The best reason to ‘Let Hawaii Work’ is to save lives

This commentary appeared originally in Honolulu Civil Beat on May 30, 2020.

Our leaders need to move quickly to completely lift the state and county COVID-19 lockdowns

Evidence has been mounting for years that prolonged unemployment in a community can result in increased deaths from suicides, substance abuse and other related problems.

That’s why Hawaii lawmakers need to move quickly to lift completely the state and county lockdowns imposed in response to the coronavirus pandemic, to prevent them from causing more deaths in Hawaii than the virus itself.

They also need to increase entrepreneurial opportunity and labor mobility, through lower taxes and regulatory reform, so Hawaii’s almost 140,000 unemployed residents can soon get back to work and once again enjoy reasonable levels of prosperity.

According to an estimate by the Well Being Trust and the Robert Graham Center, Hawaii’s current levels of unemployment could result over the next decade in 616 additional “deaths of despair” — from suicides, alcohol abuse and drug overdoses.

And that’s a conservative estimate. That study was based on a national estimate of 15% unemployment, while Hawaii’s unemployment rate is closer to 25%.

Amy Cartwright from Marin County just arrived at Daniel K. Inouye International Airport under a 14-day quarantine due to Coronavirus concerns.

Most arrivals at Daniel K. Inouye International Airport must still submit to a 14-day quarantine due to coronavirus concerns. But how long must this go on?

Cory Lum/Civil Beat

In 2018, at least 492 people died in Hawaii from deaths of despair, and based on the study’s methodology, that means this year there could be an additional 63 deaths, a 13% increase to 555.

If Hawaii’s primary industry, tourism, recovers slowly, as economists are predicting, this could result in even more avoidable deaths.

Concern for mental health

Dr. Elinore McCance-Katz, assistant secretary for the U.S. Department of Health & Human Services’ Substance Abuse and Mental Health Services Administration, said at a White House cabinet meeting on May 20: “Containing the effects of coronavirus are critically important, but so, too, is preventing suicide. So, too, is keeping a person from being terrified to ever leave their home. So, too is protecting the mental health of our nation’s young people.”

Unemployment has been linked with depression, anxiety and psychosomatic symptoms. People who are unemployed are more than twice as likely to experience psychological problems than those who are employed. Unemployment is not only correlated with distress, it causes symptoms of mental illness.

McCance-Katz added: “As a psychiatrist, I would argue that a life lost to suicide is just as important as a life lost to coronavirus. A family who loses someone to drug overdose experiences the same grief as a family who loses a loved one to coronavirus.”

A related problem is the loss of health insurance, and this, too, could result in additional deaths. Hawaii employers are required to provide health insurance for all their full-time employees, so a high unemployment rate means many Hawaii residents have also lost or will soon lose their health insurance coverage.

A 2017 study in the Annals of Internal Medicine “summarized the findings of multiple studies that compared mortality rates among those who are uninsured versus those who are not,” leading one of the researchers to conclude, “Despite the drastically different conclusions … it’s impossible to deny that insurance status does influence mortality.”

That’s because people without health insurance are less likely to receive recommended preventive and screening services that can detect early stage cancers and other diseases. Uninsured people with cancer are more likely to receive a later stage diagnosis and die prematurely than people who have health insurance.

Lack of health insurance also makes it less likely that people with chronic illnesses such as diabetes, cardiovascular disease and mental illness will receive appropriate care to manage their health conditions, and they will have worse clinical outcomes.

In addition, domestic abuse may be “exacerbated” due to the damaged economy, according to Nanci Kreidman, CEO of the Hawaii nonprofit Domestic Violence Action Center, who said the center’s helpline calls increased from 692 in April 2019 to 1,066 in April 2020.

The state and county lockdowns in Hawaii might have saved some lives from the coronavirus, but they also have increased the likelihood of deaths from other causes.

Simply reopening the economy won’t be enough.

In the short run, Hawaii lawmakers should move as quickly as possible to lift the lockdowns completely, including a reasoned approach to eliminating the 14-day quarantines imposed on newly arriving travelers.

But simply reopening the economy won’t be enough. In the long run, Hawaii needs a major dose of economic freedom. We need to expand opportunities for entrepreneurs to get Hawaii rolling again, if we hope to ever recover from the extensive economic and social damage caused by the lockdowns.

A new report produced by the Grassroot Institute of Hawaii, “Road map to prosperity,offers many specific steps our lawmakers can take to help Hawaii’s economy recover and even excel after the coronavirus lockdowns — and save lives.

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