Abstract MP37: Macroeconomic Growth is Associated with Increases in Cardiovascular Mortality in Countries with Lower Social Protection Spending

Abstract

Background: Macroeconomic growth has been shown to be associated with increases in cardiovascular (CVD) mortality. However, it is unclear whether concurrent social protection policies may mitigate the observed associations. Objective: To study if social protection expenditure modifies the association between macroeconomic growth and cardiovascular mortality. Methods: We included 21 OECD countries from 1980 to 2010 with available data in the Comparative Welfare States Data Set and the WHO Mortality Database. Gross Domestic Product (GDP) was used as a proxy for economic growth. Age-adjusted cardiovascular mortality rates were calculated. Countries were divided into tertiles of average Social Protection expenditure. We used fixed-effect models to study the association of GDP growth with CVD mortality stratified by tertile of social protection expenditure. We included four lagged GDP terms to account for the cyclical nature of GDP. A second fixed-effects model was fitted with time-varying linear and quadratic social protection expenditure and its interaction with GDP. Results: Overall, a 1% increase in GDP was associated with an increase in CVD mortality of 0.5% (95% CI: 0.21-0.83%, p=0.001). In countries with high and medium social protection expenditure, GDP increases were not associated with changes in CVD mortality (p=0.80 and p=0.52 respectively). In countries with the lowest social protection expenditure, a 1% GDP increase was associated with a significant increase in CVD mortality of 0.7% (95% CI: 0.04-1.32% p=0.03). These results were consistent in analysis using time-varying social protection expenditure (Figure). Conclusion: Our results highlight the need for social protection policies to accompany economic growth to mitigate its potential deleterious effects on cardiovascular diseases. Further research should study specific policies that mitigate the harmful effects of macroeconomic growth.