Abstract
Is long-term economic stress from occupational decline linked to poor health or death? Using Swedish administrative data matched with US occupational trends, I examine this in reduced form and using instrumental variables. Workers who in 1985 worked in occupations that subsequently declined unexpectedly were more likely to die early than similar workers in non-declining occupations, with effect sizes of 6–19 percent of mean mortality. Cardiovascular deaths rose among men, while women faced higher mortality from alcohol, drugs, and suicide. Hospitalization days rose, as did prescription drug use for mental health problems. Effects were strongest for the lowest-paid.