International Journal of Public Health

, Volume 56, Issue 1, pp 3–5 | Cite as

Hard times or good times? Inequalities in the health effects of economic change

  • Mylène RivaEmail author
  • Clare Bambra
  • Susan Easton
  • Sarah Curtis

The financial crisis in 2007 led to a deepening economic recession with global reductions in economic growth and rising unemployment. This has led to renewed discussions about the effects of economic cycles on population health both in the popular media and in academia. The media coverage tends to speculate on the idea that mortality increases around times of economic downturn, reflecting findings from some research which suggests that mortality trends are ‘counter-cyclical’ to economic trends. However, there appear to be varying views in the academic literature concerning the relationship between macroeconomic fluctuations and population health. A ‘pro-cyclical’ relationship has been reported in several studies; i.e. mortality rates get worse when the economy is growing and improve during periods of economic recession (Gerdtham and Ruhm 2006; Ruhm 2000; Tapia Granados 2005; Tapia Granados and Ionides 2008; Laporte 2004; Neumayer 2004). In other words, economic recession is associated...


Health Inequality Employment Rate Economic Recession Economic Trend Local Labour Market 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. Bosma H, van de Mheen HD, Borsboom G, Mackenbach JP (2001) Neighborhood socioeconomic status and all-cause mortality. Am J Epidemiol 153:363–371CrossRefPubMedGoogle Scholar
  2. Charles KK, DeCicca P (2008) Local labor market fluctuations and health: is there a connection and for whom? J Health Econ 27:1532–1550CrossRefPubMedGoogle Scholar
  3. Cummins S, Macintyre S, Davidson S, Ellaway A (2005) Measuring neighbourhood social and material context: generation and interpretation of ecological data from routine and non-routine sources. Health Place 11:249–260CrossRefPubMedGoogle Scholar
  4. Edwards R (2008) Who is hurt by procyclical mortality? Soc Sci Med 67:2051–2058CrossRefPubMedGoogle Scholar
  5. Equality and Human Rights Commission, Department for work and pensions, Government Equalities Office (2009) Monitoring the impact of the recession on various demographic groups. Department for Work and Pensions, LondonGoogle Scholar
  6. Fone D, Dunstan F, Williams G, Lloyd K, Palmer S (2007a) Places, people and mental health: a multilevel analysis of economic inactivity. Soc Sci Med 64:633–645CrossRefPubMedGoogle Scholar
  7. Fone D, Lloyd K, Dunstan FD (2007b) Measuring the neighbourhood using UK benefits data: a multilevel analysis of mental health status. BMC Public Health 7:69CrossRefPubMedGoogle Scholar
  8. Gerdtham UG, Johannesson M (2005) Business cycles and mortality: results from Swedish microdata. Soc Sci Med 60:205–218CrossRefPubMedGoogle Scholar
  9. Gerdtham UG, Ruhm CJ (2006) Deaths rise in good economic times: evidence from the OECD. Econ Hum Biol 4:298–316CrossRefPubMedGoogle Scholar
  10. Hopkins S (2006) Economic stability and health status: evidence from East Asia before and after the 1990s economic crisis. Health Policy 75:347–357CrossRefPubMedGoogle Scholar
  11. Horton R (2009) The global financial crisis: an acute threat to health. Lancet 373(9661):355–356CrossRefPubMedGoogle Scholar
  12. Kondo N, Subramanian SV, Kawachi I, Takeda Y, Yamagata Z (2008) Economic recession and health inequalities in Japans: analysis with a national sample, 1986–2001. J Epidemiol Community Health 62:869–875CrossRefPubMedGoogle Scholar
  13. Laporte A (2004) Do economic cycles have a permanent effect on population health? Revisiting the Brenner hypothesis. Health Econ 13:767–779CrossRefPubMedGoogle Scholar
  14. Martikainen PT, Valkonen T (1996) Excess mortality of unemployed men and women during a period of rapidly increasing unemployment. Lancet 348:909–912CrossRefPubMedGoogle Scholar
  15. Miller DL, Page ME, Stevens AH, Filipski M (2009) Why are recessions good for your health? Am Econ Rev 99:122–127CrossRefGoogle Scholar
  16. Neumayer E (2004) Recessions lower (some) mortality rates: evidence from Germany. Soc Sci Med 58:1037–1047CrossRefPubMedGoogle Scholar
  17. Office for National Statistics (2009) The impact of the recession on the labour market. England. LondonGoogle Scholar
  18. Riva M, Bambra C, Curtis S, Gauvin L (2010) Collective resources or local social inequalities? Examining the social determinants of mental health in rural areas. Eur J Public Health. doi: 10.1093/eurpub/ckq064
  19. Ruhm CJ (2000) Are recessions good for your health? Q J Econ 115:617–650CrossRefGoogle Scholar
  20. Ruhm CJ (2007) A healthy economy can break your heart. Demography 44:829–848PubMedGoogle Scholar
  21. Ruhm CJ, Black WE (2002) Does drinking really decrease in bad times? J Health Econ 21:659–678CrossRefPubMedGoogle Scholar
  22. Stafford M, Martikainen P, Lahelma E, Marmot M (2004) Neighbourhoods and self rated health: a comparison of public sector employees in London and Helsinki. J Epidemiol Community Health 58:772–778CrossRefPubMedGoogle Scholar
  23. Stafford M, Cummins S, Macintyre S, Ellaway A, Marmot M (2005) Gender differences in the associations between health and neighbourhood environment. Soc Sci Med 60:1681–1692CrossRefPubMedGoogle Scholar
  24. Stuckler D, Basu S, Suhrcke M, Coutts A, McKee M (2009a) The public health effect of economic crises and alternative policy responses in Europe: an empirical analysis. Lancet 374:315–323CrossRefPubMedGoogle Scholar
  25. Stuckler D, Basu S, Suhrcke M, McKee M (2009b) The health implications of financial crisis: a review of the evidence. Ulster Med J 78:142–145PubMedGoogle Scholar
  26. Tapia Granados JA (2005) Increasing mortality during the expansions of the US economy, 1900–1996. Int J Epidemiol 34:1194–1202CrossRefPubMedGoogle Scholar
  27. Tapia Granados JA, Ionides EL (2008) The reversal of the relation between economic growth and health progress: Sweden in the 19th and 20th centuries. J Health Econ 27:544–563CrossRefPubMedGoogle Scholar
  28. Valkonen T, Martikainen P (1996) The association between unemployment and mortality: causation or selection? In: Lopez A, Casell G, Valkonen T (eds) Adult mortality in developed countries: from description to explanation. Clarendon Press, Oxford, UK, pp 1859–1861Google Scholar

Copyright information

© Swiss School of Public Health 2010

Authors and Affiliations

  • Mylène Riva
    • 1
    Email author
  • Clare Bambra
    • 1
  • Susan Easton
    • 1
  • Sarah Curtis
    • 1
  1. 1.Department of GeographyDurham University, Science LaboratoriesDurhamUK

Personalised recommendations