The human toll of a debt default would be felt worldwide

If Congress fails to raise the debt ceiling, the resulting national default will not only cause vast economic carnage. It would also cause human carnage, a blow to the health of people around the world and to Americans, likely costing at least tens of thousands of lives. A vote to raise the debt ceiling is a vote for life. 

Millions of Americans will become unemployed and incomes would vanish. And the effect would extend far beyond our shores. As Treasury Secretary Janet Yellen observed, a default “would spark a global downturn,” with reduced U.S. consumer and business spending cutting demand for imports, the U.S. dollar plummeting, exchange rate fluctuations and supply chain disruptions all contributing to dire global economic consequences. And even as Americans and people around the world are still reeling from high inflation, prices could spike again.  

The human toll would be hugely consequential across the world. Parents would not be able to afford nutritious food and school expenses for their children, whose childhoods would be stolen as they are forced to drop out of school and slave away in unforgiving jobs to support their families. Many of these children will end up in terrifying working conditions — in hot fields, in mines where they dig with their bare hands and breathe toxic dust with walls and tunnels that may collapse at any moment, and as domestic workers subject to physical, sexual and verbal abuse. Families may marry off their daughters even as they remain children to offset debts and reduce their economic burden. 

We find an example of the potential impacts by studying the Great Recession of 2007-09 and the accompanying global financial crisis. That crisis pushed about 100 million people into extreme poverty. Poverty can be a death sentence. In 2009, in sub-Saharan Africa alone, 28,000-50,000 infants died as a result of the economic contraction. Reduced food consumption will lead to more children experiencing wasting and being underweight, as it did then. Forced to go to school on empty bellies — if their parents can still afford to send them to school — these children will not be able to concentrate, learn, or reach their full potential. 

All of this would happen at a time when people are still reeling from the sting of COVID-19-driven inflation, food price shocks severely aggravated by Russia’s invasion of Ukraine, and the ever-growing harms from climate change. As of mid-2022, an unprecedented 100 million-plus people were forcibly displaced and in need of international protection. Food insecurity has more than doubled from before the pandemic, with close to 350 million people facing such acute levels of hunger and malnutrition that their very lives or livelihoods are at risk. Rohingya refugees are now forced to live on 33 cents per day and people in parts of Somalia are on the “brink of famine,” with tens of thousands already dead.” 

Alongside greater vulnerability is reduced capacity to weather the storm. Last year, the United Nations identified 54 countries — home to more than half the world’s poorest people — in urgent need of debt relief. The United States and other richer countries may cut humanitarian aid, which is already failing to keep up with the growing need.  

Americans would die too. People who lose their jobs face an increased risk of early death, especially older workers, who experience higher rates of heart attacks, suicides, cancers and mental illnesses after being laid off. A recession would also lead to more “deaths of despair,” like from drug overdoses and suicides, which increased sharply during the pandemic, are also a significant contributor. A recession would lead to even more of these deaths.  

A recession would also lead to a rapid rise in homelessness, as more people cannot afford rent or mortgage payments. Many may become chronically homeless and, if so, their life expectancy will fall by decades. Domestic violence cases could also surge as loss of income leads to more stress at home — hospital and emergency room visits for domestic violence incidents tripled during the first year of the Great Recession in California, for instance. The stress would also likely lead to increases in mental illness.  

The suspension of public benefits like SNAP, Social Security and veteran benefits would cause further health harm. Missed rent payments could also contribute to homelessness, families — even mothers with young children — would not have enough to eat, and Americans will be forced to skip even life-sustaining medication. 

Averting a default may require a tough vote in Congress. It may require a compromise that satisfies no one. Or it may require a handful of courageous Republicans to work across the aisle in a vote that demonstrates their willingness to put the country’s interest, the global economy and human lives above partisan politics. In doing so, those congresspeople should be proud that in preventing economic meltdown, they will have saved the lives of tens of thousands of people at home and abroad. 

The Congressional Budget Office has warned of the national debt reaching unprecedented heights in the coming decades and of the attendant economic risks. But that cannot be an excuse for defaulting on our debt. In casting that hard vote, members should think about all those who would die as a result of default, the women who would experience domestic violence and the young girls who would be forced into marriage. Once we go off the cliff, it may be too late to save them from a tragic fate. 

Eric A. Friedman is a global health justice scholar at the O’Neill Institute for National & Global Health Law at Georgetown Law. Lawrence O. Gostin is a professor and faculty director of the O’Neill Institute for National & Global Health Law at Georgetown Law, and director of the World Health Organization Collaborating Center on Public Health Law & Human Rights.