Impact of the Great Recession on Heart Disease Mortality in US States and European Countries: A Geo-Spatial Analysis

Purpose:

This study determines the extent to which the global recession of 2008 has had a harmful influence on heart disease mortality rates among US States and European Union (EU) countries.

Data:

Data on the extent of the recession are given by national income per capita (GDP pc) and the unemployment rate in US States and EU countries. Heart disease mortality is the outcome variable. Control variables for the US include health insurance coverage, smoking prevalence, alcohol consumption, body mass index (BMI) and percent of population African-American. For the EU, controls include smoking prevalence, alcohol consumption, BMI. US economic data are from the Departments of Commerce and Labor; demographic and health-related data and heart disease mortality are from the NCHS. EU economic data are from EUROSTAT, while health-related data and heart disease mortality are from the WHO European region.

Statistical Methods:

Using geo-spatial analysis, age-standardized heart disease mortality among the US States and EU countries are predicted by GDP pc and unemployment rates for US States and EU countries respectively with controls for the variables listed under “DATA” (above). Pooled cross-sectional time-series linear regression analysis estimates these relations over 2000 – 2010.

Results:

For both US States and EU countries, GDP pc is inversely, and unemployment is positively, related to age-adjusted heart disease mortality (US model R squared .75; EU R squared .60). Recessional and control variables for both countries were significant at p < .0001.

Conclusions/Policy:

Decreased income per capita and high unemployment rates served to increase heart disease mortality rates in the US and Europe. Targeted economic policies involving the social safety net, unemployment payments and retraining and health insurance are crucial to the health of US and European populations.