From Our 2009 Archives

Recession Is Bad for Health

Americans Are Taking Grave Chances With Their Health Because of Recession and Money Fears

By Bill Hendrick
WebMD Health News

Reviewed by Elizabeth Klodas, MD, FACC

May 21, 2009 -- Americans are skipping doctor's appointments and the gym, scrimping on drugs, delaying preventive care, and eating more unhealthy foods because of growing fears about the recession, according to two national surveys and health experts.

The American Academy of Family Physicians (AAFP) says a new survey of its members suggests the recession and fears of money problems are having negative and potentially serious effects on public health.

And the American Heart Association says in another survey that it is concerned that people are cutting back on exercise and eating more low-cost fattening foods to save money, which could worsen the nation's obesity problem.

Almost 90% of 600 family doctors surveyed said their patients have expressed concerns about paying their bills, and 87% said more patients were showing up with stress symptoms than before the recession.

The American Heart Association surveyed 1,000 people in March. Its survey showed that 57% reported the economy had affected their ability to take care of their health. The AHA survey also found that:

  • 32% had delayed preventive care, skipped doctor's appointments, or stopped taking medication to save money.
  • 25% with gym memberships had canceled them in the past six months.
  • 42% percent planned to buy fewer fruits and vegetables.

"We've made dramatic gains in recent years in our fight against heart disease and stroke, but trends like these threaten to reverse these gains," says Timothy Gardner, MD, president of the AHA. "We need to remind people that even in hard times, their health is important."

Health Care and the Recession: Doctor Visits Down

In the AAFP's survey of member doctors, 60% reported seeing more problems caused by patients skipping preventive care. Also:

  • 66% said they were reducing fees to cut patient costs or making other arrangements to help people pay. Others said they'd increased charity care or moved patients to cheaper, generic drugs.
  • 54% reported seeing fewer total patients since January 2008, which is about when the recession began.
  • 73% reported an increase in uninsured patients.
  • 64% reported a drop in patients with employer-sponsored health insurance.

AAFP President Ted Epperly, MD, tells WebMD that angst has become pervasive "and so many people are trying to save," which can be dangerous. "We've seen bad outcomes. I have personal knowledge of a 45-year-old male with underlying heart disease that he knew about [who] was also diabetic. Because he lost his health insurance when he lost his job, he stopped taking his diabetes medicine, it got out of control, he had a [heart attack] and he died.

"We know of another gentleman with bipolar disease who stopped taking his antipsychotic to save money. He became manic, lost his job, his house, and then his family."

Stress Can Make You Sicker

"Stress has a direct impact on the immune system, and this can make people sicker," he tells WebMD. "Patients need to exercise 30 minutes a day, five days a week, whether they can afford a gym or not. And this is not the time to go back to fast-food chains, which are less expensive than for people to buy more organic food. We have a sicker society because of the economic recession. This all underscores that we have a broken health care system that needs to be reformed."

Thousands of people, he says, "are taking chances. I see 62-year-olds with uncontrolled hypertension or diabetes thinking they can make it to 65 when they can get Medicare," he tells WebMD.

Allen Dollar, MD, an interventional cardiologist at Emory University School of Medicine in Atlanta, says he has "a lot of patients who are well off but think their jobs are in jeopardy. This is stressful, so they are cutting back on health costs. Blood pressures are higher."

"I worry mostly about people stopping their medicines," he tells WebMD. "But the whole reason many are not in the hospital is their medications. It's the perfect storm. People are scared, but fruits and vegetables are expensive. And people get depressed and don't exercise."

And people are avoiding preventive practices such as mammograms and colonoscopies, which eventually will cost them, he says, as well as society.

Furthermore, the stress of the economic downturn is causing millions to lose sleep, "which is bad because sleep decreases stress," he says.

Staying Healthy When Money Is Tight

Sandra Fryhofer, MD, an Atlanta internist, says corporate downsizing and the resultant loss of health insurance is literally killing people.

"Now patients have to be proactive," she tells WebMD. "Take a walk instead of worrying. Some people are saying they can't pay, and we just try to do what we can. A lot of people have had to be put on antidepressants. I tell them to eat the right foods and exercise, even if they have to give up their [health] clubs."

Kara Thompson, a spokeswoman for the International Health, Racquet & Sportsclub Association, says membership has dropped 2.4% since 2007, to 45.5 million. However, "More and more people are realizing that money spent on a health club membership is not just money spent, it's an investment in and commitment to their health," she tells WebMD. "The return on investment is high, the benefits of exercise are innumerable."

Bonnie Jacobson, PhD, director of the New York Institute for Psychological Change and an adjunct professor at New York University, says she believes the worst is over, at least on Wall Street, where many of her clients work. "There was a level of panic, and that migrated out to shock the country," she tells WebMD. "We're a country in an anxiety disorder. It's been a rude awakening."

The AAFP's Epperly says it's going to be a while before people start taking care of themselves again, whether they have health insurance and jobs or not.

Gardner says employers can save $16 for every $1 they invest in health and wellness.

"It needs to be done," Fryhofer says. "Everybody needs to help. People are stressed even if they still have a job and insurance because they've seen the value of their retirement portfolios drop. We all need to reassure each other that we're going to get through this."

SOURCES:
News release, American Academy of Family Physicians.
News release, American Heart Association.
Ted Epperly, MD, AAFP president.
Sandra Fryhofer, MD, Atlanta internist.
Allen Dollar, MD, Emory University.
Bonnie Jacobson, PhD, director, New York Institute for Psychological Change.
Kara Thompson, International Health, Racquet & Sportsclub Association.
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