Years examined 1950–2002 1988–94, 1999–2000 1990–94 16. OECD countries 1960–1997 17. Romania 1990–1998 18. Romania 19. Russia 20. Russia Table 1. Cont. Country 15. Japan 21. Southeast Asia 1990s 22. Southeastern 1963–1968 Europe and Balkans1990–95 23. South Korea 1990–2002 Study design Measure of economic or political crisis Descriptive GDP and national analysis unemployment rate Multivariate National regression unemployment rate Descriptive Period of economic, analysis political, and social transition Descriptive Post communism analysis economic recession- % decrease in GDP Descriptive Collapse of Soviet analysis Union 1991- decline in average per capita real income by 2/3 between 1990–5 Descriptive Transition from analysis communism to capitalism, civil wars Descriptive Mortality rates before analysis and after recession (1997) GDP decline from 5–10% to 26.7% in 1998 Unemployment rate increase by 5.8% 1997–1999 Reduction in household income by 6.7% 1998 Descriptive Period of East Asian analysis Financial Crisis HIV/AIDS, STIs 24. United States 1950–1975 25. United States, 1974–1995 New York Descriptive Unemployment analysis variation in United States Cost of illness analysis Reduction in Department of Health budget by 20% TB 26. United States, 2007 California Descriptive Period of housing analysis crisis West Nile virus Health Outcome Pneumonia mortality rate Infectious and parasitic diseases Pneumonia and influenza Key Findings Negative correlation in both males and females (greater in males than in females) of deaths from pneumonia with unemployment (p,0.001 and p,0.05). No significant association with GDP. Influenza and Deaths from influenza and pneumonia decrease pneumonia by 1.1% with a 1% increase in national unemploy- ment rate. Mortality due Increase in mortality in 5–9 years olds due to AIDS mainly to AIDS 1980–98 and Descriptive War and population 1990–2004 analysis migration Human Increase in incidence from 19.6 per 100,000 Trichinellosis persons in 1980–89 to 71.8 in 1990–2004 Increase in causes of death due to infectious and parasitic diseases in Russia by 9900 cases in 1990–94 Increase in pneumonia and influenza by 135.5%. Notzon 1998 JAMA Economic Crises and Infectious Diseases Thailand- 54% reduction in health promotion and 33% reduction in HIV/AIDS budget. Increase in CSW. Increase in AIDS patients reported from 40.89 per 100,000 in 1997 to 43.6 in 1998 Trichinellosis Threefold increase in number of cases in Romania 1963–8 v.s. 1969–86 Pneumonia Age 1–34: Decline in infectious diseases and parasites and influenza (1.20 rate ratio 1998/1996 decreased to 0.93 rate ratio 2002/1996 in males and 0.96 decreased to 0.61 in females). Age 35–64: increase in rate ratio between 1998–2000 of approx 40–70%, then decline to L 1996 level by 2002 for pneumonia. Step-wise decrease in TB mortality rates and rate ratio between 1998/1996 and 2002/1996 (0.91 to 0.62 in males and 0.82 to 0.56 in females). Age 65–79: Smaller but still step-wise decrease in TB mortality rates and rate ratio between 1998/1996 and 2002/1996 (0.93 to 0.75 in males and 0.95 to 0.81 in females). Increase in rate of deaths due to pneumonia in males and females between 1998 and 2000 followed by decline. Pneumonia Little variation in deaths from pneumonia and and influenza influenza over this time period. Unemployment only accounts for 1.07% of business cycle variation of death rate. Closure of 6 of 14 chest clinics 52,000 excess cases TB Increase in drug resistant TB by 13% Increase in homeless population (at increased TB risk) from 7584 to 23494 20% excess cases HIV Cost of excess TB cases- $500 million Cost of excess HIV cases- $4.7 billion Outbreak of West Nile Virus- 140 cases Source Granados Demography 2008; 45(2): 323–43 Gerdtham Economics and Human Biology 2006; 4(3): 298–316 Dolea JECH 2002; 56: 444–9 Blaga Am J Trop Med 2007; 76(%):983–86 Kontorovich 2001; Communist and Post- communist studies Hopkins Health Policy 2006; 75: 347–57 Cuperlovic Veterinary Parasitology 2005; 132: 159–166 Khang; Int J Epi 2005; 34: 1291–1301 Eyer Int J Health Services 1977; 7(1): 125–50 Freudenberg; Am J Pub Health 2006; 96(30): 424 Reisen 2008 Emerging Infectious Diseases PLoS ONE | www.plosone.org 6 June 2011 | Volume 6 | Issue 6 | e20724