When I think of the Great Depression of the 1930s, for example, I imagine financially ruined men jumping from the windows of the great buildings of New York City.
The global recession of 2008 inspired a series of studies on the health effects of economic collapse. John Ioannidis, MD, DSc, professor of health research and policy, and two colleagues at City University London wondered about the trustworthiness of these studies and decided to examine 41 empirical studies that were conducted in Europe. The 41 studies looked at outcomes ranging from suicide rates or mental health status (31 studies) to mortality, tuberculosis or infant health.
The article appears in the British Medical Journal.
Overall, the studies suggested an increase in suicides and a deterioration in mental health during the recession. But the team found a lot of variability from country to country and, importantly, a substantial likelihood of bias in all the studies except two. The team examined seven types of bias [Table 1], including reporting bias — the inaccurate reporting of parts of the study — and time bias, or the examination of an appropriate time frame.
Of those studies, 30 (73 percent) were deemed to be at high risk of bias, nine (22 percent) at moderate risk of bias, and only two (5 percent) at low risk of bias, limiting the conclusions that can be drawn.
One of the two studies deemed relatively unbiased reported that, in Greece, self-rated health and mental health both deteriorated among the unemployed compared to those who kept their jobs. The other study, in Iceland, found a transitory increase in the prevalence of hypertension among pregnant women.
The three researchers concluded:
There is a need for better empirical studies, especially those focused on identifying mechanisms that can mitigate the adverse effects of the crisis.