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J Epidemiol Community Health 66:410-419 doi:10.1136/jech.2010.121376
  • Research report

Banking crises and mortality during the Great Depression: evidence from US urban populations, 1929–1937

  1. Martin McKee6
  1. 1Department of Global Health and Population, Harvard University, Boston, USA
  2. 2Department of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
  3. 3Department of Economics and NBER, University of California, Davis, Davis, California, USA
  4. 4Department of Economics and NBER, University of Arizona, USA
  5. 5Department of Medicine & San Francisco General Hospital, Division of General Internal Medicine, University of California San Francisco, San Francisco, California, USA
  6. 6London School of Hygiene & Tropical Medicine & European Observatory on Health Systems and Policies, London, UK
  1. Correspondence to Prof David Stuckler, Harvard University, 677 Huntington Avenue, Boston, MA USA; dstuckler{at}hsph.harvard.edu
  1. Contributors DS designed and conducted the empirical analysis and drafted the manuscript; PF collected the data; CM, PF, SB and MM oversaw the design of the study, facilitated the interpretation of the findings and helped draft the manuscript.

  • Accepted 22 December 2010
  • Published Online First 24 March 2011

Abstract

Background Previous research suggests that the Great Depression led to improvements in public health. However, these studies rely on highly aggregated national data (using fewer than 25 data points) and potentially biased measures of the Great Depression. The authors assess the effects of the Great Depression using city-level estimates of US mortality and an underlying measure of economic crisis, bank suspensions, at the state level.

Methods Cause-specific mortalities covering 114 US cities in 36 states between 1929 and 1937 were regressed against bank suspensions and income data from the Federal Deposit Insurance Corporation Database, using dynamic fixed-effects models and adjustments for potential confounding variables.

Results Reductions in all-cause mortalities were mainly attributable to declines in death rates owing to pneumonia (26.4% of total), flu (13.1% of total) and respiratory tuberculosis (11.2% of total), while death rates increased from heart disease (19.4% of total), cancer (8.1% of total) and diabetes (2.9%). Only heart disease can plausibly relate to the contemporaneous economic shocks. The authors found that a higher rate of bank suspensions was significantly associated with higher suicide rates (β=0.32, 95% CI 0.24 to 0.41) but lower death rates from motor-vehicle accidents (β=−0.18, 95% CI −0.29 to −0.07); no significant effects were observed for 30 other causes of death or with a time lag.

Conclusion In contrast with existing research, the authors find that many of the changes in deaths from different causes during the Great Depression were unrelated to economic shocks. Further research is needed to understand the causes of the marked variations in mortality change across cities and states, including the effects of the New Deal and Prohibition.

Footnotes

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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