Increasing mortality during the expansions of the US economy, 1900-1996.
BACKGROUND
In Western countries mortality dropped throughout the 20th century, but over and above the long-term falling trend, the death rate has oscillated over time. It has been postulated that these short-term oscillations may be related to changes in the economy.


METHODS
To ascertain if these short-term oscillations are related to fluctuations in the economy, age-adjusted total mortality and mortality for specific population groups, ages and causes of death were transformed into rate of change or percentage deviation from trend, and were correlated and regressed on indicators of the US economy during the 20th century, transformed in the same way.


RESULTS
Statistically and demographically significant results show that the decline of total mortality and mortality for different groups, ages and causes accelerated during recessions and was reduced or even reversed during periods of economic expansion-with the exception of suicides which increase during recessions. In recent decades these effects are stronger for women and non-whites.


CONCLUSIONS
Economic expansions are associated with increasing mortality. Suggested pathways to explain this deceleration or even reversal of the secular decline in mortality during economic expansions include both material and psychosocial effects of the economic upturns: expansion of traffic and industrial activity directly raising injury-related mortality, decreased immunity levels (owing to rising stress and reduction of sleep time, social interaction and social support), and increased consumption of tobacco, alcohol and saturated fats.
Tapia Granados
José A
JA
Institute of Labor and Industrial Relations and School of Social Work, The University of Michigan, 1111 East Catherine Street, Ann Arbor, MI 48109-2054, USA. jatapia@umich.edu
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D004463:Ecology; D004467:Economics / Q000639:trends*; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends*; D012737:Sex Factors; D012959:Socioeconomic Factors; D014478:Unemployment / Q000639:trends; D014481:United States / Q000453:epidemiology