Who suffers during recessions? Economic downturns, job loss, and cardiovascular disease in older Americans

Am J Epidemiol. 2015 Nov 15;182(10):873-82. doi: 10.1093/aje/kwv094. Epub 2015 Oct 16.


Job loss in the years before retirement has been found to increase risk of cardiovascular disease (CVD), but some studies suggest that CVD mortality among older workers declines during recessions. We hypothesized that recessionary labor market conditions were associated with reduced CVD risk among persons who did not experience job loss and increased CVD risk among persons who lost their jobs. In our analyses, we used longitudinal, nationally representative data from Americans 50 years of age or older who were enrolled in the Health and Retirement Study and surveyed every 2 years from 1992 to 2010 about their employment status and whether they had experienced a stroke or myocardial infarction. To measure local labor market conditions, Health and Retirement Study data were linked to county unemployment rates. Among workers who experienced job loss, recessionary labor market conditions at the time of job loss were associated with a significantly higher CVD risk (hazard ratio = 2.54, 95% confidence interval: 1.39, 4.65). In contrast, among workers who did not experience job loss, recessionary labor market conditions were associated with a lower CVD risk (hazard ratio = 0.50, 95% confidence interval: 0.31, 0.78). These results suggest that recessions might be protective in the absence of job loss but hazardous in the presence of job loss.

Keywords: business cycles; cardiovascular disease; recessions; unemployment.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Aged
  • Depression / epidemiology
  • Economic Recession / statistics & numerical data*
  • Female
  • Health Behavior
  • Health Status
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Myocardial Infarction / epidemiology*
  • Proportional Hazards Models
  • Retirement
  • Risk Factors
  • Sex Factors
  • Socioeconomic Factors
  • Stroke / epidemiology*
  • Unemployment / statistics & numerical data*
  • United States