Consider this seeming paradox: when economic times are good, deaths in the United States increase. The reasons for this economic impact on mortality are not well understood, but the negative health effects of over-work, stress, and work-related behavior are often cited as culprits. However, this explanation is not completely persuasive, because other evidence shows that losing a job when the economy sours causes individuals' health to deteriorate. If that were the case, it would seem that, during good economic times, mortality would decline. These conflicting theories about the effect of individuals' work on their own health suggest that the mechanisms driving the unemployment-mortality link are more complex. This brief, adapted from a recent paper, departs from earlier studies suggesting individuals' own work behavior causes the unemployment-mortality link and summarizes an empirical scavenger hunt to find an alternative explanation. A key initial finding is that most of the additional deaths due to a falling unemployment rate occur among the elderly, particularly elderly women. Since the elderly are usually retired, factors unrelated to their work are most likely to explain rising mortality. And since the elderly use medical services more as they age, the health care labor force is a logical place to search for clues. The first section of this brief discusses the prior research on the relationship between declining un-employment and rising death rates and tests it using new sources of data. The second section explains a process of elimination that isolates additional deaths among the elderly as the main reason for rising death rates during good economic times. The conclusion is that an expanding economy generates a greater scarcity of front-line caregivers in nursing homes, which may cause more deaths among the elderly.
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