Recessions, healthy no more?

Over the 1976-2010 period, total mortality shifted from strongly procyclical to being weakly or unrelated to macroeconomic conditions. The association is likely to be poorly measured when using short (less than 15 year) analysis periods. Deaths from cardiovascular disease and transport accidents continue to be procyclical; however, countercyclical patterns have emerged for fatalities from cancer mortality and external causes. Among the latter, non-transport accidents, particularly accidental poisonings, play an important role.

Understanding overeating and obesity.

The combination of economic and biological factors is likely to result in overeating in the current environment of cheap and readily available food. This propensity is shown using a "dual decision" approach where choices reflect the interaction of a "deliberative" system, operating as in standard economic models, and an "affective" system that responds rapidly to stimuli without considering long-term consequences. This framework is characterized by excess food consumption and body weight, in that individuals prefer both ex-ante and ex-post to eat and weigh less than they actually do, with weight loss attempts being common but often unsuccessful or only partially successful. As in the standard model, weight is related to prices. However, another potentially important reason for rising obesity is that food producers have incentives to engineer products to stimulate the affective system so as to encourage overeating. Data from several sources are used to investigate predictions of the dual decision model, with the evidence providing broad support for at least some irrationality in food consumption. Most importantly, there is little indication that the large secular increases in body mass index have been accompanied by corresponding growth in utility-maximizing weight. One result is that efforts to reduce weight have become more common as obesity has increased.

Inheritances, health and death.

We examine how wealth shocks, in the form of inheritances, affect the mortality rates, health status and health behaviors of older adults, using data from eight waves of the Health and Retirement Survey. Our main finding is that bequests do not have substantial effects on health, although improvements in quality-of-life are possible. This absence occurs despite increases in out-of-pocket spending on healthcare and in the utilization of medical services, especially discretionary and non-lifesaving types such as dental care. Nor can we find a convincing indication of changes in lifestyles that offset the benefits of increased medical care. Inheritances are associated with higher alcohol consumption, but with no change in smoking or exercise and a possible decrease in obesity.

Rising educational gradients in mortality: the role of behavioral risk factors.

The long-standing inverse relationship between education and mortality strengthened substantially at the end of the 20th century. This paper examines the reasons for this increase. We show that behavioral risk factors are not of primary importance. Smoking declined more for the better educated, but not enough to explain the trend. Obesity rose at similar rates across education groups, and control of blood pressure and cholesterol increased fairly uniformly as well. Rather, our results show that the mortality returns to risk factors, and conditional on risk factors, the return to education, have grown over time.

Healthy living in hard times.

Using microdata for adults from 1987 to 2000 years of the Behavioral Risk Factor Surveillance System (BRFSS), I show that smoking and excess weight decline during temporary economic downturns while leisure-time physical activity rises. The drop in tobacco use occurs disproportionately among heavy smokers, the fall in body weight among the severely obese and the increase in exercise among those who were completely inactive. Declining work hours may provide one reason why behaviors become healthier, possibly by increasing the non-market time available for lifestyle investments. Conversely, there is little evidence of an important role for income reductions. The overall conclusion is that changes in behaviors supply one mechanism for the procyclical variation in mortality and morbidity observed in recent research.