Will There Be an Epidemic of Corollary Illnesses Linked to a COVID-19–Related Recession?

M. Harvey Brenner, PhD


Am J Public Health. 2020;110(7):974-975. 

In This Article

Abstract and Introduction


Currently, US unemployment claims have skyrocketed to 30 million in the past six weeks, continuing in a stark upward trend, and labor economists estimate the unemployment rate at minimally 18.3%. These unemployment figures are a feature of the COVID-19 recession that is characterized by sharp gross domestic product (GDP) growth decline. Despite the greatly damaging impact of the opioid crisis over 2015 to 2017 resulting in a decrease in life expectancy over these three years, the long-term increases in average GDP per capita from 1999 to 2018 managed to save lives on average (i.e., age-adjusted mortality rates declined in the United States). For example, during 1999 to 2018, the average GDP per capita annually increased 1.2%, whereas the related age-adjusted mortality rate has shown an annual decrease of approximately 1% on average (0.99%). However, recessions erase some of this beneficial effect of GDP growth on mortality reduction.[1]

The legislated relief measures have challenged the dichotomy between either combatting the COVID-19 pandemic or concentrating on economic recovery. Similarly, an epidemic of chronic disease, mental illness, and mortality is a potential consequence of the COVID-19–related recession. This can be hypothesized considering both primary health care use decline and stress-induced illness likely to result from short- and long-term unemployment, including loss of income and employer-based health insurance as well as the destruction of wealth.

These corollary effects of major economic distress need to be distinguished from the anxiety, fear, and depression that have arisen from the pandemic itself and its widespread mental health consequences. The supervening corollary public health outcomes are expected to be generated by unemployment,[2] poverty, prevailing health disparities, and a decline in access to health care resulting from the COVID-19 economic breakdown. Public policy experts have already sounded the alarm, questioning whether the $2 trillion relief package as well as planned additional measures will be sufficient to stem the tide of economic shock, sharp GDP decline, and projected long-term damage to livelihoods. However, although the priority is to contain the spread of COVID-19, public health officials need to anticipate and plan for the potential health impact of the recession that results from the pandemic.