College-educated homeowners showed higher increases in blood pressure
Medication use declined among those taking prescription blood pressure and diabetes drugs post-recession
The Great Recession of the early 21st century was a period of global economic decline marked by high unemployment and stagnant wages.
In the United States, the effects included a toll on human health, in particular significant increases in blood pressure and blood glucose levels, a new study published Monday in the journal Proceedings of the National Academy of Sciences found.
Teresa Seeman, lead author of the study and a professor of medicine & epidemiology in the Geffen School of Medicine at UCLA, said she and her colleagues found substantial differences between demographic groups.
“When populations are faced with major economic stresses, we need to keep in mind the likely health risks that may result,” she said.
The Great Recession, wrote Seeman and her co-authors, was a “major shock: Its timing and depth were largely unanticipated, and resulted in levels of aggregate economic stress not experienced since the Great Depression.” Characterized by high unemployment and stagnant wages, some economists define it as lasting from 2007 through 2009.
To examine the health effects of an ailing economy, Seeman and her colleagues used data from the Multi-Ethnic Study of Atherosclerosis, or MESA, a study funded by the National Heart Lung and Blood Institute. MESA began in 2000 at which time researchers collected health data on about 4,600 participants who ranged between 45 and 84 years old. Though health measurements continue to be collected, Seeman and her colleagues looked at data gathered through 2012.
For their analysis, the researchers matched each participant’s actual post-recession blood pressure and fasting blood glucose levels to the scores a doctor would predict for participants based on their original scores.
Compared to expected measurements, Seeman and her colleagues saw changes in both blood pressure and blood glucose levels following the recession. Next, they crunched the numbers to find larger patterns and trends.
Here, they saw broader effects among those groups more severely hurt by the recession.
For instance, two of the impacted groups included younger adults who likely needed jobs (as opposed to retirees) and older homeowners who likely witnessed their investments plummet alongside their home values – the recession had ripped their financial security out from under them.
Older college grads who were on meds prior to the Great Recession showed an increase in systolic blood pressure of 12mmHg compared to an increase of only 5.68mmHg among those with less education, said Seeman.
The data also revealed greater impacts on those taking blood pressure or diabetes medications at the start of the recession.
For example, looking at all the college graduates age 65 and older, those taking medication prior to the recession showed an increase of 12.3 mmHg in systolic blood pressure following the economic fall, while those not taking medication showed only a 3.94 mmHg increase.
The data also showed that medication use declined post-recession. Changes in health insurance status or an inability to pay for medicine might explain some of the blood pressure and glucose increases, the researchers said.
Seeman acknowledged one shortcoming of the study, namely that “the available data do not allow us to answer questions about longer term health effects after the recession.” Over time, though, MESA will provide the necessary information to examine health effects through the cycles of economic ups and downs.
Claire E. Margerison, an assistant professor in the Department of Epidemiology & Biostatistics in the College of Human Medicine at Michigan State University, said the new study “makes an important contribution” to the field of population health.
Beyond your control
Uninvolved in the new study, Margerison previously reviewed scientific research published as of July 2015 on this topic.
By examining blood pressure and fasting glucose, the new study reveals two specific ways in which economic events influence health, she said.
One “curious” aspect of the study, though, is the fact that the authors did not investigate differences by gender or ethnicity or race – after all, MESA provides the data to do this.
“Previous research suggests that men and racial/ethnic minorities were uniquely vulnerable to the Recession, perhaps because job loss was greater in these groups,” said Margerison, based on her own research. She also noted the study design could not eliminate the possibility that time-related trends, including but not limited to the passage of the 2010 Affordable Care Act (which the authors themselves acknowledged), might have influenced the results.
Margerison believes that one of the most important take-aways from this entire area of research is that population-level conditions, including economic downturns, can impact our mental and physical health.
Could the reverse be true – do good economies benefit individual health?
This is “certainly debated,” said Margerison. One thing previous research does show is that the stress of economic slumps can influence health among those untouched by income loss.
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“Even people who keep their jobs during a recession may feel more stress about the possibility of losing a job or they may have to work more hours to cover others who are laid off,” she said. “It is also hypothesized that living in neighborhoods with high rates of foreclosure could affect health even if you do not personally lose your house.”
Most of us worry about individual risk factors for poor health, such as diet, exercise, smoking and drinking, Margerison said: “But this work – along with a large body of other research – suggests that conditions beyond the individual can have important influences on our health as well.”