The impact of macroeconomic fluctuations on health and mortality rates has been a highly studied topic in the field of economics. Many studies, using fixed-effects models, find that mortality is procyclical in many countries, such as the United States, Germany, Spain, France, Pacific-Asian nations, Mexico, and Canada. On the other hand, a small number of studies find that mortality decreases during economic expansion. Differences in the social insurance systems and labor market institutions across countries may explain some of the disparities found in the literature. Studies examining the effects of more recent recessions are less conclusive, finding mortality to be less procyclical, or even countercyclical. This new finding could be explained by changes over time in the mechanisms behind the association between business cycle conditions and mortality. A related strand of the literature has focused on understanding the effect of economic fluctuations on infant health at birth and/or child mortality. While infant mortality is found to be procyclical in countries like the United States and Spain, the opposite is found in developing countries. Even though the association between business cycle conditions and mortality has been extensively documented, a much stronger effort is needed to understand the mechanisms behind the relationship between business cycle conditions and health. Many studies have examined the association between macroeconomic fluctuations and smoking, drinking, weight disorders, eating habits, and physical activity, although results are rather mixed. The only well-established finding is that mental health deteriorates during economic slowdowns. An important challenge is the fact that the comparison of the main results across studies proves to be complicated due to the variety of empirical methods and time spans used. Furthermore, estimates have been found to be sensitive to the use of different levels of geographic aggregation, model specifications, and proxies of macroeconomic fluctuations.
Cristina Bellés-Obrero and Judit Vall Castelló
King Davis and Hyejin Jung
This entry defines the term disparity as measurable differences between groups on a number of indices. The term disparity originated in France in the 16th century and has been used as a barometer of progress in social justice and equality in the United States. When disparity is examined across the U.S. population over a longitudinal period, it is clear that disparities continue to exist and that they distinguish groups by race, income, class, and gender. African American and Native American populations have historically ranked higher in prevalence and incidence than other populations on most indices of disparity. However, the level of adverse health and social conditions has declined for all population groups in the United States. The disparity indices include mortality rates, poor health, disease, absence of health insurance, accidents, and poverty. Max Weber’s theory of community formation is used in this entry to explain the continued presence and distribution of disparities. Other theoretical frameworks are utilized to buttress the major hypothesis by Weber that social ills tend to result from structural faults rather than individual choice. Social workers are seen as being in a position to challenge the structural origins of disparities as part of their professional commitment to social justice.