Could the Recession Be Good for Your Health?

TUESDAY Sept. 29, 2009 -- The economic downturn may not be all bad - in fact, researchers say recessions may actually be good for health.

University of Michigan researchers looked at death rates during the Great Depression, the worst economic slump in the 20th century. From the stock market crash of 1929 through the early 1930s, economic activity fell sharply, dropping 14 percent in 1932, while unemployment hit 22.9 percent that same year.

Black and white images from the era of bread lines and migrant farmers make it easy to assume the economic misery would have affected public health.

But when the researchers looked at mortality rates among men, women and children from 1920 to 1940, they found death rates declined during years of falling economic activity and rose when times were better.

The study is in the Sept. 28 online edition of the Proceedings of the National Academy of Sciences.

During the two decades spanning the 1920s and 1930s, overall life expectancy increased by 8.8 years. But it wasn't a steady rise, instead shooting up and falling back in a pattern that correlated with the rise and fall of economic activity.

Between 1921 and 1926, the so-called "Roaring 20s" and a time of robust economic growth, life expectancy for non-white men fell by 8.1 years. Yet between 1929 and 1933, the years of steepest economic decline, their life expectancy grew a similar amount.

Likewise, non-white women lost 7.4 years of life expectancy during the Roaring 20s, but they gained 8.2 years of life expectancy during the Depression.

Whites showed a similar pattern, though the loss in life expectancy wasn't as extreme as for non-whites.

"The basic finding of the paper is that mortality rates tend to evolve in parallel to the economy," said lead study author Jose Tapia Granados, an assistant research scientist at University of Michigan Institute for Social Research. "When the economy goes up, mortality tends to go up. When the economy goes down, mortality rates tend to go down, too."

Researchers did find one exception. During the 1920s and 1930s, two-thirds of all deaths were caused by cardiovascular and renal diseases, cancer, influenza and pneumonia, tuberculosis, motor vehicle accidents and suicide.

All became less deadly during difficult economic times, with the exception of suicides. But suicides accounted for fewer than 2 percent of all deaths, not enough to alter the overall trend, the study authors added.

The country's climb out of the Great Depression began in 1933. The economy grew by more than 10 percent annually from 1933 to 1936. Mortality again peaked in 1936, four years after the worst year of the Depression, even for children under age 4.

The surge in deaths in 1936 isn't just attributable to lag time, the researchers noted. Deaths from motor vehicle accidents went up, in which lag time would not play a role.

So why would the return of good times be bad for health?

More economic activity means people have money to drive cars, meaning more die in auto wrecks, the researchers theorize. In the 1920s and 1930s, cars became objects of mass consumption.

As motor vehicle use increases, so does pollution. Recent studies have linked particulate matter from cars and trucks and carbon monoxide with heart attacks and strokes.

During periods of growth, people have more money to spend on alcohol and cigarettes. And more economic activity means more factory orders, meaning people are working harder and longer and sleeping less.

Still, this is not to say that losing a job is good for your health. The study looks at the bigger picture -- fewer cars, fewer people working overtime, less pollution -- and how it may benefit public health as a whole.

A similar pattern may be at work during the current downturn, the authors suggested.

"My expectation is that mortality rates in 2008 will be lower than in 2007, and probably in 2009 will be lower than 2008," Tapia said. "There is a general improvement, even though suicides are going up."

Joshua Klapow, associate professor at the University of Alabama Birmingham's School of Public Health, said he would be cautious about applying any of the findings to today's recession.

Society has changed significantly in the past 60 to 80 years, he said. Medical advances enable people to live with chronic diseases for much longer nowadays. Infectious diseases, such as tuberculosis, kill fewer people today. Fewer people do manual labor, smoking has declined, and obesity has shot up.

"The only points of similarity are the economic factors," Klapow said. "You can't equate health status, health care, health costs or lifestyles with the 1920s or the 1930s. You have confounding factors right now that prevent us from drawing any reasonable conclusion about our current state."

And during this downturn, studies show that many Americans are making poor health choices, such as cutting back on medications and putting off medical care because of costs.

"We have a lot of indicators during this economic turmoil that the health status of our population is not getting better," Klapow said. "The study is fascinating, but we have to be very careful not to forecast a trajectory to our present day."

More information

The Herbert Hoover Presidential Library & Museum has more on the Great Depression.

Posted: September 2009


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