The Body Economic

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Authors: David Stuckler Sanjay Basu
family. There, he studied health economics and statistics, and learned that his situation was not unique: all across America, people were one paycheck away from becoming homeless and needing help, just as he had done.
    From a young age, Sanjay’s life was affected by illness as well. His mother was sick for years from a lung infection called coccidiomycosis (the “Valley Fever” of the American Southwest). His father traveled across states to findwork and make ends meet. The family moved in and out of hospitals; oxygen machines were delivered every week to the garage. He was good at math, though, and when he enrolled as an undergraduate at MIT, he discovered the mathematics of life and death—how statistics described the reasons behind who lived and who died.
    We met in graduate school, studying public health and medicine because we wanted to help others. Since that time, we have studied how social and economic policies affect our health. That’s because ultimately these policies make more of an impact on who lives and who dies than any pill, surgery, or insurance plan. Good health doesn’t start in hospitals and clinics; it starts in our homes and our neighborhoods, in the food we eat, the air we breathe, and the safety of our streets. Indeed, a top predictor of your life expectancy is your zip code. That’s because much of what keeps us healthy has to do with our social environment. 1
    All of the research on health and social policy presented in this book has been subjected to extensive peer review. Leading independent economists, epidemiologists, physicians, and statisticians have checked our data, our methods, and how we present these findings. We draw on the most recent research in the field, as well as many studies of our own. Our work has been published in respected scientific and medical journals, such as The Lancet, British Medical Journal , and PLoS Medicine , in addition to economics and social science journals.
    Academic journals can be obscure, however, and so this book is an attempt to translate that data into plain English. Our goal is to provide people with the information they need to make informed, democratic choices about their economy and their health. We also want to inject hard evidence into the debate about austerity—a debate that has been shaped far more by ideology than facts.
    The political debate about the Great Recession has been intense. Free marketeers and proponents of austerity tend to believe in paying off debt, regardless of the human price. Some of their opponents believe in maintaining a strong social safety net, even if that means less economic growth. Their longstanding disagreement about these basic principles has devolved into a cacophony of shrill voices and combative viewpoints. And both sides have grossly failed to see the false dichotomy in this debate.
    Making smart policy choices can boost growth without human costs. Often those choices require up-front investment in public health programs. These programs, if administered correctly, can help spur growth in the short run, in addition to their long-term benefits. In other words, our data reveal that we can have good health, and tackle our debts too. But creating this balance requires funding the right government programs.
    To identify the best drugs and treatments in medicine, doctors use large, randomized controlled trials. But it is difficult, if not impossible, to enroll entire societies into randomized controlled trials to test out the best social policies. So to understand how policies affect our health, we use rigorous statistical methods to study what are known as “natural experiments.” These experiments arise, for example, when policy makers face similar problems such as a large recession, but choose different courses of action. This divergence creates the potential for us, as researchers, to learn how political choices ultimately come to affect our health, for better and for

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