Impact of COVID-19 related unemployment on increased cardiovascular disease in a high-income country: Modeling health loss, cost and equity

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Abstract

Background

Cardiovascular disease (CVD) is a leading cause of health loss and health sector economic burdens in high-income countries. Unemployment is associated with increased risk of CVD, and so there is concern that the economic downturn associated with the COVID-19 pandemic will increase the CVD burden.

Aims

This modeling study aimed to quantify health loss, health cost burden and health inequities among people with CVD due to additional unemployment caused by COVID-19 pandemic-related economic disruption in one high-income country: New Zealand (NZ).

Methods

We adapted an established and validated multi-state life-table model for CVD in the national NZ population. We modeled indirect effects (ie, higher CVD incidence due to high unemployment rates) for various scenarios of pandemic-related unemployment projections.

Results

We estimated the CVD-related heath loss in NZ to range from 23,300 to 36,900 HALYs (health-adjusted life years) for the different unemployment scenarios. Health inequities for Māori (Indigenous population) were 3.7 times greater compared to non-Māori (49.9 vs 13.5 HALYs lost per 1000 people).

Conclusions and policy implications

Unemployment due to the COVID-19 pandemic is likely to cause significant health loss and health inequities from CVD in this high-income country. Prevention measures should be considered by governments to reduce this risk, including job creation programs and measures directed towards CVD prevention.

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