Economic fluctuations and cardiovascular diseases: A multiple-input time series analysis

• Published in: PloS one Vol. 14; no. 8; p. e0219358
• Main Authors: Lee, Chiachi Bonnie, Liao, Chen-Mao, Peng, Li-Hsin, Lin, Chih-Ming
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 06.08.2019; Public Library of Science (PLoS)
• Subjects: Adult; Age differences; Aged; Air pollution; Alcoholic beverages; Budgets; Cardiovascular disease; Cardiovascular diseases; Cardiovascular Diseases - economics; Cardiovascular Diseases - epidemiology; Cigarettes; Coronary artery disease; Demographic aspects; Ecology and Environmental Sciences; Economic analysis; Economic conditions; Economic Status - statistics & numerical data; Economics; Elderly men; Employment; Female; Fluctuations; Health aspects; Health care costs; Health risk assessment; Heart diseases; Hospitalization - economics; Hospitalization - statistics & numerical data; Humans; Hypertension; Impact analysis; Ischemia; Male; Medical economics; Medical research; Medicine and Health Sciences; Middle Aged; Mortality; Myocardial ischemia; National health insurance; People and Places; Pollution; Pollution effects; Risk factors; Social Sciences; Statistical analysis; Studies; Subgroups; Systematic review; Time Factors; Time series; Unemployment; Websites; Womens health; Young Adult; Young women; Taiwan; Greece; Sweden; United States > US; China
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0219358

Little is known about the gender and age differences associated with the effects of economic fluctuations on hospitalization for cardiovascular diseases. This paper investigates the impact of economic fluctuations on hospitalization for ischemic heart disease (IHD), stroke, and hypertension by age and gender between January 1996 and December 2012 in Taiwan. We adopted a multiple-input time series analysis to examine the strength of the immediate and latent effects of the 17-year quarterly unemployment rates (UR), air pollution exposure (APE), gross domestic product (GDP), per capita consumption expenditure in cigarette and alcohol (ECA), and per capita healthcare expenditure (HE) on the adjusted quarterly incidence rate of hospitalization. The data used in this paper were retrieved from the National Health Insurance Research Database and the website of the Directorate-General of Budget, Accounting and Statistics (DGBAS), Executive Yuan. Our findings indicate that higher UR increased IHD hospitalization in young men and women and middle-aged women but reduced stroke hospitalization in young men. Higher APE increased IHD hospitalization in young men but reduced it for young women, increased stroke hospitalization in old men and middle-aged women but reduced it for young men, and increased hypertension hospitalization in middle-aged men and young women. Higher ECA reduced IHD hospitalization in middle-aged men, increased stoke hospitalization in middle-aged and old men and middle-aged women. Higher HE reduced IHD hospitalization in old men, young and old women, reduced stroke hospitalization in old women, and reduced hypertension hospitalization in young and middle-aged women. Overall, we found that the economic fluctuations caused increased harmful effects in certain population subgroups but also brought some soothing effects to some groups.