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

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

Abstract

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.

Suggested Citation

  • Ann Huff Stevens & Douglas L. Miller & Marianne E. Page & Mateusz Filipski, 2011. "The Best of Times, the Worst of Times: Understanding Pro-cyclical Mortality," NBER Working Papers 17657, National Bureau of Economic Research, Inc.
  • Handle: RePEc:nbr:nberwo:17657
    Note: AG HC LS
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    References listed on IDEAS

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    1. Ruhm, Christopher J., 2005. "Healthy living in hard times," Journal of Health Economics, Elsevier, vol. 24(2), pages 341-363, March.
    2. Miller, Douglas L. & Paxson, Christina, 2006. "Relative income, race, and mortality," Journal of Health Economics, Elsevier, vol. 25(5), pages 979-1003, September.
    3. Christopher Ruhm, 2007. "A healthy economy can break your heart," Demography, Springer;Population Association of America (PAA), vol. 44(4), pages 829-848, November.
    4. Reagan A. Baughman & Kristin E. Smith, 2012. "Labor Mobility Of The Direct Care Workforce: Implications For The Provision Of Longā€Term Care," Health Economics, John Wiley & Sons, Ltd., vol. 21(12), pages 1402-1415, December.
    5. Christopher J. Ruhm, 2000. "Are Recessions Good for Your Health?," The Quarterly Journal of Economics, Oxford University Press, vol. 115(2), pages 617-650.
    6. Ruhm, Christopher J., 2003. "Good times make you sick," Journal of Health Economics, Elsevier, vol. 22(4), pages 637-658, July.
    7. 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 122-127, May.
    8. Mark Aguiar & Erik Hurst & Loukas Karabarbounis, 2013. "Time Use during the Great Recession," American Economic Review, American Economic Association, vol. 103(5), pages 1664-1696, August.
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    More about this item

    JEL classification:

    • I1 - Health, Education, and Welfare - - Health
    • J6 - Labor and Demographic Economics - - Mobility, Unemployment, Vacancies, and Immigrant Workers

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