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Is recession really good for our health?

So it costs $60 to fill up the tank, you're struggling with your credit cards and your job might evaporate any day now.

You feel stressed, anxious and blue — all a recipe for poor health, right?

So you would think. But some researchers say that public health actually tends to improve during a recession.

"When times are bad, mortality rates fall, and most measures of physical health improve," says Christopher Ruhm, an economics professor at the University of North Carolina at Greensboro.

Huh?

Ruhm is among a handful of researchers who advocate this surprising theory, which has generated recent news coverage from New York to Los Angeles.

I'm not the only one who finds this silver lining idea, well, unexpected.

"I'm reluctant to buy into the argument by these folks," says Jay Wolfson, a professor of public health and medicine at the University of South Florida and associate vice president of USF Health.

Wolfson backs the more traditional view: that when the economy falters, so does public health.

"If employees are laid off, they lose their corporate health benefits," he said. "You also have companies that modify their benefits … so what was fully covered in the past is not."

People who lose benefits or pay more for co-payments put off going to the doctor. They put off medical tests and may skip getting prescriptions filled to save cash. They feel anxiety and stress, which can contribute to a number of health problems, from getting sick more easily to having higher blood pressure.

Ruhm said he agrees that people may be depressed.

"There may well be a distinction between physical and mental health," he said. "People are healthier, but they're not necessarily happier."

Yes, people put off doctor visits in a recession, but a typical downturn doesn't last long enough to affect most people's health, he said.

Meanwhile, some surprising things happen. Economic activity slows, and so do factories, lowering air pollution, a benefit to all our lungs. When people work less, they drive less, so accidents drop.

Ruhm has documented changes in death rates in several countries. During an economic downturn, when unemployment rises by 1 percent, deaths drop measurably from liver problems, flu and heart attacks, he said.

But if they're unemployed, you might expect people to drink more. "People are taking up their sorrow with alcohol and drugs," Wolfson argues.

But no, Ruhm said. People drink less, because alcohol costs a lot. And most social drinkers do a lot of their drinking in restaurants and bars — but such outings are among the first things to go when budgets get tight.

The two differ on smoking, too. Cigarettes are an "emotional and physical crutch" that people turn to in bad times, Wolfson said. No, they're a costly habit that people cut back on, Ruhm said.

What about exercise? Don't people drop their gym memberships?

Maybe, Ruhm said. But walking and running is free, and job counselors often advise people to exercise, he said.

"People say, 'Well, my job is at risk, but one thing I can do is take care of myself,' " he said.

Put the exercise together with dropping high-calorie meals out, and obesity rates drop. So yes, people may be miserable, Ruhm said, but at least they're skinny and sober.

"I'm not arguing for recessions in any way," Ruhm said. "This is more to point out that things aren't always as bad as we think."

And maybe not as good. One of Ruhm's papers says that when the economy gets better and unemployment goes down, deaths from heart disease go up. He suggests it's because working longer hours makes it harder for people to eat right, exercise and get enough sleep.

He's got it down to a formula: a 1 percent drop in unemployment equals a 0.75 percent rise in heart attack deaths. That means about 3,900 more people die a year.

It's enough to make you wonder what to wish for.

Lisa Greene can be reached at greene@sptimes.com or (813) 226-3322.

Is recession really good for our health? 09/13/08 [Last modified: Saturday, September 13, 2008 10:18pm]
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