By KATE
SHERIDAN
MARCH 12, 2018
The Great Recession had dramatic and visible
effects: Millions of Americans lost their homes; more than 8 million
people lost their jobs. But a
new study finds that it also had invisible effects on people’s health — and
that those effects could have long-term consequences.
Using a long-running study on heart health,
scientists evaluated blood pressure and blood glucose measurements from 2000 to
2012. They found that those metrics were significantly worse after the
recession hit in 2007 — at least in part due to fewer people taking their
medicines.
The finding provides some of the strongest
evidence yet that economic stress can have a negative effect on people’s
health. “Here in the U.S., we’re not very responsive to economic downturns,”
said study author and University of California, Los Angeles, epidemiologist
Teresa Seeman. “But we particularly don’t pay much attention to the health consequences.”
These data, she said, indicate that we might
want to take a closer look. “To me, this study is ringing a bell and showing
that it’s more than just economic, health needs to be a concern as well.”
Well-timed data collection
Seeman and her colleagues had been gathering
data for years from more than 4,500 middle-aged and older people for the
Multi-Ethnic Study of Atherosclerosis, or MESA. MESA was originally designed to
suss out how heart disease may develop differently across racial and ethnic
groups. But by chance, MESA’s data collection was timed nearly perfectly to
pick up on the recession’s impact, too. The team assembled four sets of data
before the recession, including one that wrapped up in May 2007. They started
collecting again in June 2010 — one year after the recession officially ended.
They found that people who were younger than 65
and on medication when the recession hit saw their systolic blood pressure go
about 12 mmHg above where it would have risen due to aging alone. People who
were younger than 65 taking medication also saw an unexpected increase in their
blood glucose levels of about 11 percent as of 2012, the latest year the
analysis included.
Blood pressure and glucose levels are ideal
metrics for researchers studying the impact of a short-term shock, like a major
two-year recession. Both change over a relatively short time frame, and both
are known to be physiological responses to stress.
Increases in both measurements can be linked to
an increased risk of heart disease, Seeman said.
The groups that showed some of the largest
increases — adults who were likely working but approaching retirement and
older, educated homeowners — are exactly the people who were likely to be hit
hardest by the recession’s effects. “If anybody suffered economically more than
others, these are the people it would have hit,” Seeman said. Middle-class
homeowners were “particularly vulnerable to the housing market crash,”
according to the U.S. National Bureau of Economic Research.
It’s not a huge leap to assume financial strain
might be linked with health problems. Stress, for one thing, is known to take a toll on a person’s
well-being. And losing a job and the health insurance that comes with it might
mean making tough choices about money spent on food or health care, including
medications. In fact, 17 percent fewer adults over 65 were taking blood
pressure medication after the recession in this study. The number of elderly
people who were taking insulin also decreased by about 13 percent.
The paper was published Monday in Proceedings of the
National Academy of Sciences.
“Medications tend to be relatively expensive for
most of us,” Seeman explained — even for people eligible for Medicare.
“Unfortunately, high blood pressure and high levels of glucose tend to be
non-symptomatic, by and large. Not taking your medication, you wouldn’t
necessarily start feeling the consequences of that.”
A lack of research
Hard data about the recession’s impact can be
hard to find; the Great Recession and its impact on health and health care
systems accounted for only 92 published papers in
the last two years. Among them is one published by Jessica Jones-Smith,
an epidemiologist at
the University of Washington’s School of Public Health. In 2016, she and her
colleagues published a paper finding that children
were at a higher risk of gaining weight during the recession if they lived in
counties where unemployment rose.
In fact, Jones-Smith noted, recessions can be a
valuable opportunity for public health research. “The recession allows enough
variation in economic conditions to say something about how they might impact
health,” she said.
Jones-Smith called Seeman’s paper “probably one
of the strongest papers on the recession.” However, some questions remain
unanswered. It won’t be clear if the effects found are temporary until more
data is collected. Seeman and her colleagues will also need to wait and watch
their cohort before they can say whether these changes might actually lead to
more heart attacks than expected.
The study cohort wasn’t designed to be
nationally representative, Seeman noted, so the results might not be
generalizable to the entire country. The paper didn’t include an analysis of
whether a person’s health outcomes varied by their racial or ethnic identity —
which could matter, especially given that rates of home ownership in
the United States do vary widely between groups.
Finally, Jones-Smith noted, the study could have
been even stronger if Seeman and her colleagues had analyzed their data based
on foreclosure rates in a person’s neighborhood — which is exactly what Seeman
and her team is planning to do next, pending funding.
Unfortunately, Seeman’s research could be
relevant again someday. Economic downturns are cyclical — which means another
will come. What we do as a society in the face of it, however, is under our
control. The health consequences of recessions have been overlooked in the
past, Seeman said. But perhaps that won’t be true for much longer.
No comments:
Post a Comment