A healthy economy can break your heart

Abstract

Abstract:Panel data methods are used to investigate how deaths from coronary heart disease (CHD) in the United States vary with macroeconomic conditions. A one-percentage-point reduction in unemployment is predicted to raise CHD mortality by 0.75%, corresponding to almost 3,900 additional fatalities. The increase in relative risk is similar across age groups, implying that senior citizens account for most of the extra deaths. Direct evidence is obtained of a role for decreases in medical interventions treating coronary problems. CHD mortality increases rapidly when the economy strengthens but returns to or near its baseline level within five years for most groups. Article:Does mortality from coronary heart disease (CHD) fall when macroeconomic conditions strengthen? The answer to this question may seem obvious. Heart disease is the leading source of death in the United States (Anderson and Smith 2005), and CHD, its most important component, is highly responsive to both environmental and individual risk factors. Because economic upturns are believed to reduce social and psychological hardship, health might be expected to improve and CHD mortality to decrease (Brenner and Mooney 1983;Catalano 1991). Moreover, widely cited investigations of aggregate time-series data covering the 1930s through the 1970s suggest reductions in CHD fatalities during periods of falling unemployment (Brenner 1971(Brenner , 1979Bunn 1979). However, these results are probably wrong. Evidence presented here suggests that mortality from heart disease rises when the economy expands and that this rise in heart-disease mortality is entirely due to increased CHD deaths.

Macroeconomic conditions and population health in Iceland

“…This is not surprising since many studies have found that males and females react differently to changes in the economy (Ruhm 2003(Ruhm , 2005Ásgeirsdóttir et al 2013, 2014aDave and Kelly 2012;Tapia Granados 2005b;Birgisdóttir et al 2017). Our results are in contrast to some recent literature on the subject where both pro-and countercyclical relationships have been found (Ruhm 2000;Neumayer 2004;Gerdtham and Ruhm 2006;Ruhm 2003Ruhm , 2005Ruhm , 2007Svensson 2010Svensson , 2007Gerdtham and Johannesson 2005).…”

“…Comparably, one does not expect to see much variation in diseases that are mostly genetically determined or take a long time to materialize, such as certain types of cancer, but rather in diseases that are affected by behaviour, lifestyle, and environmental factors. Ruhm (2000Ruhm ( , 2003Ruhm ( , 2005Ruhm ( , 2007, utilizing US data from 1972 through 2000, shows state-level mortality rates to be procyclical, indicating that recessions are beneficial to population health. He speculates that rising opportunity costs may be an explanation.…”

“…Examined possible mechanisms for the procyclicality of overall mortality in the United States have mostly been personal income (Ruhm 2000), health behaviours (Ruhm 2003(Ruhm , 2007(Ruhm , 2015, and individual labour market status (Miller et al 2009). Miller et al (2009) find that the added deaths related to a rise in the unemployment rate are mostly for age groups that are not likely to be a part of the labour force; only 7% of additional deaths were for the age group 25-64.…”

“…Unemployment is a natural economic-cycle indicator, and very widely used in the literature to proxy economic conditions (Ruhm 2000(Ruhm , 2003(Ruhm , 2005(Ruhm , 2007Miller et al 2009;Eliason and Storrie 2009;Gerdtham and Johannesson 2003). We follow that tradition, with the unemployment rate reported as part of the civilian labour force.…”

Bank failures, mortality and the Great Depression: Table 1

“…As research by Ruhm,6 7 myself8 9 and others10 11 has shown, using data from a variety of market economies, economic expansions raise total mortality and cardiovascular deaths which, conversely, fall in recessions. Applying Ruhm estimates6 7 to the 2.5 million annual deaths observed in recent years in the USA, an economic recovery (ie, an expansion) reducing the unemployment rate from, say, 9% to 4%, is expected to be associated with some 60 000 extra deaths, of which almost a third would be heart attacks. In spite of the conclusions reached by Stuckler, this is what the historical experience suggests.…”