The Globe and Mail

  Study suggests health and wealth don't go hand in hand


Monday, September 14, 2009

As economic data trickles in indicating that this wicked recession may soon be over, or perhaps already is, people are breathing a sigh of relief and looking to the future with renewed optimism. Though a return to boom times would be great for stocks, this might be a good time to reflect that such a scenario could actually be bad for our health.

Beginning in the 1920s, medical researchers began to notice the odd juxtaposition that mortality rates fell faster during economic contractions than during expansions. More recently, this effect has been studied thoroughly. Dr. Christopher Ruhm, professor of economics at the University of North Carolina Greensboro, found that in the United States a one percent rise in unemployment led to a decrease of about one-half of one percent in mortality rates.

This flies in the face of intuition; we generally associate a robust economy and low unemployment with a wealthier and healthier population. A clue that health isn't all about money is that the U.S., which spends by far the most per capita on health care of any country on the planet, has health outcomes in the basement of developed nations, and is in fact on a par with struggling countries like Albania and Cuba, whose citizens earn a small fraction of what Americans make.

So why do death rates go up when it's easier to get a job? That mechanism is still a matter of conjecture. More deaths from motor vehicle crashes sort of makes sense — you would expect heavier traffic when business is doing well. But why do more people die of liver disease, pneumonia and the flu?

Most surprising, Dr. Ruhm found that deaths from heart attacks rose by 1.3 percent when unemployment decreased by one percent. Though the relationship was found in all age groups, for 20- to 44-year-olds the rate of increase was much higher, at 2.4 percent.

Dr. Ruhm speculated that more older people die due to increased levels of pollution during prosperous periods. Younger people work too hard, don't get enough sleep, don't eat right and are unable to find the time to get enough exercise.

This idea that the stress associated with plentiful work opportunities can be unhealthy is an intriguing one. It reminds Ben of when he left Ontario as a young man to take a job in Calgary's oil patch in 1981.

Alberta was at the height of a boom, but he was disappointed to find that the economy didn't make for a pleasant place to live. The city was full of gouging landlords and selfish, arrogant bravado. There was a palpable sense that if you were not on the fast track to wealth, you must be incompetent, lazy or both.

Within a year, oil prices tumbled and the economy crashed. But much to his surprise, the city suddenly shed its facade and become, well, nice. The vaunted Western hospitality and sense of community re-emerged. There were fewer patrons in the bars, but the hiking trails were busier. The city seemed more relaxed, people more connected and happy to talk about other things than making money.

None of this is to discount the awful stress that individuals and families endure when businesses fail, jobs are lost and bills go unpaid. It is a tragic fact that suicide rates increase during recessions. A strong social safety net is necessary to ensure that the health benefits enjoyed by those who slow down a bit are shared by those who are more adversely affected.

The shape and timing of this recovery are still very uncertain. But eventually growth will resume, and changing demographics suggest that in the future, labour shortages will replace unemployment as a national concern. Let's hope that once the treadmill starts spinning faster again, we can avoid working ourselves to death.