Commentary: Mortality increases during economic upturns

The conventional wisdom is that mortality falls when the economy temporarily improves and increases when it weakens. This strong apriori belief has engendered substantial attention to be paid to analyses indicating a countercyclical variation in deaths and excessive scepticism to countervailing evidence. However, this view is beginning to change as recent research, often using more sophisticated methodological designs than earlier studies, commonly finds that fatalities rise during economic upturns. ‘Increasing Mortality During Expansions of the US Economy, 1900–1996’ by José Tapia Granados1 contributes to this new understanding by showing that the secular decline in US mortality accelerates during economic recessions and slows or reverses in expansions. His analysis utilizes time-series data on total deaths, as well as age-specific and cause-specific mortality. The use of time series data for a single geographic location is traditional in this research. The next section discusses how the resulting literature has obtained ambiguous results, in part because of difficulties in adequately controlling for confounding factors that are spuriously correlated with macroeconomic conditions. This is followed by a description of a relatively new approach using panel data for multiple time periods and geographic areas. Longitudinal information allows for estimation methods that exploit within-location changes in economic conditions. Since local economies evolve somewhat independently over time, these variations are less likely to be correlated with changes in omitted determinants of death that have similar effects across areas (such as many technological innovations). Most estimates using these techniques indicate a procyclical variation in mortality.