Population Health Concerns During the United States' Great Recession

Background: Associations between economic conditions and health are usually derived from costintensive surveys that are intermittently collected with nonspecific measures (i.e., self-rated health). Purpose: This study identified how precise health concerns changed during the U.S. Great Recession analyzing Google search queries to identify the concern by the query content and their prevalence by the query volume. Methods: Excess health concerns were estimated during the Great Recession (December 2008 through 2011) by comparing the cumulative difference between observed and expected (based on linear projections from pre-existing trends) query volume for hundreds of individual terms. As performed in 2013, the 100 queries with the greatest excess were ranked and then clustered into themes based on query content. Results: The specific queries with the greatest relative excess were stomach ulcer symptoms and headache symptoms, respectively, 228% (95% CI 35, 363) and 193% (95% CI 60, 275) greater than expected. Queries typically involved symptomology (i.e., gas symptoms) and diagnostics (i. e., heart monitor) naturally coalescing into themes. Among top themes, headache queries were 41% (95% CI 3, 148); hernia 37% (95% CI 16, 142); chest pain 35% (95% CI 6, 313); and arrhythmia 32% (95% CI 3, 149) greater than expected. Pain was common with back, gastric, joint, and tooth foci, with the latter 19% (95% CI 4, 46) higher. Among just the top 100, there were roughly 205 million excess health concern queries during the Great Recession. Conclusions: Google queries indicate that the Great Recession coincided with substantial increases in health concerns, hinting at how population health specifically changed during that time.