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

Nghiem, N.; Wilson, N.

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 M[a]ori (Indigenous population) were 3.7 times greater compared to non-M[a]ori (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.