Davalos Maria E, French Michael T
Department of Sociology, 5202 University Drive, Merrick Building, Room 121F, P.O. Box 248162, Coral Gables, FL 33124-2030, USA.
J Ment Health Policy Econ. 2011 Jun;14(2):61-72.
Health-related quality of life refers to an individual's perceived physical and mental health and goes beyond the presence or absence of illnesses to encompass a multidimensional concept of well being. Previous research on the relationships between macroeconomic conditions and health status reveal improvements in physical health during economic downturns. However, few studies have examined whether mental health status improves or declines during tough economic times.
The main objective of this paper is to provide new evidence on the impact of macroeconomic conditions on Health-related quality of life (HRQL), or functional health, by analyzing the physical and mental health summary scores of the 12-Item Short Form Health Survey (SF-12).
The analysis uses panel data from Waves 1 and 2 of the National Epidemiological Survey of Alcohol and Related Conditions (NESARC) for individuals 18-59 years (in Wave 1), for a final sample of 26,313 individuals. The NESARC collected and reported data on the SF-12 health scores, including a physical health score (PCS) for overall physical functioning, and a mental health score (MCS) for mental/psychological functioning. To analyze the impact of economic downturns on HRQL, the study matches the NESARC variables with data on state-level macroeconomic conditions.
To estimate the effects of macroeconomic conditions on HRQL, this paper takes advantage of the longitudinal nature of the dataset and uses individual fixed-effect models to account for both individual and state-level heterogeneity. Although it is unlikely for individual omitted variables (e.g., individuals' preferences and attitudes) to be significantly correlated with the state unemployment rate, using longitudinal data allows for the estimation of a more fully specified model.
Findings consistently indicate that an increase in the average state unemployment rate worsens an individual's HRQL, suggesting that the loss of jobs and income and/or the economic distress associated with economic downturns have a detrimental effect on people's daily lives. Although the magnitudes of the changes are generally small, results show that mental health decreases more than physical health during tough economic times.
With the recent worldwide economic recession causing steep drops in the U.S. Gross Domestic Product along with double-digit unemployment rates, the implications of this study are disheartening. Besides macroeconomic policies to help stimulate the economy, government officials and policymakers should also consider social policies to help people cope with the recession and buffer the potential negative health impact, both mental and physical. Moreover, policymakers should keep in mind that the mental health effects might be greater and longer lasting.
健康相关生活质量指个人对自身身心健康的感知，它超越了疾病的有无，涵盖了幸福的多维度概念。先前关于宏观经济状况与健康状况之间关系的研究表明，经济衰退期间身体健康状况有所改善。然而，很少有研究探讨在经济困难时期心理健康状况是改善还是下降。
本文的主要目标是通过分析12项简短健康调查问卷（SF - 12）的身心健康汇总得分，为宏观经济状况对健康相关生活质量（HRQL）或功能健康的影响提供新的证据。
分析使用了全国酒精及相关状况流行病学调查（NESARC）第1波和第2波中针对18 - 59岁个体（第1波时）的面板数据，最终样本为26313人。NESARC收集并报告了SF - 12健康得分的数据，包括总体身体功能的身体健康得分（PCS）和心理/心理功能的心理健康得分（MCS）。为了分析经济衰退对HRQL的影响，该研究将NESARC变量与州级宏观经济状况数据进行了匹配。
为了估计宏观经济状况对HRQL的影响，本文利用数据集的纵向性质，并使用个体固定效应模型来考虑个体和州级的异质性。尽管个体遗漏变量（如个人偏好和态度）不太可能与州失业率显著相关，但使用纵向数据可以估计一个更全面的模型。
研究结果一致表明，州平均失业率的上升会恶化个体的HRQL，这表明失业和收入损失以及/或与经济衰退相关的经济困境对人们的日常生活有不利影响。尽管变化幅度通常较小，但结果表明，在经济困难时期，心理健康下降的幅度大于身体健康。
近期全球经济衰退导致美国国内生产总值大幅下降以及失业率达到两位数，这项研究的启示令人沮丧。除了有助于刺激经济的宏观经济政策外，政府官员和政策制定者还应考虑社会政策，以帮助人们应对衰退并缓冲潜在的身心健康负面影响。此外，政策制定者应牢记心理健康影响可能更大且持续时间更长。
