title: [Economic crisis and communicable diseases. SESPAS report 2014].
abstract: Past economic crises have increased the impact of communicable diseases especially on groups particularly vulnerable to the social and health consequences of the recession. However, it has been shown that the impact of these crises largely depends on the response of governments and the inhabitants of affected countries. We describe the consequences of the current crisis in the causal chain of infectious disease, including the response of the health system, and explore whether there is evidence of its impact in Spain. It is assumed that the possible effect of the crisis on living and working conditions is due to individual and social debt coupled with high unemployment as defining features of the crisis. We highlight the potential negative consequences of healthcare cuts on vulnerable populations, which have been partly excluded with the recent reform of health coverage. We compare mortality and morbidity data between two periods: before and after 2008, integrating, where possible, observed trends and institutional reports. Overall, no effect on infectious disease has been detected so far, although some signs of worsening, which could be compatible with the effects of the crisis, have been observed and need to be monitored and confirmed. We review the limitations of data sources that may not be sufficiently sensitive or up-to-date to detect changes that may require a latency period to become manifest. Instead of cutting resources, surveillance of these diseases should be improved, and an equitable social health response, which targets the population most affected by the crisis, should be guaranteed.
authors.affiliation: Centro Nacional de Epidemiología, Madrid, España; CIBER de Epidemiologia y Salud Pública (CIBERESP), España. Electronic address: allacer@isciii.es.
authors.forename: Alicia
authors.initials: A
authors.lastname: Llácer
authors.affiliation: Centro Nacional de Epidemiología, Madrid, España; CIBER de Epidemiologia y Salud Pública (CIBERESP), España.
authors.forename: Rafael
authors.initials: R
authors.lastname: Fernández-Cuenca
authors.affiliation: Escuela Nacional de Sanidad, Madrid, España.
authors.forename: Ferrán
authors.initials: F
authors.lastname: Martínez-Navarro
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003141:Communicable Diseases / Q000453:epidemiology*; D057172:Economic Recession; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D013030:Spain / Q000453:epidemiology; D055815:Young Adult
keywords: Communicable diseases; Crisis; Economic recession; Epidemiologic surveillance; Patología infecciosa; Poblaciones vulnerables; Vigilancia epidemiológica; Vulnerable populations