Recessions, Poverty, and Mortality in the United States: 1993–2012

Prior studies suggest that higher unemployment rates reduce mortality, but newer research suggests this relationship may have attenuated in recent decades. Moreover, individual-level evidence shows a negative effect of economic adversity on survival. We revisit this question using county-level data and two additional macroeconomic measures: poverty rates and median incomes. Examining county-level mortality among nonelderly adults from 1993 to 2012, we find that higher unemployment has modest negative impacts on mortality, in contrast to prior work using older state-level data. More notably, county-level poverty rates and lower median incomes produce larger and consistently negative effects on mortality, both in the short term and also for several years afterwards. These findings are consistent across multiple causes of death and for different subgroups of adults. While previous research has found that higher unemployment may produce small beneficial effects on survival, our analysis using more recent and granular data suggests this relationship no longer holds, and other economic measures such as median income and poverty rates provide stronger evidence that adverse economic conditions lead to higher mortality.