Employmentweb_low

employment relations and health inequalities: a conceptual and empirical overvieW
Case study 17. Do health inequalities increase when employment grows - José a. tapia granados
recent research has proved the counterintuitive fact that, for the evolution of mortality rates, periods in which the economy
expands, jobs are created, and unemployment drops, are worse than economic downturns in which jobs disappear and unemployment
grows. death rates tend to increase in expansions and decrease in recessions (gerdtham & ruhm, 2006; tapia granados, 2005; 2008;
tapia granados & ionides, 2008; ortega osona & reher, 1997; abdala, geldstein, & mychaszula, 2000). in the united states, a one
percentage point reduction in unemployment is predicted to increase coronary heart disease mortality by 0.75 per cent, corresponding
to almost 3900 additional fatalities (ruhm, 2007). atmospheric pollution, consumption of harmful substances or foods, and the
worsening of quality of life and working conditions when economic activity accelerates have been suggested as potential links between
the economy and changes in mortality. in the united states, in the last decades of the 20th century, the death rates of females and
nonwhites seem to be substantially more linked to the fluctuations of the economy than those of males and whites (tapia granados,
2005). using the u.s. national longitudinal mortality study it has been found that during the 1980s, low-income and low-education
groups may have been disproportionately at risk during periods of increased economic activity (edwards, 2006). mortality increases
during expansions seemed to be greater among those who were working than among those who were not, and it appeared greater in
african americans than in whites, though the increase in mortality was much smaller in the top third of family income. in general, high
income seemed to be protective against rising mortality during economic expansions. additional evidence suggesting that health
inequalities may increase during economic expansions rather than during recessions is provided by a study of mortality at working ages
35-64 in Finland (valkonen et al., 2000). during the years 1981-1995 (see Figure), which included an economic expansion (1981-1990)
and a strong recession (1991-1995), the mortality of women in manual work occupations is flat, though showing a slight (not statistically
significant) tendency to rise during the expansion, while the mortality of women in non-manual occupations decreased significantly in
that period. during the expansionary 1980s, the manual/non-manual gap in female mortality clearly widened. during the recession,
female mortality significantly dropped in both groups. male mortality was manifestly falling throughout the whole period, but for manual
occupations the decline was slow during expansion and accelerated significantly with the downturn. the mortality of men in nonmanual
occupations seemed to fall at a slightly faster rate during the expansionary years, than in the recessionary 1990s. mortality
overall evolved for the better during the recession than during the expansion, and if the health inequality gaps are widening in any
period, it seems to be precisely during the expansion years.
Figure. evolution of annual agestandardized
mortality at ages 35-64
(per 100,000 population), by sex and
social class, Finland, 1981-1995.
1000
900
800
Men, manual
straight segments are regression lines (slopes
with standard errors are indicated) computed
with the data corresponding to the expansion
(1981-1990) or recession years (1991-1995) of the
period considered.
700
600
500
400
300
200
100
EXPanSIOn
rECESSIOn
Men, non manual
Women, manual
Women, non manual
0
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
Computed from data used in
Valkonen et al., 2000
References
abdala, F., geldstein, r. n., & mychaszula, s. m. (2000). economic reestructuring and mortality changes in argentina-is
there any connection. in g. a. cornia & r. paniccià (eds.), The mortality crisis in transitional economies (pp. 328-350).
new york: oxford university press.
edwards, r. d. (2006). Who is hurt by procyclical mortality proceedings from the 2006 annual meeting of the population
association of america. los angeles, 2006.
gerdtham, u. g., & ruhm, c. J. (2006). deaths rise in good economic times: evidence from the oecd. Economics and Human
Biology, 4, 298-316.
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