Business cycles, hypertension and cardiovascular disease: evidence from the Icelandic economic collapse.

BACKGROUND

Business cycles affect people's lives. A growing literature examines their effect on health outcomes. The available studies on the relationship between ambient economic conditions and cardiovascular health show mixed results. They are furthermore limited in their outcome measures, focusing mostly on mortality.

METHODS

We examined the relationship between economic conditions and cardiovascular disease and hypertension, using the Icelandic economic collapse of 2008. Logit regression analyses are used to examine the relationship between economic conditions and the probability of reporting a cardiovascular disease or hypertension. We furthermore investigated potential mediators of this relationship. The data used come from a health and lifestyle survey carried out by the Public Health Institute of Iceland in 2007 and 2009.

RESULTS

The crisis was positively related to hypertension in males but no statistically significant relationship was found for females. The mediation analyses indicated partial mediation through changes in working hours and stress level, but negligible mediation through changes in income. The male hypertension was, however, suppressed by concurrent changes in smoking and body weight.

CONCLUSIONS

Only examining mortality effects of society-wide economic conditions may understate the overall effect on cardiovascular health.