During the Great Depression, too, life expectancy rose, according to research by Jose Tapia Granados and Ana Diez Roux of the University of Michigan. As they conclude, “The evolution of population health during the years 1920-1940 confirms the counter-intuitive hypothesis that, as in other historical periods and market economies, population health tends to evolve better during recessions than in expansions.”
How could this be? In a series of important papers, Christopher Ruhm, an economist at the University of Virginia, has explored the reasons. It appears that while suicide rates rise during downturns, other types of fatalities, such as from motor-vehicle accidents, fall more. The surprising findings apply even to heart attacks. In a study titled “A Healthy Economy Can Break Your Heart,” Ruhm finds that higher unemployment reduces deaths from heart attacks, perhaps because when there is less economic activity, hazards such as air pollution and traffic congestion are less severe. Smoking and obesity also tend to decline, Ruhm has found.
By the way, the reduction in deaths averted tends to be proportionally smaller for the elderly, but larger in absolute numbers — because their underlying mortality rates are higher than those of younger people. This may partly explain why, over the past few years, Medicare spending has decelerated more than commercial health-care spending has. The big debate concerning the recent slowing in the growth of health-care costs is over whether it reflects structural changes (and therefore will last) or merely the weak economy (and therefore will fade). I believe the weight of evidence suggests a significant structural component.
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