Unfolding the relationship between mortality, economic fluctuations and health in Italy

Despite the long run strong negative association between economic development and mortality, their short run relationship remains controversial. In the present work, we study comovement between mortality growth (overall, gender- and cause-specific) and economic fluctuations in Italy over the period 1862-2013. To this aim, we use Johansen (1991) procedure to jointly estimate the short and long run dynamics of the two variables, avoiding omitted variable bias in the cyclical co-movement extraction or spurious association attributable to trends. We also take into account possible asymmetric responses of mortality growth to shocks in GDP. We find that an increase of 1% in real GDP per capita induces a reduction in mortality rate of 0.27% for total population. Moreover, we observe that business cycle fluctuations do not affect mortality in the prewars era, where only the long run decrease matters driven by reduction in infections and accidents mortality. On the contrary, in the post-wars period, expansive phases of business cycle are associated with reduction in mortality growth and periods of recession generate an ever-deeper decrease. However, in this period, mortality for cancer is procyclical and significantly increasing in expansion: this reinforces the debate for controlling environmental factors.