Recessions: Good for Our Health?

The name seems to say it all. The Great Depression was bad all around, wasn't it? Maybe not.

New findings show that the Great Depression was actually good for U.S. health. Annual death rates declined during years of downturn and increased in years of expansion.

The findings could offer a silver lining to today's financial crisis.

The results reinforce earlier research showing recessions reduce mortality, but researchers didn't know whether the effect would hold through a full blown economic meltdown like the Great Depression.

"I've done a lot of work showing that people get healthier in recessions. I've always said I don't know if these results would hold up in a real downturn like a depression. I guess they do," said Christopher Ruhm of the University of North Carolina at Greensboro, who was not a part of the new study. "If you had asked me whether I would have predicted these results, I wouldn't necessarily have said yes."

In the new study, researchers analyzed mortality rate and life expectancy in the years 1920 to 1940. "For most age groups, mortality tended to peak during years of strong economic expansion," the authors wrote in Proceedings of the National Academy of Sciences. "In contrast, the recessions of 1921, 1930-1933 ad 1938 coincided with declines in mortality and gains in life expectancy."

The team also looked specifically at six causes of death representing two-thirds of all mortality: cardiovascular disease, tuberculosis, cancer, flu and pneumonia, motor vehicle deaths and suicide.

The only one that increased in down years was suicide, said study lead author Jose Tapia Granados of the University of Michigan, Ann Arbor. But suicide represented less than 2 percent of all deaths, so overall, mortality improved.

Why do people get healthier in depressions? "If you want a short answer, I don't know," Tapia Granados said.

There are many possible reasons. People smoke and drink more when times are good, and there is money to spare. Traffic accidents, industrial accidents, work hours and work stress all go up when the economy is booming.

"It is increasingly known that over time, stress in the work place can increase the risk of things like heart attacks," Tapia Granados said.

"There are other possibilities which are speculative," he added. "Many people believe that the Depression was a period of social support. When you are at risk of losing your job, you get much more connected with members of your community." Social support seems to improve health, he said.

Atmospheric pollution may also have played a role. With less industrial activity during the Depression, levels of pollutants would have fallen, which would have reduced heart attacks and other illnesses.

It is important to note that these findings are an average effect only, said Eric Neumayer of the London School of Economics, who found similar effects for economic recessions in Germany. "Clearly the health of some people will suffer -- think of the unemployed -- while the health of others will benefit. As it seems from the data I and others have analyzed, the beneficial aspects seem to outweigh the detrimental aspects."

"There is no doubt that there is a positive relationship between per capita income and health," he added. "Richer countries are more healthy than poor countries. And as countries grow richer, generally health becomes better."

But, there is a difference between the long-term trend and short-term perturbations caused by recessions and booms, he said.

Not everyone agrees with the findings. "It is true that there is a very short-term decline in mortality during the period of recession itself coupled with a large increase in damaging mental health effects," said Harvey Brenner of University of North Texas Health Science Center and Johns Hopkins University in Baltimore.

But in Brenner's view, the increases in mortality seen during economic recovery are actually the recessions' lagging effects. Unemployment remains high, he said, and companies overwork their remaining employees as business picks back up. "In the medium- to longer-term, the effect of recession is to increase mortality substantially," he said.

So is this good news for today's economic doldrums? Possibly so. "This downturn should have the same effect," Neumeyer predicts, and Tapia Granados agrees.

However, it's too early to tell. The data needed to prove it are not yet available.