ECONOMIC RECESSION

Economic Recession



Executive Summary

Economic recession periodically occur in all the world's economies. Despite the importance of recessions, there has been relatively little conclusive research conducted on their impact on a population's health and healthcare providers. Those few researchers who have studied the issue tend to break into two camps. In the one camp, economists and public health researchers argue that recessions and health are countercyclical; that is, as the economy deteriorates, more individuals become ill and seek out healthcare services thereby placing a strain on healthcare providers. In contrast, researchers in the other camp argue that recessions and health are procyclical; that is, as the economy deteriorates, fewer individuals have the economic resources to pursue unhealthy behaviors such as overeating, smoking, and consuming alcohol, which lead to improved health and decreased healthcare utilization. Both camps study the issue by focusing on mortality data and/or healthcare utilization data.

Economic Recession

Intorduction to Economic Recession

Economic recession is defined in macroeconomic theory as two or more calendar quarters of consecutive decline in a nation's gross domestic product (GDP). The National Bureau of Economic Research (NBER) more broadly defines recession as a significant decline in economic activity spread across the economy, lasting more than a few months. Recession may also have accompanying declines in employment rates, among other measures of a nation's economic health such as business profitability, stock market performance, and inflation.

Health Problems and Economic Recession

One of the first researchers to study the relationship between unemployment and health in the United States was M. Harvey Brenner. In the late 1960s, Brenner studied the effect of economic change on the patterns of psychiatric hospitalizations and psychopathological conditions in general. He initially studied the effects of economic change on the mental hospitalization levels of various socioeconomic groups. Brenner found that it was not necessarily the traditional poor alone who became psychiatric victims of precipitating economic stress—under sufficient economic pressure, members of all socioeconomic stratum responded in terms of mental hospitalization. Hospital utilization—a surrogate for the incidence of disease or morbidity—in the larger population, therefore, increased during times of increasing unemployment and declining gross domestic product growth. As unemployment increased, the incidence in job-loss related stress and macroeconomic stressors increased, thereby increasing the utilization of mental health services.

Analysis

Economic recession appears to increase the probability of a variety of losses and social changes that potentially threaten health in at least three ways: Poverty or lack of material resources to meet the ordinary requirements as well as the extraordinary problems of life can affect many of the unemployed and others who experience financial loss; the psychological stress associated with financial loss is potentially damaging itself, especially if it leads to withdrawal and the loss of potentially beneficial relationships; and attempts to alleviate psychological distress by medicating with alcohol or legal and illegal drugs, by overeating or under-eating, or by smoking tobacco will tend to exacerbate existing morbidity and produce additional health problems.

In a more recent mental health example, there is an emerging area of research related to the ...