4.7 Article

Association between disability-related budget reductions and increasing drug-related mortality across local authorities in Great Britain

Journal

SOCIAL SCIENCE & MEDICINE
Volume 284, Issue -, Pages -

Publisher

PERGAMON-ELSEVIER SCIENCE LTD
DOI: 10.1016/j.socscimed.2021.114225

Keywords

Drug-related mortality; Opioids; Austerity; Health inequalities; UK

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The study found that deeper cuts to local government spending in Great Britain in the 2010s were associated with larger increases in drug-related deaths. The association between budget reductions and drug-related death rates remained statistically significant even after adjusting for regional, demographic, and economic factors, suggesting a clear link between austerity measures and public health outcomes.
Background: Drug-related mortality in the UK rose markedly after 2012. Here we test the hypothesis that cuts to disability-related spending were associated with increased drug-related mortality across local governments in Great Britain. Methods: We regressed changes in drug-related death rates (years 2010-12 versus 2015-17) on local government disability-related budget reductions, adjusting for a range of regional, demographic, and economic factors. Budget reductions are captured with a combined measure of financial losses due to Incapacity Benefit and Disability Living Allowance reforms, expressed in pounds sterling per capita, per year. 364 local authorities across England, Scotland, and Wales were included in the study. Findings: Greater budget reductions were associated with greater increases in drug-related death rates. In the unadjusted model, each 100 pound per capita budget reduction was associated with an increase in drug-related death rates of 3.30 per 100 000 population (95% CI: 2.43 to 4.17). The magnitude of the association increased after adjusting for region and demographic factors (b = 4.84; 95% CI: 3.26 to 6.43). The association remained statistically significant after adjusting for a full set of controls, including baseline and trends in unemployment rates, median hourly pay, and gross disposable household income per capita (b = 4.41; 95% CI: 2.57 to 6.24). Conclusion: Deeper cuts to local government spending in Great Britain in the 2010s were associated with larger increases in drug-related deaths.

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