Mary Davis, the author of “Jobs, Health, and the Meaning of Work,” explores the effects of economic downturns and air pollution on public health.
Davis’s interest in how economic shifts affect health began while researching diesel exhaust and lung cancer among truck drivers at Harvard. Her investigation was part of the Trucking Industry Particle Study (TrIPS). During this period, many doubted the link between air pollution and diseases like lung cancer. However, in 2012, the International Agency for Research on Cancer confirmed diesel exhaust as a known carcinogen.
As a postdoctoral fellow, Davis faced the challenge of creating a diesel exposure profile for numerous truckers to correlate with lung cancer outcomes. While substantial data existed regarding recent diesel exposure, the work histories of many truckers lacked details, complicating her quest to reconstruct past exposure levels. Turning to economic data, she examined employment trends and business cycle indicators for insights into air pollution exposure.
Interestingly, a down economy might have health benefits due to decreased consumption of harmful products.
Davis was surprised to find that economics holds significant insights into the relationship between a poor economy and human health. Starting in 2000, economist Christopher Ruhm highlighted the counterintuitive notion that health often improves during economic downturns, evidenced by lower mortality rates — excluding suicides. He proposed that reduced employment and income limit access to detrimental products, while increased physical activity may reduce obesity rates.
While studies uphold Ruhm’s findings, some economists contend otherwise, with outcomes depending on data aggregation and health metrics analyzed. Results vary regarding chronic health issues and overall mortality rates, with some suggesting that the recession-health correlation diminishes over time. The impact of specific recessions on different demographics leads to varied health outcomes.
Notably, 90% of overdose deaths in the U.S. occur among individuals without a college degree.
The rise of “deaths of despair,” namely those from drug and alcohol abuse and suicides, underscores a troubling health trend among middle-aged, non-Hispanic White individuals in the U.S. A study estimates that approximately half a million deaths between 1999 and 2013 could have been avoided if this group’s mortality rate had mirrored that of 1998. In contrast to other demographics, this cohort currently faces a decreased life expectancy. The ongoing rise in mortality rates complicates attributing these deaths to specific economic downturns. Identifying root causes, including the opioid crisis and the societal effects of economic strains, is crucial for understanding this phenomenon.
As labor markets evolve towards more advanced sectors, those without college degrees face diminishing opportunities. Research indicates a correlation between rising “deaths of despair” and state-level de-unionization efforts, suggesting inequality in working conditions contributes to growing health disparities. Additionally, job insecurity is linked with increased physical pain and a greater reliance on pain medication, while workplace stress affects overall health. Despite varying economic impacts on health, certain groups may benefit during recessions, prompting further inquiry into how economic conditions can sometimes enhance public health.
David’s early work on the link between economic cycles and air pollution suggests that reduced economic activity lessens pollution levels, potentially explaining healthier populations during recessions. Analysis of air quality and unemployment trends in New Jersey and California reinforces this connection. Findings show that periods of heightened unemployment correspond with decreased air pollution, indicating an intriguing relationship between economic conditions and health outcomes.
While these elements offer potential explanations for health patterns during economic downturns, the intricate dynamics of economic conditions and population health remain poorly understood. The COVID-19 pandemic has introduced new variables, shifting job market dynamics and complicating historical trends. Factors such as labor mobility and the heightened risks associated with a pandemic-induced recession require further exploration to fully grasp their implications for future health outcomes. Ultimately, the evolving landscape of work, public health, and economic conditions continues to shape an uncertain future.
Mary Davis is an Associate Professor of Urban and Environmental Policy and Planning at Tufts University and the author of “Jobs, Health, and the Meaning of Work,” from which this article is adapted.
