What's the verdict on the relationship between recessions and health?

Studying the relationship between recessions and health is well trodden ground. When I started looking at this relationship in 2009, the height of the the 'Great Recession', I knew that I was getting into a controversial area of research. Aggregate-level studies that amalgamate the employed and unemployed, job stayers and movers, and retirees and new entrants to the labor force, find that recessions are good for health and health promoting behaviors. In fact, in my own research I had found this counterintuitive relationship. However, when similar methods examined the health consequences of changes in unemployment rates on populations disaggregated by age, race and sex, the results were less conclusive. In contrast to the population level studies, individual-level studies that have often focused on the unemployed only, have consistently found adverse effects on mental health and poor health behaviors. However, careful longitudinal studies of the unemployed also show that when these workers regain employment they may recover and that workers that were laid off were also at higher risk for adverse health or health related behavior to begin with. These complexities made this area of research one that requires careful attention to the population of interest, timing and measurement of outcomes. In a review, I detailed how different populations could experience recessions differently.

Now a recent review of 41 articles on the recent recession in Europe details the common biases in the study of recessions and health. The authors finds that it is unlikely that health improves during recessions. The main contribution of this work is detailing the common biases that we need to be aware of.