Effects of macroeconomic fluctuations on mental health and psychotropic medicine consumption


Our aim in this paper is to understand the impact of macroeconomic fluctuations on mental health and psychotropic medicine consumption. In order to do that we exploit differences in the fluctuations of business cycle conditions across regional units in Catalonia. Our findings suggest that, in general, economic fluctuations at the local level had no significant effect on the consumption of psychotropic medicines. However, we show that a deterioration in local labour market conditions is associated with a reduction in the consumption of anxiolytics medicines. We also report an increase in the consumption of anxiolytics in regions with a softer deterioration in the economic situation. Although we report mild improvements in both mental and physical health for some sub-groups of the population, we also find significant reductions on the probability of sleeping 6 h or more. Thus, these elements point towards potential negative effects of local labour market conditions on health in the medium/long term.

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Fig. 1

Source: Catalan Institute of Statistics (IDESCAT)


  1. 1.

    It should be noticed that, in Spain, mental healthcare is an integral part of the general healthcare with universal coverage funded by taxation (Salvador-Carulla et al. 2006). Moreover, general practitioner doctor can offer psychotropic treatments as part of their service, especially in patients who suffer anxiety or depression.

  2. 2.

    See further information in: https://www.aemps.gob.es/.

  3. 3.

    Individuals cannot be followed over time.

  4. 4.

    Except for 2010 in which the survey is collected only once.

  5. 5.

    We use 6 h per day as a measured of enough sleep because of, according to Möller-Levet et al. (2013), sleeping less than 6 h can have a broad negative impact on long-term well-being.

  6. 6.

    It should be noted that the most disaggregated regional variable provided by ESCA is the Territorial Health Government (GTS), which its main aim is to promote the interaction between Government, Administration and citizens, and is composed by 37 health regions. However, we used 31 regions as some of them are merger in order to match with their specifically unemployment rate. For instance, there are 4 GTS for the area of Barcelona.

  7. 7.

    Figure 2 plots the evolution of the unemployment rate in Catalonia and in Spain and we can see that the evolution is very similar. Furthermore, Fig. 3 plots the evolution of the unemployment rate in the four provinces in Catalonia. As it can be seen, there are regional differences in business cycle conditions within Catalonia.

  8. 8.

    We define this variable as a dummy variable that takes value 1 if the region experiences an increase in the unemployment rate above the mean during our sample period and zero otherwise.


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Correspondence to Judit Vall Castelló.

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See Table 9, Fig. 2, 3, 4.

Table 9 Description and categorization of the variables included in the analysis
Fig. 2

Source: National Institute of Statistics

Evolution of the unemployment rate in Catalonia and Spain by trimester during our sample period.

Fig. 3

Source: Catalan Institute of Statistics (IDESCAT)

Evolution of the employment rate in Catalonia by provinces during our sample period.

Fig. 4

Source: Catalan Institute of Statistics (IDESCAT)

Evolution of the number of inhabitants in Catalonia during our sample period.

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Martínez-Jiménez, M., Vall Castelló, J. Effects of macroeconomic fluctuations on mental health and psychotropic medicine consumption. Int J Health Econ Manag. 20, 277–297 (2020). https://doi.org/10.1007/s10754-020-09281-3

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  • Psychotropic consumption
  • Business cycle fluctuations
  • Mental and physical health

JEL Classification

  • I12
  • I10
  • I18