Recovery From Schizophrenia: Psychiatry And Political Economy

HEALTH, ILLNESS AND THE ECONOMY 39divorce rates, fragmentation of the community due to increased migration andsuch job-related factors as overwork, alienating work processes and industrialdisputes. The lag between these stresses and the development of pathology, arguesEyer, pointing to research on the impact of life events, would not be years, asBrenner suggested, but a few days, weeks or months-if the impact were notimmediate. 66Observing that industrialization brings about an increase in mortality in youngeradults at the age of labor-market entry, Eyer sees the development of wage workas central to the disease-producing stresses of our society. He argues, moreover,that the deleterious impact of modern labor conditions may be seen in the highmortality that affects those cohorts of workers who enter the US labor marketduring the boom to a greater extent than those who enter during thedepression. 67That this type of cohort analysis may lead to more than one interpretation isevident from economist Alfred Bunn’s study of heart-disease mortalityin Australia. Bunn has traced an epidemic increase in coronary heart disease backto a point source in the twentieth-century Great Depression. Each cohort ofAustralian citizens born in successive decades experienced a dramatic increase inmortality during the 1930s—an increased risk that was sustained throughout thelives of surviving members of these cohorts. The decline in the death rate fromheart disease after 1968—a phenomenon that has not otherwise been adequatelyexplained—is due, Bunn argues, to the eventual death of most of the populationwho had been of working age during the Great Depression. Immediate and lateeffects of unemployment and economic stress, suggests Bunn, contribute to heartdiseasemortality; the more recent recessions of the early 1960s and late 1970s addtheir own lesser waves of increased mortality to the epidemic initiated by theGreat Depression. Bunn, like Brenner, finds an association between high annualunemployment rates and fluctuations in mortality from coronary heart disease. 68Bunn disagrees with Eyer’s claim that high mortality is closely related to lowunemployment and the boom, and there is evidence to support each side of theargument. Regardless of which view is correct, both researchers agree on aprinciple that will become important later in this book: circumstances early in lifeprime an individual to respond to environmental stimuli later in a way that canpromote ill health. According to Eyer, for example, entering the labor forceduring the boom increases the individual’s susceptibility to the effects ofeconomic stress; according to Bunn, working through the Great Depressionproduces a permanent increase in the risk of heart disease. When we discussfactors promoting the occurrence of schizophrenia in Chapter 9, this idea willemerge again; there it will be suggested that, if a woman’s nutrition changes laterin life in response to economic change, migration or class-related factors, her riskof obstetric complications will increase and so will her child’s risk ofschizophrenia.Which is more harmful to one’s health—the boom or the slump? Both havebeen incriminated. The case of infant mortality gives us the opportunity to pursue