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Understanding the Impacts of Economic Changes on Health: Insights from Swedish Data

This study explores the relationship between economic shifts—such as recessions, GDP changes, and unemployment—and health outcomes in Sweden from 1751 to 2004. It reveals that while economic growth historically decreased mortality rates, recessions may paradoxically improve health among the employed due to reduced stress and harmful behaviors. Analysis of historical data indicates significant (p<0.05) correlations between GDP increases and decreased infant mortality. However, the health impact of unemployment requires further examination, highlighting a complex interplay of socio-economic factors over time.

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Understanding the Impacts of Economic Changes on Health: Insights from Swedish Data

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  1. Structural shift: the effect of a factor changes over time • Economy – health • Economy – thefts • Economy - emigration

  2. Are Recessions Good For Your Health? Past times: No! Now: Yes? Economic indicators: - GDP/capita - Unemployment Health indicators: - Infant mortality - Mortality 15-59 years

  3. Past times (18th and 19th century): people lived close to subsistence level, small margins bad timesstarvation, malnutrition, increased mortality • Economic growth improved sanitary conditionsand nutrition reduced mortality

  4. Sweden, 1751-1899

  5. Sweden, 1751-1899

  6. Sweden, 1751-1899

  7. Time series analysis of differenced data  significant (p<0.05) effect of GDP: increased GDP  reduced infant (and total) mortality

  8. But: analyses of Swedish data 1861-1913decreasing effect of the economy on mortality (Norström, Eur J Population 1988)

  9. Elasticity wages – mortality 1861-1913

  10. Preston (Population Studies 1975)

  11. Sweden 1751-2004, life expectancy and GDP

  12. Received wisdom: - Pritchett & L. Summers (1996) “Wealthier is Healthier” Journal of Human Resources Doubts: - Ruhm, C. (2000), “Are Recessions Good For Your Health?”, Quarterly Journal of Economics No doubts: - Ruhm, C. (2003), “Good Times Make You Sick”, Journal of Health Economics - Tapia Granados, J.A. (2005) “Increasing Mortality during the Expansions of the US economy, 1900-1996.” International Journal of Epidemiology

  13. . Health of unemployed - Population health Recessions + Health of employed +

  14. How could recessions be good for your health? • Less overtime and stress • Less smoking and alcohol • Less air pollutions • Less driving fewer accidents

  15. Male mortality 15-39 years and unemployment, Finland 1950-2000

  16. More rigorious test of the link between unemployment and mortality: ARIMA-analyses of differenced data 1950-2000 for a larger numer of countries. Outcome= male mortality 15-34 and 15-59 Explanatory variable: unemployment

  17. Result: increase in unemployment by 1 percentage point  reduced male mortality by 1% (not significant for women) Same as Tapia Granados found for the US

  18. Mechanism via reduced alcohol consumption (Finland) Unemployment +1%-point -0.3% Mortality -0.9% -0.6% Alcohol Consn -0.2 liter

  19. Conclusions • Recessions  worse health among unemployed(?), but better health among the rest • Common design (micro data comparing health of unemployed with the rest) has an inbuilt bias that masks positive health effects among the rest

  20. Recessions  worse health among unemployed? . Health of unemployed -? Population health Recessions + Health of employed +

  21. Unemploymentsuicide? • Micro data: Unemployed have an elevated suicide risk (RR=3). Selection effect? • Several TSA report significant relationships • Structural shift? • Focus 2 time periods with marked changes in unemployment in Sweden: • 1925-1938 • 1980-2002

  22. Sweden 1925-1938

  23. Sweden 1980-2002

  24. 4 model estimations: % change in suicide of a 1-unit increase in the predictor. Differenced data*** p<0.001 ** p<0.01 * p<0.05 (*) p<0.10

  25. Structural shift Exemple 2: Economy – thefts

  26. 2 hypotheses on the link economy - thefts • Improved economy reduced theft rate (poverty related crimes) • Improved economy increased theft rate (opportunity structure)

  27. Thefts (dotted) and real wages (solid). Sweden 1841-1984

  28. Theft rate (Y-axis) and real wages (X-axis) Negative relationship confirmed by ARIMA-analyses of differenced data

  29. Theft rate (above) and thefts not explained by real wages=noise (below)

  30. Indicators 1950-1985, cf Merton Durable goods Job vacancies

  31. Results ARIMA 1950-1984, elasticities (SE)

  32. Observed Vacanciesfixed Durable goodsfixed Noise

  33. Conclusion • Support for both hypotheses on the link between economy - thefts

  34. Parenthesis: suicide

  35. Suicide rate per 100 000 25 Other causes 10 5 Cause: alcohol 1915 1955 1925 Cause: unemployment What’s an important cause? May change

  36. Example 3: Emigration from Sweden 1861-1913

  37. Questions • Most important: pull- or push factors? • Wages or business climate?

  38. Determinants of emigration: Swedish and US economic indicators1861-1913 Importance Decreasing Small Increasing Small Increasing

  39. TriangulationHas economic growth effect also after 1850? Test with multiple indicators on life chancesstronger evidence TSA 1860-1914 Emigration - - Economic growth Mortality - Thefts

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