Intended for healthcare professionals


Covid-19, unemployment, and health: time for deeper solutions?

BMJ 2020; 371 doi: (Published 08 October 2020) Cite this as: BMJ 2020;371:m3687

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  1. Martin Hensher, associate professor of health systems financing and organisation12
  1. 1Deakin Health Economics, Deakin University, 221 Burwood Highway, Burwood, VIC 3125, Australia
  2. 2Menzies Institute for Medical Research, University of Tasmania
  1. Correspondence to: martin.hensher{at}

As covid-19 drives unemployment rates around the world to levels unseen in generations, once radical economic policy proposals are rapidly gaining a hearing. Martin Hensher examines how job guarantee or universal basic income schemes might support better health and better economics

Covid-19 has been a dramatic global health and economic shock. As SARS-CoV-2 spread across nations, economic activity plummeted, first as individuals changed their behaviour and then as government “lockdowns” took effect.1 Macroeconomic forecasters foresee a major recession continuing through 2020 and into 2021.2 Although the governments of many nations have taken novel steps to protect workers, unemployment has risen dramatically in many countries (box 1, fig 1); poverty and hunger are on the rise in low and middle income countries.5 Covid-19 has directly caused illness and death at a large scale, and further threatens health through disruption of access to health services for other conditions.

Box 1

Covid-19 and unemployment

Although unemployment soared in response to covid-19 in some nations, the policy measures undertaken by others have prevented many workers from becoming technically unemployed. In the United Kingdom, the headline rate of unemployment for April-June 2020 was 3.9%—only slightly higher than the 3.89% rate in April-June 2019. Yet in June 2020 9.3 million people were in the coronavirus job retention scheme (“furlough”) and another 2.7 million had claimed a self-employment income support scheme grant; there had been the largest ever decrease in weekly hours worked; 650 000 fewer workers were reported on payrolls in June than in March; and the benefit claimant count had more than doubled from 1.24 million to 2.63 million people.3 The Australian Bureau of Statistics has produced an adjusted estimate of Australian unemployment that includes all those temporarily stood down or laid off, to allow a closer comparison with US and Canadian statistics (fig 1). As …

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