Lifecycle effects of a recession on health behaviors: Boom, bust, and recovery in Iceland

Abstract

This study uses individual-level longitudinal data from Iceland, a country that experienced a severe economic crisis in 2008 and substantial recovery by 2012, to investigate the extent to which the effects of a recession on health behaviors are lingering or short-lived and to explore trajectories in health behaviors from pre-crisis boom, to crisis, to recovery. Health-compromising behaviors (smoking, heavy drinking, sugared soft drinks, sweets, fast food, and tanning) declined during the crisis, and all but sweets continued to decline during the recovery. Health-promoting behaviors (consumption of fruit, fish oil, and vitamins/minerals and getting recommended sleep) followed more idiosyncratic paths. Overall, most behaviors reverted back to their pre-crisis levels or trends during the recovery, and these short-term deviations in trajectories were probably too short-lived in this recession to have major impacts on health or mortality. A notable exception is for binge drinking, which declined by 10% during the 2 crisis years, continued to fall (at a slower rate of 8%) during the 3 recovery years, and did not revert back to the upward pre-crisis trend during our observation period. These lingering effects, which directionally run counter to the pre-crisis upward trend in consumption and do not reflect price increases during the recovery period, suggest that alcohol is a potential pathway by which recessions improve health and/or reduce mortality.

Health Impacts of the Great Recession: a Critical Review

“…Multilevel and aggregate studies provided little evidence to support any relationship between the Recession and smoking [26, 38, 83]. A particularly rigorous multilevel study from Iceland that controlled for time-invariant confounders such as sex and risk preferences indicated that individuals smoked less during the recession than they had prior to the recession [86]. In the Netherlands, the Recession appeared to widen existing education and income inequalities in current smoking among older adults and in smoking cessation among younger adults [87].…”

“…In Russia, there was no change in the food consumption among households experiencing income loss during the crisis [88]. In Iceland, consumption of soft drinks, sweets, and fast food increased but consumption of fruit declined during the crisis [86]. …”

Income-related inequalities in diseases and health conditions over the business cycle

“…Although only Ásgeirsdóttir and Ragnarsdóttir [40] have examined the business-cycle effects of the collapse on income-related health distributions, the special research opportunity created by those dramatic circumstances in Iceland has been taken advantage of in multiple studies examining the effect of the crisis on health [13, 41–44] and health behaviors [45–50]. Due to the incredibly low pre-crisis unemployment rate (of only 2% in October 2007) the large percentage increase in unemployment during the crisis still resulted in a lower rate (of 6% in October 2009) than in most other hard-hit countries such as Spain and Ireland [46, 51]. However, while these countries experienced a deflation during the crisis, in Iceland, on the contrary, prices rose due to a devaluation of the Icelandic Krona by about 36% in exchange markets [46].…”

“…Due to the incredibly low pre-crisis unemployment rate (of only 2% in October 2007) the large percentage increase in unemployment during the crisis still resulted in a lower rate (of 6% in October 2009) than in most other hard-hit countries such as Spain and Ireland [46, 51]. However, while these countries experienced a deflation during the crisis, in Iceland, on the contrary, prices rose due to a devaluation of the Icelandic Krona by about 36% in exchange markets [46]. This was evident both from the consumer price index which increased by roughly 12% between 2007 and 2008 and again 12% between 2008 and 2009 and from more than 10% drop in real wages between 2007 and 2010 [52].…”

Macroeconomic conditions and population health in Iceland

“…For instance, a longer-term analysis has been made on the relationship between business cycles and workplace accidents (Ásgeirsdóttir and Tryggvason 2014), and the most recent economic downturn has been the subject of several studies on business cycles and health (Ásgeirsdóttir, Ólafsdóttir, and Ragnarsdóttir 2014;Guðjónsdóttir et al 2012;Ólafsdóttir, Hrafnkelsson, and Ásgeirsdóttir 2014;Jónsdóttir and Ásgeirsdóttir 2014;Ásgeirsdóttir et al 2013;Ásgeirsdóttir and Ragnarsdóttir 2014;Eiríksdóttir et al 2013;Ólafsdóttir and Ásgeirsdóttir 2015;Hauksdóttir et al 2013;Ásgeirsdóttir et al 2016;Birgisdóttir, Jónsson, and Ásgeirsdóttir 2017), with the majority of research examining health behaviours (Ólafsdóttir, Hrafnkelsson, and Ásgeirsdóttir 2014;Guðjónsdóttir et al 2012;Jónsdóttir and Ásgeirsdóttir 2014;Ásgeirsdóttir et al 2013;Ásgeirsdóttir et al 2016;Ólafsdóttir and Ásgeirsdóttir 2015).…”