929 J Epidemiol Community Health: first published as 10.1136/jech.57.12.935 on 2 December 2003. Downloaded from GLOSSARY Economics, demography, and epidemiology: an interdisciplinary glossary J A Tapia Granados ............................................................................................................................... J Epidemiol Community Health 2003;57:929–935 This glossary focuses on the ‘‘borderland’’ between theory or the causation of mental illness by the influence of the moon. Demography, which demography, economic history, economic theory, and originally arose from a Malthusian background epidemiology with strong emphasis on theories and mathema- ........................................................................... tical models, often taken from economics, has recently developed into a largely empirical discipline, where checking the data can quite straightforwardly solve discrepancies. In eco- nomics however the situation is quite different, because not only the approaches but also the When different fields of inquiry have been answers to basic problems depend on the separately cultivated for a while, the border- theoretical orientation. For this reason this land between them often provide fertile glossary also includes entries referring to the ground for new investigations. major currents of economic thought—neoclassi- Allyn A Young, 1924 cal, Keynesian, Marxian, and ecological. Of course, even that these and not others are the t is a basic tenet of epidemiology that the main currents of economic thought would itself conditions in which people live and work are be matter of dispute among economists. In Iimportant predictors of health outcomes, entries corresponding to economic concepts including the incidence and timing of specific references are general and specialised works are disorders, injuries, disabilities, and death. Today not cited. copyright. epidemiology, demography, and economics are Terms appearing in SMALL CAPITALS are defined distinct fields with few overlapping areas, but in other entries of the glossary. the three disciplines once had common roots—in political arithmetic, political economy and such ACYCLICAL EFFECTS authors as William Petty, John Graunt, Thomas See BUSINESS CYCLE Malthus, and Frederick Engels. From its begin- nings in the works of Johann Peter Frank, Louis BOSERUPIAN PARADIGM Villerme´, and Rudolph Virchow, the interactions According to the agricultural economist Esther of living and working conditions with health, Boserup, historically, high population density disease, and mortality issues were a primary often led to the adoption of technical innovations concern in the field of public health. During the and subsequent higher productivity in agricul- 20th century epidemiological research has pri- ture.1 In economic history or agricultural eco- http://jech.bmj.com/ marily focused on particular effects of the nomics the term Boserupian is applied to effects or natural, social, and economic context (nutrition, processes referring to a rise in productivity due to income, education, social class, occupational technical progress stimulated by population exposures and behaviours, atmospheric pollu- increase. McKeown2 criticised the Boserupian tants, etc) on health, risk of disease, and paradigm because the role it attributes to mortality. Today there is a growing recognition population induced technological change in the of the importance of macroeconomic influences determination of food availability leaves popula- on health. tion size itself as an undetermined variable, so on September 29, 2021 by guest. Protected The focus of this glossary is the ‘‘borderland’’ that the change in population density is suppo- between the fields of demography, economic sedly attributable to fortuitous causes such as history, economic theory, and epidemiology. The infectious diseases. terms defined are drawn from publications that focus on the influence of the economy as a whole BRENNER’S HYPOTHESIS ....................... on health and mortality—or vice versa. However, Since the 1970s, Harvey Brenner3–5 has main- Correspondence to: despite their significance for epidemiology and tained that recessions have an impact on J A Tapia Granados, The health policy, many economic terms like ‘‘GDP’’, population health, increasing both mortality University of Michigan, ‘‘economic growth’’, or ‘‘sustainable develop- (general mortality, cause specific mortality attri- Institute of Labor and ment’’ are not included because they are beyond Industrial Relations and butable to cardiovascular disease, infant mortal- School of Social Work, the scope of this glossary. ity, etc) and morbidity (as measured for instance 1111 East Catherine Though epidemiologists often diverge on theo- by the incidence of alcoholism, hospitalisations Street, Ann Arbor, retical approaches and methodological nuances, in mental institutions, etc). A number of Michigan 48109-2054, there are few or no disagreements about basic authors6–10 have criticised Brenner’s contribu- USA; [email protected] epidemiological facts, methods and theories. No tions. Critiques have included the limitations of ....................... epidemiologist today defends the miasmatic analysis based on time series of only a few www.jech.com 930 Tapia Granados J Epidemiol Community Health: first published as 10.1136/jech.57.12.935 on 2 December 2003. Downloaded from decades—with very low statistical power—the controversial BUSINESS FLUCTUATIONS methods to detrend the series, and the contentious use of See BUSINESS CYCLES lags. Indeed, Brenner has never been very clear in stating the relation between the BUSINESS CYCLE and mortality. He referred COHORT SIZE HYPOTHESIS to rising unemployment as leading to an increase in See EASTERLIN HYPOTHESIS mortality, but he also mentioned ‘‘peak lags between unemployment and mortality rates[that] are two to three COUNTERCYCLICAL EFFECTS OR VARIABLES years in many industrialized countries’’ and also ‘‘adverse effects of rapid economic growth on mortality.’’4 As ‘‘on See BUSINESS CYCLES average, economic cycles tend to be 4–5 years in length’’ and as there is a ‘‘classic 2- to 3-year lag in mortality after the DEMOGRAPHIC TRANSITION peak in the unemployment rate (...) the zero-lag relationship This term refers to the transformation of a society from high between unemployment and mortality rates is actually levels of fertility and mortality to low levels of both. The term inverse’’.5 This means, briefly, that mortality increases when usually implies that the drop in mortality occurs before the unemployment decreases—that is, that mortality is drop in fertility so that the transition includes a period of PROCYCLICAL, which Brenner has never explicitly accepted. rapid population growth. The terms fertility transition and Indeed he has also asserted that economic recession ‘‘as mortality transition refer respectively to the fertility and 16 17 measured by the unemployment rate, and/or by the business mortality components of the demographic transition. failure rate (...) is positively related to mortality over 0–10 In the original conceptualisation the demographic transi- and 1–7 years, respectively’’.5 It is not clear what is the tion was considered to be a consequence of the transforma- tion of society from a traditional to a modernised state appropriate lag length to be considered and how a fixed-lag 16 effect of unemployment overlapped on a non-periodical through economic growth and industrialisation. Modern authors however tend to consider the causes of economic business cycle of roughly four to five years would consistently 18 19 produce mortality peaks coinciding with economic booms, growth as distinct from those of mortality reduction, with and mortality troughs coinciding with recessions. women’s education and improvement of status playing an important part in the fall of fertility. The term epidemiological Though Brenner’s model of the relation between business transition usually applies to the qualitative change in major cycles and mortality has been widely criticised, it has been causes of death associated with the demographic transition, around for the past 30 years and it is still cited, usually as with a large reduction in infectious diseases or ‘‘diseases of evidence to support the need for expansionary economic poverty’’, which are replaced as major causes of death by policies. (See also BUSINESS CYCLES, EYER’S STRESS MODEL, and non-communicable diseases or ‘‘diseases of affluence’’.2 UNEMPLOYMENT.) DEMOGRAPHIC TRAP copyright. BUSINESS CYCLES See POPULATION GROWTH Since the early industrial revolution it has been observed that market economies show a succession of periods of upturn DEMOGRAPHY and downturn of business activity that have been called business cycles (industrial cycles and trade cycles are synonymous See POPULATION GROWTH terms). The phase of increasing or accelerating economic activity of these ‘‘cycles’’ has been called ‘‘boom’’, ‘‘expan- EASTERLIN HYPOTHESIS sion’’ or ‘‘prosperity’’, while the phase of decreasing, Other things being equal, the size of a birth cohort tends to contracting or slowing business has usually been referred to have a negative effect on the social and economic fortunes of as ‘‘slump’’, ‘‘downturn’’ or ‘‘recession’’ when mild in the members of that cohort. According to this demographic intensity, ‘‘economic crisis’’ or ‘‘depression’’ if the decelera- hypothesis, also known as the ‘‘cohort size hypothesis’’— 20 11–13 stated by Richard Easterlin in 1980, — a rise