Policy Implications and Conclusions

Any discussion of economic stressors and their effects must at least allude to economic policy because such stressors result mostly from public and private decisions regulated by political institutions. Regulatory institutions intervene in these decisions only when costs appear to exceed benefits.

While researchers may study the health effects of economic perturbations to satisfy their curiosity, they typically claim that the work has applied value in that it could help regulators better account the social costs of public and private decisions. The claim implies that public policy could, indeed, should reduce the frequency or virulence of economic stressors such as job loss.

Much controversy has arisen in Europe and North America over whether regulators have gone too far or not far enough in their attempts to reduce the stress of economic change. Policies now in place appear to assume that we previously went too far and discouraged private investment by depressing the return to capital.

Defenders of the current policy acknowledge that increasing the return to private investment induces economic restructuring and its attendant pain in our personal and communal experience. They predict, however, that lowering the return to investors would drive capital to less regulated and less taxed economies. This would supposedly displace more labor in the developed world than restructuring, and inflict much unregulated stress and untreated illness in developing countries.

The assumptions underlying current policy remain controversial. The epidemiology of economic stress, therefore, will likely remain an important issue in public health as well as in the debate over economic policy.

In summary, the performance of an economy can affect the health of the population it supports. Economic contraction increases the number of persons coping with undesirable job and financial events. These events increase the risk of experiencing other stressors not intuitively connected to the economy. The adverse effects of these stressors spread to family and friends.

Rapid economic growth also induces adaptations that should, according to classic theory, increase the incidence of stress-related illness. Research on work-related trauma and alcohol consumption, for example, supports this connection.

A contracting economy affects our capacity to cope with stressors. Persons who lose income cannot purchase as many coping resources as they once did. This reduces their ability to deal not only with new economic stressors but also with chronic stressors previously buffered with purchased coping resources. The tangible and intangible coping resources gotten from social networks are also more difficult to obtain when the economy contracts. This is true because there are fewer surplus resources to contribute to the common pool at the same time that there are more demands upon it.

Economic stressors can also increase the incidence of illnesses not typically thought to be stress related, because coping with such stressors can leave us with fewer resources to avoid risk factors for, or detect early signs of, illnesses unrelated to stress. The economy can, moreover, affect the tolerance of society for persons coping with stressors. We know that overstaffed communities, as indicated by high unemployment rates, reduce competition for scarce jobs by increasing the diagnosis of disability.

Economic contraction inevitably increases the number of persons who are poor. Being poor is a risk factor for stressors of all sorts and, by definition, means that access to coping resources is relatively constrained.