The Great Recession was associated with increased blood pressure and glucose levels, especially among groups of older homeowners and individuals younger than 65 years still employed, according to new research published in Proceedings of the National Academy of Sciences. Medication use fell after the Great Recession, and the results provide strong evidence that economic crises can have measurable effects on public health.
The Great Recession, spanning 2008 to 2010, was associated with increased blood pressure and glucose levels, especially among groups of older homeowners and individuals younger than 65 years still employed, according to new research published in Proceedings of the National Academy of Sciences.
The results, which showed that medication use fell after the recession began, provide strong evidence that economic crises can have measurable effects on public health and, if well understood, may help providers and policy makers prepare for another recession in a better way. The Great Recession was the most significant economic crisis since the Great Depression of the 1930s.
Previous effects of major economic downturns on health have been mixed, with some studies reporting negative health effects and others reporting benefits.
A team led by the David Geffen School of Medicine at the University of California, Los Angeles, is the first to study the question objectively by analyzing health measures at multiple time points leading up to the recession.
They looked at data from the Multi-Ethnic Study of Atherosclerosis for the period from 2000 to 2012. Blood pressure and glucose data for the 4600 participants, aged 45 to 84 years, were analyzed at the beginning, at multiple times leading up to the Great Recession, and once right after the recession ended.
The researchers calculated changes in blood pressure and glucose that would have been expected to occur naturally with age had the recession not happened. They compared that information with the changes that were actually observed at the end of the recession.
The increases were especially large for individuals on blood pressure or diabetes medications at the onset of the recession. The authors said that that finding indicates more vulnerability to economic stress among patients on medications.
In addition, the onset of the recession was accompanied by a substantial decline in medication use and treatment intensity for control of both blood pressure and glucose, which runs counter to the expectation of increased use of medication with age and time.
Among older adults, medication use fell 17% for those on blood pressure drugs. For patients with diabetes, there were significant declines in the use of any medication used and in the intensity of medication used. The difference was 3 times larger for younger adults than for older adults, but the authors said that the differences between age groups were statistically signifcant only for medication intensity.
These shifts in medication use and treatment intensity alone cannot explain the worsening of the health indicators, and the evidence suggests that the stresses of the Great Recession took their greatest toll on those who are on medication.
Both older homeowners over 65 years and those adults still employed might be especially vulnerable to psychological fallout of economic downturns, as they could be at risk of losing their houses, jobs, health insurance, savings, and investments, the study pointed out.
The effect were much different for 1 group on medication, those aged at least 65 years who had not yet completed college, the authors wrote. They were the least likely to be working and more likely to be reliant on Social Security for retirement, rather than investments in the stock market; they were the least affected by the recession.
The 2 outcomes of blood pressure and glucose, which are particularly valuable because they change rapidly in response to stress, provide a more accurate snapshot of how the crisis may have affected public health.
The team next plans to look at additional time points after the Great Recession and to include other markers of health, including inflammation and insulin resistance. They’ll also try to determine whether there were any regional differences.
Seaman T, Thomas D, Stein Merkin S, Moore K, Watson K, Karlamangla A. The Great Recession worsened blood pressure and blood glucose levels in American adults [published online March 12, 2018]. PNAS. doi: 10.1073/pnas.1710502115.