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 co-movement between mortality growth (overall, gender- and cause-specific) and economic fluctuations in Italy over the period 1862-2013. To this aim, we use Johansen (Econometrica 59:1551-1580, 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 pre-wars era, where only the long run decreases 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.