Advertisement

Population Health Concerns During the United States’ Great Recession

      Background

      Associations between economic conditions and health are usually derived from cost-intensive surveys that are intermittently collected with nonspecific measures (i.e., self-rated health).

      Purpose

      This study identified how precise health concerns changed during the U.S. Great Recession analyzing Google search queries to identify the concern by the query content and their prevalence by the query volume.

      Methods

      Excess health concerns were estimated during the Great Recession (December 2008 through 2011) by comparing the cumulative difference between observed and expected (based on linear projections from pre-existing trends) query volume for hundreds of individual terms. As performed in 2013, the 100 queries with the greatest excess were ranked and then clustered into themes based on query content.

      Results

      The specific queries with the greatest relative excess were stomach ulcer symptoms and headache symptoms, respectively, 228% (95% CI=35, 363) and 193% (95% CI=60, 275) greater than expected. Queries typically involved symptomology (i.e., gas symptoms) and diagnostics (i.e., heart monitor) naturally coalescing into themes. Among top themes, headache queries were 41% (95% CI=3, 148); hernia 37% (95% CI=16, 142); chest pain 35% (95% CI=6, 313); and arrhythmia 32% (95% CI=3, 149) greater than expected. Pain was common with back, gastric, joint, and tooth foci, with the latter 19% (95% CI=4, 46) higher. Among just the top 100, there were roughly 205 million excess health concern queries during the Great Recession.

      Conclusions

      Google queries indicate that the Great Recession coincided with substantial increases in health concerns, hinting at how population health specifically changed during that time.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to American Journal of Preventive Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Burgard S.A.
        • Brand J.E.
        • House J.S.
        Toward a better estimation of the effect of job loss on health.
        J Health Soc Behav. 2007; 48: 369-384
        • Catalano R.
        • Goldman-Mellor S.
        • Saxton K.
        • et al.
        The health effects of economic decline.
        Annu Rev Public Health. 2011; 32: 431-450
        • McKee-Ryan F.
        • Song Z.
        • Wanberg C.R.
        • Kinicki A.J.
        Psychological and physical well-being during unemployment: a meta-analytic study.
        J Appl Psychol. 2005; 90: 53-76
        • Boland M.
        • Sweeney M.R.
        • Scallan E.
        • Harrington M.
        • Staines A.
        Emerging advantages and drawbacks of telephone surveying in public health research in Ireland and the U.K.
        BMC Public Health. 2006; 6: 208
        • Cooper B.
        Economic recession and mental health: an overview.
        Neuropsychiatry. 2011; 25: 113-117
        • King G.
        Ensuring the data-rich future of the social sciences.
        Science. 2011; 331: 719-721
        • Bennett G.G.
        • Scharoun-Lee M.
        • Tucker-Seeley R.
        Will the public's health fall victim to the home foreclosure epidemic?.
        PLoS Med. 2009; 6: e1000087
        • Catalano R.
        Health, medical care, and economic crisis.
        N Engl J Med. 2009; 360: 749
        • Pollack C.E.
        • Lynch J.
        Health status of people undergoing foreclosure in the Philadelphia region.
        Am J Public Health. 2009; 99: 1833-1839
        • Pollack C.E.
        • Kurd S.K.
        • Livshits A.
        • Weiner M.
        • Lynch J.
        A case–control study of home foreclosure, health conditions, and health care utilization.
        J Urban Health. 2011; 88: 469-478
        • Alley D.E.
        • Lloyd J.
        • Pagán J.A.
        • Pollack C.E.
        • Shardell M.
        • Cannuscio C.
        Mortgage delinquency and changes in access to health resources and depressive symptoms in a nationally representative cohort of Americans older than 50 years.
        Am J Public Health. 2011; 101: 2293-2298
        • Ayers J.W.
        • Ribisl K.
        • Brownstein J.S.
        Using search query surveillance to monitor tax avoidance and smoking cessation following the United States' 2009 "SCHIP" cigarette tax increase.
        PLoS One. 2011; 6: e16777
        • Ayers J.W.
        • Ribisl K.M.
        • Brownstein J.S.
        Tracking the rise in popularity of electronic nicotine delivery systems (electronic cigarettes) using search query surveillance.
        Am J Prev Med. 2011; 40: 448-453
        • Ayers J.W.
        • Althouse B.M.
        • Allem J.P.
        • Ford D.E.
        • Ribisl K.M.
        • Cohen J.E.
        A novel evaluation of World No Tobacco Day in Latin America.
        J Med Internet Res. 2012; 14: e77
        • Ayers J.W.
        • Althouse B.M.
        • Allem J.P.
        • Rosenquist J.N.
        • Ford D.E.
        Seasonality in seeking mental health information on Google.
        Am J Prev Med. 2013; 44: 520-525
        • Ayers J.W.
        • Althouse B.M.
        • Johnson M.
        • Cohent J.E.
        Circaseptan (weekly) rhythms in smoking cessation contemplations.
        JAMA Int Med. 2013; https://doi.org/10.1001/jamainternmed.2013.11933
      1. Paul MJ, Dredze M. You are what you tweet: analyzing Twitter for public health. Fifth International AAAI Conference on Weblogs and Social Media (ICWSM 2011); Jul 2011; Barcelona, Spain.

        • Ayers J.W.
        • Althouse B.M.
        • Allem J.P.
        • et al.
        Novel surveillance of psychological distress during the Great Recession.
        J Affect Disord. 2012; 142: 323-330
        • Katon W.
        • Sullivan M.
        • Walker E.
        Medical symptoms without identified pathology: relationship to psychiatric disorders, childhood and adult trauma, and personality traits.
        Ann Intern Med. 2001; 134: 917
        • Kuhn A.
        • Lalive R.
        • Zweimüller J.
        The public health costs of job loss.
        J Health Econ. 2009; 28: 1099-1115
        • Lihm H.S.
        • Park S.H.
        • Gong E.H.
        • Choi J.S.
        • Kim J.W.
        Relationship between occupational stress and gastric disease in male workers.
        Korean J Fam Med. 2012; 33: 311-319
        • Rios R.
        • Zautra A.J.
        Socioeconomic disparities in pain: the role of economic hardship and daily financial worry.
        Health Psychol. 2011; 30: 58-66
        • Schulz A.J.
        • Kannan S.
        • Dvonch J.T.
        • et al.
        Social and physical environments and disparities in risk for cardiovascular disease: the healthy environments partnership conceptual model.
        Environ Health Perspect. 2005; 113: 1817-1825
        • Gallo W.T.
        • Teng H.M.
        • Falba T.A.
        • Kasl S.V.
        • Krumholz H.M.
        • Bradley E.H.
        The impact of late career job loss on myocardial infarction and stroke: a 10-year follow up using the health and retirement survey.
        Occup Environ Med. 2006; 63: 683-687
      2. Business Cycle Dating Committee, National Bureau of Economic Research; www.nber.org/cycles/dec2008.html. 2008.

        • King G.
        • Tomz M.
        • Wittenberg J.
        Making the most of statistical analyses: improving interpretation and presentation.
        Am J Pol Sci. 2000; 44: 341-355
        • Rothman K.J.
        No adjustments are needed for multiple comparisons.
        Epidemiology. 1990; 1: 43-46
        • World Health Organization
        ICD-10: International statistical classification of diseases and related health problems.
        World Health Organization, Geneva2004
        • Reeves A.
        • Stuckler D.
        • McKee M.
        • Gunnell D.
        • Chang S.S.
        • Basu S.
        Increase in state suicide rates in the USA during economic recession.
        Lancet. 2012; 380: 1813-1814
        • Ramsay C.R.
        • Matowe L.
        • Grilli R.
        • Grimshaw J.M.
        • Thomas R.E.
        Interrupted time series designs in health technology assessment: lessons from two systematic reviews of behavior change strategies.
        Int J Technol Assess Health Care. 2003; 19: 613-623
        • Posada D.
        • Buckley T.R.
        Model selection and model averaging in phylogenetics: advantages of Akaike information criterion and Bayesian approaches over likelihood ratio tests.
        Syst Biol. 2004; 53: 793-808
        • Gallo W.T.
        • Bradley E.H.
        • Siegel M.
        • Kasl S.V.
        Health effects of involuntary job loss among older workers: findings from the health and retirement survey.
        J Gerontol B Psychol Sci Soc Sci. 2000; 55: S131-S140
        • Link B.G.
        • Phelan J.C.
        Stigma and its public health implications.
        Lancet. 2006; 367: 528-529
        • Hoffman C.
        • Paradise J.
        Health insurance and access to health care in the U.S.
        Ann N Y Acad Sci. 2008; 1136: 149-160
        • Althouse B.M.
        • Ng Y.Y.
        • Cummings D.A.
        Prediction of dengue incidence using search query surveillance.
        PLoS Negl Trop Dis. 2011; 5: e1258
        • Goel S.
        • Hofman J.M.
        • Lahaie S.
        • Pennock D.M.
        • Watts D.J.
        Predicting consumer behavior with Web search.
        Proc Natl Acad Sci U S A. 2010; 107: 17486-17490
        • Ruhm C.J.
        Are recessions good for your health?.
        Q J Econ. 2000; 115: 617-650