Working Paper: NBER ID: w17657
Authors: Ann Huff Stevens; Douglas L. Miller; Marianne E. Page; Mateusz Filipski
Abstract: A growing literature documents cyclical movements in mortality and health. We examine this pattern more closely and attempt to identify the mechanisms behind it. Specifically, we distinguish between mechanisms that rely on fluctuations in own employment or time use and those involving factors that are external to the individual. Our investigation suggests that changes in individuals' own behavior contribute very little to pro-cyclical mortality. Looking across broad age and gender groups, we find that own-group employment rates are not systematically related to own-group mortality. In addition, we find that most of the additional deaths that occur during times of economic growth are among the elderly, particularly elderly women, who have limited labor force attachment. Focusing on mortality among the elderly, we show that cyclicality is especially strong for deaths occurring in nursing homes, and is stronger in states where a higher fraction of the elderly reside in nursing homes. We also demonstrate that staffing in skilled nursing facilities moves counter-cyclically. Taken together, these findings suggest that cyclical fluctuations in the mortality rate may be largely driven by fluctuations in the quality of health care.
Keywords: Procyclical Mortality; Economic Cycles; Healthcare Quality; Elderly Mortality
JEL Codes: I1; J6
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| Unemployment Rate (J64) | Mortality Rate (J11) |
| Economic Conditions (E66) | Healthcare Quality (I11) |
| Economic Growth (O49) | Mortality Rate (Elderly Women) (I12) |
| Healthcare Quality (I11) | Mortality Rate (J11) |
| Economic Conditions (E66) | Mortality Rate (Nursing Homes) (I18) |