In the last couple of decades, there has been a lot of interest on the impact of macroeconomic fluctuations on health and mortality rates. Many studies, for different countries, find that mortality is procyclical. However, studies examining the effects of more recent recessions are less conclusive, finding mortality to be less procyclical, or even countercyclical. In this paper, using data of Spanish provinces from 1999 to 2016, we investigate how this relationship works in the context of a country that is subject to extreme business cycle fluctuations. Furthermore, we analyze the impact of unemployment for different mortality causes and we explore differences by sex, age group and level of education. In general terms, we find mortality to be procyclical so that when the economy is in a recession, mortality falls. When exploring mortality causes, we show that deaths from cardiovascular disease, cancer, senility, transport accidents and homicides are procyclical. By sex, we find procyclicality for both men and women. By age, mortality is procyclical for all age groups; however, the causes of death that result in this procyclical behavior are specific to each age group. By educational level, suicide appears as a countercyclical cause for individuals with intermediate levels of education.

在过去的几十年里，宏观经济波动对健康和死亡率的影响引起了很多兴趣。许多针对不同国家的研究发现，死亡率是顺周期性的。然而，对近期经济衰退影响的研究并不具有结论性，发现死亡率的顺周期性甚至反周期性较低。在本文中，我们使用西班牙各省 1999 年至 2016 年的数据，研究了这种关系在一个受到极端商业周期波动影响的国家的背景下是如何运作的。此外，我们分析了失业对不同死亡原因的影响，并探讨了性别、年龄组和教育水平的差异。一般而言，我们发现死亡率是顺周期性的，因此当经济处于衰退时，死亡率会下降。在探索死亡原因时，我们表明，心血管疾病、癌症、衰老、交通意外和凶杀导致的死亡是顺周期性的。通过性别，我们发现男性和女性都具有顺周期性。按年龄划分，所有年龄组的死亡率都呈顺周期性；然而，导致这种顺周期行为的死亡原因因每个年龄组而异。从教育水平来看，自杀似乎是中等教育水平的个人的反周期原因。