Economic expansions are associated with increasing mortality. Suggested pathways to explain this deceleration or even reversal of the secular decline in mortality during economic expansions include both material and psychosocial effects of the economic upturns: expansion of traffic and industrial activity directly raising injury-related mortality, decreased immunity levels (owing to rising stress and reduction of sleep time, social interaction and social support), and increased consumption of tobacco, alcohol and saturated fats.

The relationship between economic fluctuations and mortality is assessed with data from Spain during the years 1980-1997, when national unemployment oscillated between 7% and 24%. Mortality rates of the Spanish provinces are modeled in fixed-effect panel regressions as functions of the demographic structure and the economic conditions. Unemployment effects on general mortality, sex-specific mortality, and mortality for major causes of death are negative, i.e., death rates increase procyclically when joblessness diminishes in an economic expansion. Homicides and female suicides are only weakly related or unrelated to economic fluctuations, but male suicides escalate countercyclically during economic downturns.Re´sume´. L'article s'inte´resse aux relations entre fluctuations e´conomiques et mortalite´en Espagne sur la pe´riode 1980-1997, au cours de laquelle le taux de choˆmage a oscille´entre 7 et 24%. Un mode`le de re´gression a`effets constants sur donne´es de panel est applique´aux taux de mortalite´par provinces espagnoles, prenant en compte la structure de´mographique et les conditions e´conomiques. Le choˆmage a un effet ne´gatif sur la mortalite´totale, la mortalite´par sexe et les principales causes de de´ce`s. Autrement dit, les taux de mortalite´augmentent quand, en phase d'expansion e´conomique, le choˆmage diminue. Les homicides et les suicides fe´minins sont faiblement ou pas du tout lie´s aux fluctuations e´conomiques alors que les suicides masculins augmentent lorsque la situation e´conomique se de´te´riore.

Recent events highlight the importance of examining the impact of economic downturns on population health. The Great Depression of the 1930s was the most important economic downturn in the U.S. in the twentieth century. We used historical life expectancy and mortality data to examine associations of economic growth with population health for the period 1920 -1940. We conducted descriptive analyses of trends and examined associations between annual changes in health indicators and annual changes in economic activity using correlations and regression models. Population health did not decline and indeed generally improved during the 4 years of the Great Depression, 1930 -1933, with mortality decreasing for almost all ages, and life expectancy increasing by several years in males, females, whites, and nonwhites. For most age groups, mortality tended to peak during years of strong economic expansion (such as 1923, 1926, 1929, and 1936 -1937). In contrast, the recessions of 1921, 1930 -1933, and 1938 coincided with declines in mortality and gains in life expectancy. The only exception was suicide mortality which increased during the Great Depression, but accounted for less than 2% of deaths. Correlation and regression analyses confirmed a significant negative effect of economic expansions on health gains. The evolution of population health during the years 1920 -1940 confirms the counterintuitive hypothesis that, as in other historical periods and market economies, population health tends to evolve better during recessions than in expansions.longevity ͉ mortality ͉ United States

Recent research has shown that after long-term declining trends are excluded, mortality rates in industrial countries tend to rise in economic expansions and fall in economic recessions. In the present work, co-movements between economic fluctuations and mortality changes in postwar Japan are investigated by analyzing time series of mortality rates and eight economic indicators. To eliminate spurious associations attributable to trends, series are detrended either via Hodrick-Prescott filtering or through differencing. As previously found in other industrial economies, general mortality and age-specific death rates in Japan tend to increase in expansions and drop in recessions, for both males and females. The effect, which is slightly stronger for males, is particularly noticeable in those aged 45-64. Deaths attributed to heart disease, pneumonia, accidents, liver disease, and senility--making up about 41% of total mortality--tend to fluctuate procyclically, increasing in expansions. Suicides, as well as deaths attributable to diabetes and hypertensive disease, make up about 4% of total mortality and fluctuate countercyclically, increasing in recessions. Deaths attributed to other causes, making up about half of total deaths, don't show a clearly defined relationship with the fluctuations of the economy.

Cuba's economic crisis of 1989-2000 resulted in reduced energy intake, increased physical activity, and sustained population-wide weight loss. The authors evaluated the possible association of these factors with mortality trends. Data on per capita daily energy intake, physical activity, weight loss, and smoking were systematically retrieved from national and local surveys. National vital statistics from 1980-2005 were used to assess trends in mortality from diabetes, coronary heart disease, stroke, cancer, and all causes. The crisis reduced per capita daily energy intake from 2,899 calories to 1,863 calories. During the crisis period, the proportion of physically active adults increased from 30% to 67%, and a 1.5-unit shift in the body mass index distribution was observed, along with a change in the distribution of body mass index categories. The prevalence of obesity declined from 14% to 7%, the prevalence of overweight increased 1%, and the prevalence of normal weight increased 4%. During 1997-2002, there were declines in deaths attributed to diabetes (51%), coronary heart disease (35%), stroke (20%), and all causes (18%). An outbreak of neuropathy and a modest increase in the all-cause death rate among the elderly were also observed. These results suggest that population-wide measures designed to reduce energy stores, without affecting nutritional sufficiency, may lead to declines in diabetes and cardiovascular disease prevalence and mortality.