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I do wonder if the poor really do 'have less to loose'. A striking feature of the media coverage of this recession are pictures of bankers clearing their desks and walking out of the front door. The cleaners and ancillary staff sloping out of the back door get much less coverage. When low paid workers, like shop workers at Woolworth, loose their jobs the chances are that they and their families are thrown into absolute poverty. We might speculate that they are less resilient, more vulnerable, and will have a much harder time finding employment. As Adam notes, for anyone to loose their job is devastating, but for some it will be more devastating than for others. Dr Nick Emmel School of Sociology and Social Policy University of Leeds Leeds LS2 9JT +44 (0) 113 343 6958 -----Original Message----- From: The Health Equity Network (HEN) on behalf of Adam Oliver Sent: Fri 09/01/2009 10:24 To: [log in to unmask] Subject: Re: recession and health I don't really remember the early 1980s recession as being a particularly great time for narrowing income inequalities, directly causing improvements in health for the poor, or directly causing improvements in health generally. I have to confess that I'm sort of pleased that the housing market bubble has burst (and I'm one of the 'losers' from that), and that the ridiculous and irresponsible policy of credit extension has finally been exposed, but some of the members of the list seem to be suggesting that economic recession may be a good thing. It's a devastating thing for someone when they lose their job and can't find another one. I've seen it, and it may be wise not to lose sight of that. ________________________________ From: The Health Equity Network (HEN) on behalf of Stephen Bezruchka Sent: Fri 09/01/2009 3:58 AM To: [log in to unmask] Subject: recession and health Larry Adelman's question and others' about health consequences brings up important basic ideas about the production of health in populations. One analysis suggests economic growth has been bad for health in the US. Granados, J. A. T. (2005). "Increasing mortality during the expansions of the US economy, 1900-1996." Int. J. Epidemiol. 34(6): 1194-1202. That article was followed by many commentaries as the concept is pretty controversial. -Brenner, M. H. (2005). "Commentary: Economic growth is the basis of mortality rate decline in the 20th century--experience of the United States 1901-2000." Int. J. Epidemiol. 34(6): 1214-1221. -Catalano, R. and B. Bellows (2005). "Commentary: If economic expansion threatens public health, should epidemiologists recommend recession?" Int. J. Epidemiol. 34(6): 1212-1213. -Edwards, R. D. (2005). "Commentary: Work, well-being, and a new calling for countercyclical policy." Int. J. Epidemiol. 34(6): 1222-1225. -Granados, J. A. T. (2005). "Response: On economic growth, business fluctuations, and health progress." Int. J. Epidemiol. 34(6): 1226-1233. -Neumayer, E. (2005). "Commentary: The economic business cycle and mortality." Int. J. Epidemiol. 34(6): 1221-1222. -Ruhm, C. J. (2005). "Commentary: Mortality increases during economic upturns." Int. J. Epidemiol. 34(6): 1206-1211. The background noise, so-to-speak, is that health keeps on improving over time unless you screw up big. (viz the Former Soviet Union after 1991, or sub-Saharan Africa in the last few decades). Reasons are many and likely country specific, but have more to do with improving the social environment than other more commonly considered factors. So it likely depends on how the script is written and played out. If relative disparity declines in a recession, which is likely, then health may improve quicker. Eibner, C. and W. N. Evans (2005). "Relative Deprivation, Poor Health Habits, and Mortality." J. Human Resources XL(3): 591-620. and Eibner, C. and W. N. Evans (2004). The income-health relationship and the role of relative deprivation. Social inequality. K. M. Neckerman. New York, Russell Sage Foundation: 545-568. Stephen Stephen Bezruchka MD, MPH Departments of Health Services & Global Health School of Public Health and Community Medicine Box 357660 University of Washington Seattle, Washington 98195-7660 USA (206)932-4928 http://depts.washington.edu/hserv/faculty/?Bezruchka_Stephen http://depts.washington.edu/eqhlth/ Please access the attached hyperlink for an important electronic communications disclaimer: http://www.lse.ac.uk/collections/secretariat/legal/disclaimer.htm