Why, as an occupational health adviser, I should be so interested in the world financial situation is a bit strange.  I did work in a bank once, but it was terribly boring so was never going to be a career path.  Perhaps it was growing up with a father who was very successful in the insurance market and used to bring any number of similarly successful people home for dinner to discuss this or that financial issue of the day.  He’s still my “go to” person for the sharpest opinion of what is going on in the world.  Perhaps it’s because I have run my own business for 6 years and this stuff matters.  I have a client in the oil business and if the economy takes a hit, my client takes a hit and the work I had planned starts to dry up.

Or perhaps it’s deeper than that. “It’s the economy, stupid” is a slight variation of the phrase “The economy, stupid” which James Carville coined as a campaign strategist of Bill Clinton’s successful 1992 presidential campaign against sitting president George H. W. Bush. By focussing on the economy, change and healthcare, Clinton’s campaign swung public opinion from a 90% approval rating of Bush in early 1991, days after the ground invasion of Iraq, to 64% disapproval by August 1992.

The phrase has been amended over the years and variations of it have featured in numerous TV satires including The West Wing and The Thick of it. It’s become even more popular in the last 4 years since the crash of 2008 when the view of many has been “it really is the economy, stupid”.   There’s no doubt that we are a bit knackered at the moment and the outlook is not great. America’s debt is basically owned by China, which can’t ultimately end well. The BRIC economies continue to grow but with huge inequalities and imbalances in their wealth and cultures, which will be difficult to sustain and many unelected Europeans soldier on with a process of integration against a backdrop of huge cultural differences and many smaller countries wanting their own identifies.  I have never worked out why many in Scotland and Wales support the EU but not the union of the UK.

Hence, I find myself in a twitter debate with @profcarycooper, a man I have respected for many years and who despairs at the negative predictions of our economists and the demotivating impact this ultimately has on our working population, particularly the young. I admire his willingness to be optimistic but for me, the facts just get in the way.  That’s not to say I want to be pessimistic.  As I have said, I have run my own business for the last 6 years, as has Professor Cooper, and I have no intention of giving up now.  But it will be tough and I give no false hope to my children, one of whom will leave university next year and the other who is considering whether and where he wants to go in 2014.

We are due many more years of what everyone likes to call austerity but I am increasingly distrusting of this term.   Austerity comes from the view that what we had pre 2008 was normality.  But actually, when you look at the huge increases in properly prices in western economies that far outstripped income, the growth of personal debt, the excesses of the banks and many other indicators, what we had pre 2008 was profligacy.  The good times rolled and we grabbed all we could.  If you take that view, what we have now is not austerity but something like a return to normality.  A time when you can’t max every single credit card you have without consequence.   A time when your mortgage is a good deal less than the value of your house and if you want to borrow money some stringent checks are made into your ability to one day pay it back.

So, as I’m still an occupational health adviser and not a corporate banker, what impact does all this have on health at work?  There is no doubt that many are struggling with a combination of financial problems, an employer who wants more for less and a public who wants as much as they ever had and is slowly realising that might not be achievable.   Stress and mental ill health will continue to have a major impact on our working lives. But if we can accept that we’ll be living with a bit less in years to come, mental health may improve, the world economies might balance out a bit and the younger generation might understand that success is still there for hard work and innovation and realise “it really is the economy, stupid”.  Get that right and some good and more stable times may start to return.