Thursday, March 27, 2008

Why Recessions are Good...for Your Health

Yes, there is a silver lining to the recession of 2008: your health should improve. At least that is the finding from a number of empirical studies. These studies indicate recessions help induce behavioral changes that are conducive to healthier lifestyles. Christopher Ruhm, a seminal figure in this literature, explains how this process could work: "Individuals might adopt healthier lifestyles when the economy weakens because increases in non-market time make it less costly to undertake health-producing activities such as exercise or the consumption of a healthy diet. Reductions in incomes and employment related stress could also decrease the frequency of 'self-medication' by smoking and drinking." (source) These results are contrary to what I expected, though consistent with my own research that shows some individuals get more religious during economic downturns. Advocates for recession's 'cleansing effects', then, may find this research to bolster their case.

Here are links and abstracts to some of these studies. First up, Christopher Ruhm's paper "Healthy Living In Hard Times":

Using microdata for adults from 1987 to 2000 years of the Behavioral Risk Factor Surveillance System (BRFSS), I show that smoking and excess weight decline during temporary economic downturns while leisure-time physical activity rises. The drop in tobacco use occurs disproportionately among heavy smokers, the fall in body weight among the severely obese and the increase in exercise among those who were completely inactive. Declining work hours may provide one reason why behaviors become healthier, possibly by increasing the non-market time available for lifestyle investments. Conversely, there is little evidence of an important role for income reductions. The overall conclusion is that changes in behaviors supply one mechanism for the procyclical variation in mortality and morbidity observed in recent research.
Next, Ruhm's paper "A Healthy Economy Can Break Your Heart":

Panel data econometric methods are used to investigate how the risk of death from coronary heart disease (CHD) varies with macroeconomic conditions after controlling for demographic factors, fixed state characteristics, general time effects and state-specific time trends. The primary analysis covers 1979-1998, with a supplemental investigation of medical procedures during 1994-2003. A one percentage point reduction in unemployment is predicted to raise CHD mortality by 0.75 percent, corresponding to almost 3,900 additional fatalities. The increase in relative risk is similar across age groups implying that senior citizens, who have the highest fatality rates, account for most of the extra deaths.
And another Ruhm paper coauthored with Ulf-G. Gerdtham titled "Deaths Rise in Good Economic Times: Evidence from the OECD":

This study uses aggregate data for 23 OECD countries over the 1960-1997 period to examine the relationship between macroeconomic conditions and deaths. The main finding is that total mortality and deaths from several common causes rise when labor markets strengthen. For instance, controlling for year effects, location fixed effects, country-specific time trends and demographic characteristics, a one percentage-point decrease in the national unemployment rateis associated with growth of 0.4 percent in total mortality and the following increases in causespecificmortality: 0.4 percent for cardiovascular disease, 1.1 percent for influenza/pneumonia,1.8 percent for liver disease, 2.1 percent for motor vehicle deaths, and 0.8 percent for otheraccidents.
Finally, José A Tapia Granados paper "Increasing mortality during the expansionsof the US economy, 1900–1996":

... Statistically and demographically significant results show that the decline of total mortality and mortality for different groups, ages and causes accelerated during recessions and was reduced or even reversed during periods of economic expansion—with the exception of suicides which increase during recessions. In recent decades these effects are stronger for women and non-whites.


  1. One would think that as family budgets collapse, expenditures on health care would be one of the first casualties. And as more employees with coverage loose their jobs, they are less likely to be able to afford either COBRA or self-pay. What could this possibly do to morbidity rates? hmmm.

    And last time I checked, most leisure (exercise related) activities are rather expensive - even a membership in the local Y runs into the hundreds of dollars. Access to national parks (and teh gas to get there) is more expensive as well. And golf? forget it!

  2. Anonymous:

    Note that the last paper I cite actually shows suicides increase during recessions. So all cannot be well. I certainly can see emotional distress increasing as ones finances deteriorate. And that could not be good for health.

    However, I can also see how one could substitute into some healthier behaviors that are not costly. One does not have to join a gym to get more exercise. Also, I can see someone eating better afer loosing their job (e.g. go from steak dinners to beans and rice dinners).

    Before seeing this literature my thinking was similar to what you outline.