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Your Environment. Your Health.

Air pollution and procyclical mortality

Environmental Health Economic Analysis Annotated Bibliography


Research article Cost analysis (CA)
Heutel G and Ruhm CJ
Journal of the Association of Environmental and Resource Economists
Prior research shows that levels of air pollution fluctuate with the rise and fall of economic conditions, and this study is the first to investigate if these changes are associated with fluctuations in mortality rates. Investigators used a panel dataset to analyze the relationship between air pollutant levels (carbon monoxide, PM10, and ozone), county-level mortality rates (overall, age-, and cause-specific), and county-level unemployment rates between 1982 and 2009. They found a significant positive correlation between pollution concentrations and mortality rates after controlling for demographic variables and state-by-year fixed effects. Consistent with previous research, they also found a negative correlation between county unemployment and mortality rates after controlling for the appropriate variables. Addition of the three air pollutants to the statistical model attenuated the predicted unemployment rate effect by about 17 percent, consistent with a substantial role for air pollution. This attenuation is significant at the 10 percent level or better but is insubstantial in models that include linear time trends. Finally, carbon monoxide concentrations were estimated to be more important than PM10 or ozone concentrations. These results support the possibility that changes in pollution levels explain a portion of the observed procyclical variation in deaths.
Eight age groups: infants (0-1 year), children and young adults (1-19 years); young and middle-aged adults (20-44 years); older adults (45-54 years); elderly (55-64 years, 65-74 years, 75-84 years, and ≥ 85 years)

Health Outcomes

  • Mortality (cause- and age-specific mortality due to a variety of diseases/outcomes including respiratory diseases, cardiovascular diseases, acute myocardial infarction (heart attack), ischemic heart disease, cerebrovascular disease (stroke), cancer, accidents (total, vehicular, and nonvehicle), suicide, and homicide)

Environmental Agents

List of Environmental Agents:

  • Air pollutants (carbon monoxide (CO), particulate matter (PM10/coarse), ozone (O3))

Source of Environmental Agents: (Not available)

Economic Evaluation / Methods and Source


  • Cost analysis (CA)

Cost Measured:

  • Procyclical fluctuation in mortality rates
  • county-level overall, age-specific, and cause-specific mortality rates
  • county-level unemployment rates (as a proxy for macroeconomic conditions)

Potential Cost Measures: (Not available)

Benefits Measures: (Not available)

Potential Benefits: (Not available)


  • United States

Models Used: (Not available)

Methods Used:

  • The authors investigated how air pollutants fluctuate with macroeconomic conditions and whether these variations help to explain observed fluctuations in mortality rates between the years of 1982 and 2009. They — 1) combined county-level data on overall, cause-specific, and age-specific mortality with county-level measures of ambient concentrations for three types of air pollutants (carbon monoxide, PM10, and ozone) and unemployment rates and 2) analyzed the relationship between macroeconomic conditions, air pollution, and mortality rates using regression techniques and panel data methods to control for demographic and pollution variables as well as state-by-year fixed effects.

Sources Used:

  • Pollution levels from EPA's Air Quality System (AQS) database (; unemployment rates from the U.S. Department of Labor's Local Area Unemployment Statistics (LAUS) database (; mortality rates from the CDC's Compressed Mortality Files (CMF) (; population estimates from the Surveillance Epidemiology and End Results (SEER) program of the National Cancer Institute (; additional sources cited in publication

Economic Evaluation / Methods and Source


  • Heutel G and Ruhm CJ. 2016. Air pollution and procyclical mortality. Journal of the Association of Environmental and Resource Economists.
  • Pubmed
  • DOI: (Not available)

NIEHS Funding: (Not available)

Other Funding:

  • University of Virginia Bankard Fund
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