Heart disease mortality and economic changes; including unemployment; in Western Germany 1951-1989.

Research over the last two decades has indicated that changes in cardiovascular disease mortality rates have been influenced by those in national economic indicators as well as by measures of consumption of tobacco, animal fats and alcohol. These findings predominantly involved the United States, United Kingdom and Scandinavian countries. The economic indicators included real per capita income and social welfare expenditures (beneficial relationships to mortality rates), and unemployment rates and business failure rates (detrimental relationships to mortality). James Henry's formulations have emphasized that many different illnesses respond to emotional stresses in different psychophysiological patterns depending on the specific constellations of emotions aroused. On the assumption that the impact of national economic changes on cardiovascular mortality reflects emotional stresses, losses, frustrations and deprivations, similar tests were undertaken using Western German heart disease mortality rate data over 1951-1989. Time-series regression analysis showed that, holding constant the effects of tobacco, animal fats and alcohol, increased income and social welfare expenditures are related to heart disease mortality rate declines, whereas increased unemployment and business failure rates are related to heart disease mortality rate increases over more than a decade.