Economic crises and mortality: a review of the literature.

BACKGROUND: Studies evaluating the association of economic variables with mortality have produced mixed findings.
OBJECTIVE: We sought to evaluate whether economic crises confer increase in mortality.
METHODS: We reviewed studies analysing mortality in the general population in periods of economic crisis compared with periods prior to or after the crisis, by searching PubMed, Scopus, Cochrane and the World Wide Web.
RESULTS: Eleven studies were included in this review; they referred to economic crises that occurred in Russia, South Korea, as well as South or Central American, African or European countries (5, 2, 2, 1 and 1 studies respectively). Periods of economic crises were associated with the increase in all-cause mortality in seven out of eight studies that reported specific relevant data and increase in cardiovascular mortality in six out of seven studies. Increase in mortality because of respiratory infections, chronic liver disease, suicides, homicides and mortality in infants was noted in association with economic crises in all 5, 4, 6, 5 and 3 studies, respectively, that reported specific relevant data. Mortality from transport accidents decreased with economic crises in five out of six studies.
CONCLUSION: Economic crises in less affluent countries are accompanied with the increase in all-cause mortality, as well as mortality from most of the major specific causes. Further data are needed to establish the effect of economic crises on mortality in more affluent countries. We believe that the above-mentioned association could be attributed to increased psychosocial stress during such periods, among other factors. Public health authorities should be aware of this issue and consider appropriate preventive and control measures.