Take alcohol, for example. In rough times, some people imbibe less, while others find some solace in the bottle. "When there are stressful times, some people will respond by drinking more as a way of coping," says C. David Dooley, professor of psychology and social behavior at UC Irvine. And other people, in an effort to retain their jobs or save money, cut back. Dooley says this has been documented in several of his studies, in which he uses large-scale survey data asking about employment security and drinking habits.
And just because heart disease overall goes down when times are bad, individuals have the power to go either way. Some people worry their way into a heart attack, and it's there that a tweak in attitude could make all the difference. Instead of just fretting when watching coworkers get pink slips, they might opt to start straightening up their own act -- figuring that a workplace that tolerated bad personal habits in good times might be more choosy when budgets get tight.
People could, theoretically, minimize the effect of economic stress on their hearts, says Merz of Cedars-Sinai. It's the usual advice: Exercise more. Eat better. Relax. Meditate. Save some money by quitting smoking.
And public support for the effort would help. "If we actually played our cards right, put bike racks all over the city, helped people be more physically active, we could mobilize this [economic downturn] for the country and make it good for the heart," Merz says.
It's no surprise, Ruhm says, that when human-resources staffers give advice to the people they're about to lay off, they don't talk only about buffing up the old resume.
"One of the things they'll tell you is to eat well and exercise. And if you feel better physically, you'll feel better mentally," he says. "One of the possible things going on is that when times are bad, people are actively doing those things to protect their health."
Ruhm's findings have been duplicated by others. For example, Eric Neumayer, a London economist studying the people of Germany, found lower rates of heart disease, stroke, pneumonia, influenza and motor vehicle accidents during recessions.
Still, Ruhm's findings remain controversial. Catalano, the UC Berkeley economist, doesn't buy all of it. "I think the evidence is that the net effect of a bad economy is that health gets worse," he says.
Catalano's body of research shows that hard times affect pregnancy in the same way that a hurricane or a flood does -- which is to say, negatively. And he's found that the least controversial result from research on a bad economy and health is that mental health declines (see related stories).
"It depends on which illness you're studying," he says. Stress from any source is linked to a lot of bad health outcomes, including high blood pressure and depression. "Some part of the population is getting sicker," he says
But even skeptics agree on a few positive effects of a downturn. People who hang onto their jobs when unemployment goes up start drinking less and fighting less and take fewer risks -- probably in an attempt to remake themselves into ideal employees. "They find ways to cover themselves," Catalano says. "They come to work every day. They drink less because they don't want to be absent."
In other words, they start behaving better. It can serve them well.
During economic downturns, not all the health news is good. Mental health suffers, and so does reproduction. Page 5