News

Could there be a healthy upside to an economic downturn?

During the Great Depression of the 20th century, life expectancy actually increased in the United States, according to a new analysis of mortality statistics by University of Michigan researchers.

As the economy collapsed, life expectancy rose from 57.1 years in 1929 to 63.3 in 1932.

The findings are admittedly “counterintuitive,” said the senior author of the paper, José Tapia Granados. “Most people assume that periods of recession are harmful to health.”

But he says the opposite is true: A surge in economic growth can produce stress and other factors that could lead to an early death for some.

“During expansions, firms are very busy, they typically demand a lot of effort from their employees, who are required to work a lot of overtime and to work at a faster pace,” he explained. Boom times also generate more pollution and social isolation, which can be bad for the body.

By contrast, when recessions take hold, workers are not under the gun in the same way, he says.

So, while an advancing economy generates extra wealth that is often invested in measures that improve public health, a spike in some stress-related deaths could drive down overall life-expectancy figures.

Dr. Tapia noted that the concept of life expectancy is often misunderstood. “It's kind of a summary of all mortality rates in a particular year,” he noted. “When mortality rates go up, life expectancy goes down.”

But how does he account for the fact that longevity has been increasing in many countries? After all, people on average are living longer and the economy is generally expanding.

Dr. Tapia readily acknowledges, “the curve of longevity during the 20th century is clearly a rising one.” However, “longevity shows oscillations,” he says.

“The statistical analysis shows that the curve is steeper in periods of recession than in periods of expansion, so that the improvement of population health during periods of weak economy is faster than during periods of fast economic growth. Indeed, the faster the economic growth, the more population health tends to stagnate or even sometimes reverse the rising trend, with losses in longevity.”

Dr. Tapia, who has written extensively on long-term health, says his findings aren't all that new. Previous studies, conducted decades ago, found a similar flip-flop in life-expectancy statistics during boom-bust cycles. But those studies were largely ignored and forgotten because they didn't conform to conventional thinking, he said.

For his latest study, Dr. Tapia and research colleague Ana Diez Roux reviewed statistics for several key causes of death around the early part of the 20th century, particularly around the time of the Great Depression.

The results, published in the Proceedings of the National Academy of Sciences, found that mortality from cardiovascular disease, influenza, pneumonia, tuberculosis and motor-vehicle accidents “clearly increased during economic expansions and decreased during recessions.” Deaths from cancer remained the same, regardless of economic conditions.

But there is one dark cloud in Dr. Tapia's bright assessment of recessions. Suicides rise among those hardest hit by the slump. Still, suicides represents a relatively small component of total mortality and can't counteract the overall trend.

Although Dr. Tapia's new study is based on a depression that occurred almost eight decades ago, he thinks the findings are still relevant today. And he believes that governments should adopt measures that protect people from overwork in the boom times – such as more statutory holidays. “That's something many people would like and it would be good health policy, too.”

Caring for the whole patient

A new study indicates that patients with schizophrenia and bipolar disorder aren't getting the general medical care that they need.

It has long been known that certain drugs – known as “atypical antipsychotics” – used to treat these two conditions can cause a variety of side effects such as weight gain, high blood pressure, diabetes and other metabolic disorders. All these factors can increase the risk of cardiovascular disease.

That means these patients should be closely monitored to ensure their cardiovascular health doesn't suffer while they are taking the prescription drugs.

But a study looking at Ontario hospital admission rates has revealed that a disproportionate number of schizophrenic and bipolar patients are ending up in emergency rooms after suffering heart attacks and strokes.

“What's happening is that folks are receiving anti-psychotic medications as part of standard psychiatric care, but the care for the metabolic conditions [which can lead to heart disease] is lacking,” said the study's lead author, Russell Callaghan, of the Centre for Addiction and Mental Health in Toronto.

Dr. Callaghan said it's critical for patients to take the anti-psychotic drugs, despite their well-known side effects. “These are very effective medications for the treatment of schizophrenia and bipolar disorder … these drugs save lives,” he said. “But I think there is a lot of room for us to improve in that other area,” he said, referring to patients' cardiovascular health.

The study was published in the journal Schizophrenia Research.