J Epidemiol Community Health 67:467 doi:10.1136/jech-2012-201903
  • PostScript
  • Letter

Was the Great Depression a cause or correlate of significant mortality declines? An epidemiological response to Granados

  1. Martin McKee5
  1. 1University of Cambridge, Department of Sociology,Cambridge, United Kingdom
  2. 2Department of Economics, UC Davis, Davis, California, USA
  3. 3Department of Economics, University of Arizona, Tucson, Arizona, USA
  4. 4Department of Primary Care, Stanford University, Palo Alto, California, USA
  5. 5ECOHOST, London School of Hygiene and Tropical Medicine, London, UK
  1. Correspondence to Dr David Stuckler, Cambridge—Sociology, Free School Lane, Cambridge CB23RQ, UK; ds450{at}
  • Accepted 8 September 2012
  • Published Online First 30 November 2012

Thank you for the opportunity to respond to Dr Granados’ misunderstanding of our paper.1

First, we cannot envisage any plausible mechanism explaining the short-term relationship between the Great Depression and cancer outcomes he describes. Although healthcare can now improve survival for some cancers, and a recession might affect access to care, the Great Depression predated the widespread use of effective cancer treatments.

Second, turning to infectious diseases, our recent systematic review found that the mechanisms linking economic changes to infectious diseases are complex and time-varying,2 but we cannot identify a plausible …

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