ABSTRACT

The main purpose of this study was to assess the effects of economic recession period (years 2008–2010) compared to pre-recession (years 2005–2007) and post-recession (years 2011–2013) in Michigan, with respect to the following outcomes: poor general health, poor mental health, heavy drinking and binge drinking, adjusting for unemployment. We used a spatial regression model, taking into account the spatial dependence of the data at the Behavioral Risk Factor Surveillance System (BRFSS) regional grouping levels. In models adjusted for unemployment and taking into account the spatial variability, the results indicated that general and mental health continued to decline even after the recession. Heavy drinking increased post-recession compared to recession and also pre-recession, while binge drinking increased post-recession. Estimated spatial maps of the outcome showed a great variability and could help identify regions in need of resource allocation and policy implementation.

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