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The Best of Times, the Worst of Times: Understanding Pro-cyclical Mortality

  • Ann Huff Stevens
  • Douglas L. Miller
  • Marianne E. Page
  • Mateusz Filipski

A growing literature documents cyclical movements in mortality and health. We examine this pattern more closely and attempt to identify the mechanisms behind it. Specifically, we distinguish between mechanisms that rely on fluctuations in own employment or time use and those involving factors that are external to the individual. Our investigation suggests that changes in individuals' own behavior contribute very little to pro-cyclical mortality. Looking across broad age and gender groups, we find that own-group employment rates are not systematically related to own-group mortality. In addition, we find that most of the additional deaths that occur during times of economic growth are among the elderly, particularly elderly women, who have limited labor force attachment. Focusing on mortality among the elderly, we show that cyclicality is especially strong for deaths occurring in nursing homes, and is stronger in states where a higher fraction of the elderly reside in nursing homes. We also demonstrate that staffing in skilled nursing facilities moves counter-cyclically. Taken together, these findings suggest that cyclical fluctuations in the mortality rate may be largely driven by fluctuations in the quality of health care.

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File URL: http://www.nber.org/papers/w17657.pdf
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Paper provided by National Bureau of Economic Research, Inc in its series NBER Working Papers with number 17657.

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Date of creation: Dec 2011
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Handle: RePEc:nbr:nberwo:17657
Note: AG HC LS
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  1. Ruhm, Christopher J., 2003. "Good times make you sick," Journal of Health Economics, Elsevier, vol. 22(4), pages 637-658, July.
  2. Christopher Ruhm, 2007. "A healthy economy can break your heart," Demography, Springer, vol. 44(4), pages 829-848, November.
  3. Douglas L. Miller & Marianne E. Page & Ann Huff Stevens & Mateusz Filipski, 2009. "Why Are Recessions Good for Your Health?," American Economic Review, American Economic Association, vol. 99(2), pages 122-27, May.
  4. Christopher J. Ruhm, 2003. "Healthy Living in Hard Times," NBER Working Papers 9468, National Bureau of Economic Research, Inc.
  5. Miller, Douglas L. & Paxson, Christina, 2006. "Relative income, race, and mortality," Journal of Health Economics, Elsevier, vol. 25(5), pages 979-1003, September.
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