directly cut, it was levelled off. With an ageing population, this effectively increased pressure on healthcare services.

Meanwhile, the rate of improvement of life expectancy in the United Kingdom slowed significantly after 2010, following decades of rapid growth before this point (right-hand panel of Figure 1). Our research aimed to determine whether austerity played a role in this slowdown by studying its effect on mortality. We compared local authority districts across the UK that experienced varying levels of austerity, considering these areas both before and after the 2010 austerity measures were implemented. This approach allowed us to identify changes in life expectancy and mortality rates during the 2010s that were likely attributable to austerity measures rather than to pre-existing differences between the districts.

Figure 1: The evolution of life expectancy and public expenditure in the United Kingdom, 1999–2018

Berman Hovland - The evolution of UK life expectancy and public expenditure
For data sources, see Berman & Hovland (2024).

The impact of austerity on life expectancy and mortality rates

We find that austerity measures led to a significant drop in life expectancy, averaging about three months for men and five months for women between 2010 and 2019. Figure 2 plots the aggregate picture for the UK as a whole: it shows actual life expectancy in blue and our estimate of a counterfactual trend of what life expectancy would have been withoutausterity in black. The difference between the two indicates the effect of austerity measures on life expectancy. Without austerity, life expectancy improvement in the United Kingdom would still have slowed compared to the period from 2002 to 2010, but it would have been almost half a year higher by the end of the last decade.

This represents a very substantial loss for society, equivalent to three years of lost progress in life expectancy, with women being almost twice as affected as men. Framing it in terms of mortality rates, our estimates point to around 190,000 excess deaths directly linked to the austerity cuts from 2010 to 2019, representing a 3% increase in mortality over this period.

Figure 2: The impact of austerity on life expectancy in the United Kingdom (2002–2019)

Berman Hovland - Impact of austerity on UK life expectancy
Notes: The evolution of life expectancy in the United Kingdom (blue) and a “no-austerity” counterfactual scenario (black), where the estimated effect of austerity measures is subtracted from the actual evolution. For more details, see Berman & Hovland (2024).

We find that welfare cuts had a much larger overall impact than healthcare spending changes because the welfare cuts were more substantial. However, each pound cut from healthcare spending had a more direct and significant effect on life expectancy.

Several factors contribute to the rising death rates. One significant cause we identified is the increase in “deaths of despair,” which include drug-related deaths. We estimate that austerity measures led to around 1,000 additional deaths from drug poisoning between 2011 and 2019, accounting for about 3% of all drug-poisoning deaths in the United Kingdom during that period.

Another factor was the deterioration in ambulance response times during the austerity years. In 2008, ambulances reached the scene within 19 minutes for 96.6% of emergency calls, but by 2017, this had dropped to 89.6%. This decline was more severe in regions that experienced cuts to healthcare spending, resulting in over 35,000 people being at higher mortality risk over the past decade due to delayed emergency response times.

Austerity cuts also exacerbated regional health inequalities

Austerity cuts not only negatively affected overall life expectancy – they also disproportionately impacted the most vulnerable people in the United Kingdom. Before 2010, the average life expectancy gap between more and less affected areas was stable at about 1.6 years. By 2019, this gap had widened to 1.9 years.

Areas hit hardest by welfare cuts, typically those with a high number of benefit claimants, experienced slower increases or even decreases in life expectancy, in contrast to regions less affected by austerity, which saw better health outcomes. The North East of England, the East Midlands, South Wales, and the Glasgow City Region were among the hardest hit. Figure 3 illustrates this, with the map displaying the geographical variation in life expectancy in the United Kingdom, and the right-hand panel showing changes in life expectancy for women since 2010.

Figure 3: Geographic variation in life expectancy in the United Kingdom

Berman Hovland - Geographic variation in UK life expectancy
For data sources, see Berman & Hovland (2024).

Regrettably, the longer-term impact is likely to be even greater

It is important to stress that the figures presented here are likely to be conservative estimates. The true effects of austerity could be even more severe and enduring as the impact of welfare reform gradually builds up over time (as also highlighted in other research looking at the effects of austerity).

For one thing, economic hardship can lead to changes in lifestyle and nutrition which could have important health implications that only become clear over a period of several decades. It is also possible that several other austerity cuts that were not directly factored into the estimates for life expectancy and mortality presented here – including reductions in education, infrastructure, and police spending – may have significant (and delayed) effects. These long-term consequences serve as a clear warning about the need to consider the future impact of any policies that are carried out today.

Overall, then, the austerity measures introduced in 2010 are likely to impact the British population for many years, significantly affecting mortality and life expectancy, with women and poorer regions bearing the heaviest burden. The societal effects need to be carefully considered and debated when shaping future policies to ensure that the most vulnerable are protected, even during times of limited public finances.

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