Hessel, Philipp
(2015)
Long-term effects of economic fluctuations on health and cognition in Europe and the United States.
PhD thesis, London School of Economics and Political Science.
Abstract
Several studies suggest that population health improves during recessions and deteriorates during economic expansions. However, the majority of these studies only focus on the short-term or contemporaneous effects of economic fluctuations on health. As a result, very little evidence exists on potential long-term health effects of exposure to booms or recessions. This can be regarded as a major gap in knowledge, given the fact that most diseases are the results of exposure or behaviours during a longer period of time. Furthermore, a large body of research also suggests that many risks associated with recessions may accumulate over the course of life and lead to a gradual deterioration in health. By focusing only on the short-term effects, most studies thus ignore potential longrun health effects of economic fluctuations.
This thesis aims to bridge the gap between studies on the population level assessing the short-term effects of economic fluctuations on health, and studies on the individual level, which have analysed the health-effects of risks associated with a declining economy including unemployment, job loss and job insecurity. In order to assess potential longterm effects of business cycles on health, I linked historical information on macroeconomic fluctuations during the 20th century to individual-level data from the Survey of Health, Ageing and Retirement in Europe (SHARE) as well as the U.S. Health and Retirement Study (HRS). This approach makes it possible to identify the state of the economy during different life-course periods for every respondent and relate it to health outcomes measured in later life.
Regarding the macroeconomic conditions at any given age as largely exogenous, the four empirical papers included in this thesis thereby assess the relationship between business cycles and health during three different life-course periods: the time around graduation from full-time education, middle and late adulthood as well as the years nearing retirement. Overall, the results suggest that individuals who experienced less favourable economic conditions during these life-course periods have a higher risk of having additional limitations in physical functioning, lower levels of cognitive functioning, as well as higher risks of cardiovascular disease in later life.
In contrast to studies showing that population health improves during recessions, these findings suggest that potential short-term improvements in health may be outweighed by deteriorations in health in the long run. They also raise important questions about the role of potential mechanisms linking differential exposure to the business cycle to health in later life.
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