Panel data methods are used to investigate how deaths from coronary heart disease (CHD) in the United States vary with macroeconomic conditions. A one-percentage-point reduction in unemployment is predicted to raise CHD mortality by 0.75%, corresponding to almost 3900 additional fatalities. The increase in relative risk is similar across age groups, implying that senior citizens account for most of the extra deaths. Direct evidence is obtained of a role for decreases in medical interventions treating coronary problems. CHD mortality increases rapidly when the economy strengthens but returns to or near its baseline level within five years for most groups.