Elsevier

Social Science & Medicine

Volume 67, Issue 12, December 2008, Pages 2051-2058
Social Science & Medicine

Who is hurt by procyclical mortality?

https://doi.org/10.1016/j.socscimed.2008.09.032Get rights and content

Abstract

There is renewed interest in understanding how fluctuations in mortality and in health are related to fluctuations in economic conditions. The traditional perspective that economic recessions lower health and raise mortality has been challenged by recent findings that reveal mortality is actually procyclical. The epidemiology of the phenomenon – traffic accidents, cardiovascular disease, and smoking and drinking – suggests that socioeconomically vulnerable populations might be disproportionately at risk of “working themselves to death” during periods of heightened economic activity. In this paper, I examine mortality by individual characteristic during the 1980s and 1990s using the U.S. National Longitudinal Mortality Study. I find scant evidence that disadvantaged groups are significantly more exposed to procyclical mortality. Rather, working-age men with more education appear to bear a heavier burden, while those with little education experience countercyclical mortality.

Section snippets

Background and motivation

We typically assume that the downside of the business cycle is bad, especially for individuals of lesser means. The rise of the modern welfare state earlier in the past century was a direct effort to limit the pain inflicted by economic recessions, if not head them off entirely. Similarly, the traditional perspective on the health impacts of economic fluctuations held that recessions were bad, especially for the vulnerable (Brenner, 1971, Brenner, 1975, Brenner, 1979).

But a number of recent

The National Longitudinal Mortality Study

The NLMS is a dataset of individuals who are interviewed once in a Current Population Survey and then subsequently matched to death certificates via the National Death Index. The result is unique among U.S. datasets: a large-scale panel study of mortality connected to a one-time snapshot of covariates such as education, occupation, employment status, and family income. The NDI identifies time of death down to 6-h groupings, along with cause of death and other data from the death certificate.

Levels, trends, and volatility in mortality

Fig. 1 plots two time series of the age-adjusted mortality rate among individuals of both sexes aged 10 years and over, one using the NLMS data and the other using data from the Human Mortality Database, which is drawn from national vital statistics. Aggregate mortality in NLMS is about 17% lower than in official data, but neither trend nor volatility appears to be substantially dissimilar. The lack of institutional coverage probably accounts for both the reduced level of the NLMS series as

Discussion

Data from the National Longitudinal Mortality Study reveal that mortality was procyclical in the U.S. during the 1980s and 1990s. This result matches up well with the findings of Gerdtham and Ruhm, 2006, Laporte, 2004, Neumayer, 2004, Ruhm, 2000, Ruhm, 2003, Ruhm, 2007, Ruhm, 2008, Tapia Granados, 2005, Tapia Granados, 2008, and Tapia Granados and Ionides (2008), but it conflicts with that of Gerdtham and Johannesson (2005), the only other study that examines cyclical mortality trends using

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    An earlier version of this paper was presented at the 2006 Annual Meeting of the Population Association of America in Los Angeles. I am grateful to Jason Schnittker and conference participants for comments, and to several anonymous referees for their helpful criticism. This work was partially supported by NIH grants T32 AG000244 and T32 HD 07329. This paper uses data supplied by the National Heart, Lung, and Blood Institute, NIH, DHHS from the National Longitudinal Mortality Study. The views expressed in this paper are those of the authors and do not necessarily reflect the views of the National Heart, Lung, and Blood Institute, the Bureau of the Census, or the National Center for Health Statistics.

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