The recent recession and lingering high unemployment will likely lead to a burst of research studying the health effects of economic decline. We aim to inform that work by summarizing empirical research concerned with those effects. We separate the studies into groups defined by questions asked, mechanisms invoked, and outcomes studied. We conclude that although much research shows that undesirable job and financial experiences increase the risk of psychological and behavioral disorder, many other suspected associations remain poorly studied or unsupported. The intuition that mortality increases when the economy declines, for example, appears wrong. We note that the research informs public health programming by identifying risk factors, such as job loss, made more frequent by economic decline. The promise that the research would identify health costs and benefits of economic policy choices, however, remains unfulfilled and will likely remain so without stronger theory and greater methodological agreement.

The severity, sudden onset, and multipronged nature of the Great Recession (2007–2009) provided a unique opportunity to examine the health impacts of macroeconomic downturn. We comprehensively review empirical literature examining the relationship between the Recession and mental and physical health outcomes in developed nations. Overall, studies reported detrimental impacts of the Recession on health, particularly mental health. Macro- and individual-level employment- and housing-related sequelae of the Recession were associated with declining fertility and self-rated health, and increasing morbidity, psychological distress, and suicide, although traffic fatalities and population-level alcohol consumption declined. Health impacts were stronger among men and racial/ethnic minorities. Importantly, strong social safety nets in some European countries appear to have buffered those populations from negative health effects. This literature, however, still faces multiple methodological challenges, and more time may be needed to observe the Recession’s full health impact. We conclude with suggestions for future work in this field.

To investigate associations of trimester-specific GWG with fetal birth size and BMI at age 5 years. We examined 3,015 singleton births to women without pregnancy complications from the Child Health and Development Studies prospective cohort with measured weights during pregnancy. We used multivariable regression to examine the associations between total and trimester gestational weight gain (GWG) and birth weight for gestational age and child BMI outcomes, adjusting for maternal age, race/ethnicity, education, marital status, parity, pre-pregnancy body mass index (BMI), and smoking; paternal overweight, gestational age, and infant sex. We explored differences in associations by maternal BMI and infant sex. GWG in all trimesters was significantly and independently associated with birth weight with associations stronger, though not significantly, in the second trimester. First trimester GWG was associated with child BMI outcomes (OR for child overweight = 1.05; 95% CI = 1.02, 1.09). Each kg of first trimester GWG was significantly associated with increased child BMI z-score in women of low (β = 0.099; 95% CI = 0.034, 0.163) and normal (β = 0.028; 95% CI = 0.012, 0.044), but not high pre-pregnancy BMI. GWG in all trimesters was associated with birth weight; only first trimester GWG was associated with child BMI. If replicated, this information could help specify recommendations for maternal GWG and elucidate mechanisms connecting GWG to child BMI.

Prior research examining links between neighborhood violence and mental health has not been able to establish whether it is perceived levels of neighborhood violence, or actual levels of violent crime, that matter most for adolescents' psychological well-being. In this study, we ascertained both perceived neighborhood safety and objectively-measured neighborhood-level violent crime (using a novel geospatial index of police-reported crime incidents) for 4464 adolescent respondents from the California Health Interview Survey (CHIS 2011(CHIS -2014. We used propensity score-matched regression models to examine associations between these measures and CHIS adolescents' symptoms of psychological distress. We found that adolescents who perceived their neighborhood to be unsafe were two times more likely than those who perceived their neighborhood to be safe to report serious psychological distress (OR = 2.4, 95 % CI = 1.20, 4.96). Adolescents who lived in areas objectively characterized by high levels of violent crime, however, were no more likely than their peers in safer areas to be distressed (OR = 1.41; 95 % CI = 0.60, 3.32). Our results suggest that, at the population level, adolescents' perceptions of neighborhood violence, rather than objective levels of neighborhood crime, are most salient for their mental health.

Neighborhood poverty histories may contribute to an understanding of perinatal health and should be considered in future research.

This nonlinearity suggests that reductions in alcohol outlet density where density is highest and the association is strongest may have the largest public health impact per unit reduction. Future research should assess the impact of policies and interventions that aim to reduce alcohol outlet density, and consider nonlinearity in effects.

Objectives: Antagonists in the debate over whether the maternal stress response during pregnancy damages or culls fetuses have invoked the theory of selection in utero to support opposing positions. We describe how these opposing arguments arise from the same theory and offer a novel test to discriminate between them. Our test, rooted in reports from population endocrinology that human chorionic gonadotropin (hCG) signals fetal fitness, contributes not only to the debate over the fetal origins of illness, but also to the more basic literature concerned with whether and how natural selection in utero affects contemporary human populations. Methods: We linked maternal serum hCG measurements from prenatal screening tests with data from the California Department of Public Health birth registry for the years 2001–2007. We used time series analysis to test the association between the number of live‐born male singletons and median hCG concentration among males in monthly gestational cohorts. Results: Among the 1.56 million gestations in our analysis, we find that median hCG levels among male survivors of monthly conception cohorts rise as the number of male survivors falls. Results: Elevated median hCG among relatively small male birth cohorts supports the theory of selection in utero and suggests that the maternal stress response culls cohorts in gestation by raising the fitness criterion for survival to birth. Am. J. Hum. Biol., 2012. © 2012 Wiley Periodicals, Inc.

Objectives-Growing evidence suggests that pre-conception stressors are associated with increased risk of preterm delivery (PTD). Our study assesses stressors in multiple domains at multiple points in the life course (i.e., childhood, adulthood, within 6 months of pregnancy) and their relation to PTD. We also examine heterogeneity of associations by race/ethnicity, PTD timing, and PTD clinical circumstance.Methods-We assessed stressors retrospectively via mid-pregnancy questionnaires in the Pregnancy Outcomes and Community Health Study (1998)(1999)(2000)(2001)(2002)(2003)(2004), a Michigan pregnancy cohort (n=2,559). Stressor domains included abuse/witnessing violence (hereafter "abuse"), loss, economic stress, and substance use. We used logistic and multinomial regression for the following outcomes: PTD (<37 weeks' gestation), PTD by timing (≤34 weeks, 35-36 weeks) and PTD by clinical circumstance (medically indicated, spontaneous). Covariates included race/ethnicity, education, parity, and marital status.Results-Stressors in the previous 6 months were not associated with PTD. Experiencing abuse during both childhood and adulthood increased adjusted odds of PTD among women of white or other race/ethnicity only (aOR: 1.6, 95%CI: 1.1, 2.5). Among all women, abuse in childhood increased odds of late PTD (aOR: 1.5, 95%CI: 1.0, 2.2) while abuse in both childhood and adulthood non-significantly increased odds of early PTD (aOR: 1.6, 95%CI: 0.9, 2.7). Sexual, but not physical, abuse in both childhood and adulthood increased odds of PTD (aOR: 1.9, 95%CI: 1.0, 3.5).Conclusions-Experiences of abuse-particularly sexual abuse-across the life-course may be important considerations when assessing PTD risk. Our results motivate future studies of pathways linking abuse and PTD.